Angel Decarlo with her mother, Dr. Emily Decarlo (Photo courtesy of family.)
(1-22-19) Angel Decarlo was supposed to get help in her community for her mental illness.
Instead, she ended up dead.
It happened in December in Hopewell, Virginia, a community of about 22,000 residents south of Richmond. News coverage reported that the 31 year-old was fatally shot by a policeman after a robbery.
But a local mental health advocate familiar with Angel’s case and Angel’s mother, Dr. Emily Decarlo, are raising questions about the shooting.
They blame the state’s decision to return individuals who are sick back into their local communities to be made “competent” to stand trial rather than treating them in hospitals.
“I never thought in a million years Angel’s story would turn out like this,” Dr. Decarlo told me. “Angel was not a criminal and like so many others…she was a victim of perhaps an insensitive system that is more punitive in nature than reassuring and rehabilitating.”
According to The Progress-Index newspaper, officers were responding to a report about a robbery when they spotted Angel about a block away from the crime scene. She was reportedly running. They “ordered her to stop several times. At one point, police claimed, Decarlo turned and pointed a handgun at one of the officers, drawing the fire. She was shot once.”
Dr. Decarlo questions the police department’s account of the shooting and believes race might have been a factor. More on that later.
None of the news reports noted that Angel had an untreated serious mental illness – schizophrenia – and had been freed from a jail so she could be “restored to competency” in “the least restrictive” environment, even though she was clearly not stable.
Angel’s fateful journey began, her mother told me during an interview, after Angel was arrested for “failure to identify.” Stop and identify laws refer to a situation when a police officer asks for your name, date of birth, and identification even if there is no suspected or actual illegal activity taking place. Virginia has no such statute but some individual municipalities may have a version of stop and identify laws.
Dr. Decarlo said her daughter was held for two months in jail before she was freed to be “restored to competency” for later adjudication.
Virginia recently has begun shifting “competency restorations” from hospitals to communities:
If a criminal court finds that a defendant is incompetent to stand trial pursuant to Virginia Code section § 19.2-169.1, the court will order that the defendant receive treatment to restore their trial competence. The Code requires that the court first consider ordering restoration services on an outpatient basis unless the court specifically finds that the defendant requires inpatient hospital treatment. “Outpatient” and “community-based” are terms used interchangeably to describe restoration services that take place in a setting other than an inpatient hospital, including both the jail and larger community setting. With the addition of this language regarding the court’s consideration of the “least restrictive” setting for competency restoration, came the need for a system for the provision of restoration services in the community.
Community treatment is less disruptive and also much cheaper than restoration in a hospital.
But having your competency restored and actually getting treatment for your illness are not necessarily the same. Competency is a legal term and is defined by a suspect being able to understand basic legal concepts, such as understanding why you are being put on trial and being able to discern between a prosecutor, defense attorney, and judge. Of course, you can be delusional and still understand why you have been arrested and who the players are.
The District 19 Community Services Board was assigned to restore Angel’s competency so she could be tried. In Virginia, CSBs, as they are known, provide community based mental health care services. Here is what a local mental health official told me about Angel’s case:.
“The media depicted her as a criminal. It was completely disgraceful. The reason she was on the street is due to a new law that was passed in July that allows the court to order people to be restored to competency in the community. Angel had been arrested for failure to identify and was found to lack capacity while in jail for over two months. They ordered her to be restored and the powers that be felt it should be done in the community. As far as I can tell this process involves some unlicensed case managers from the CSB attempting to engage the person in treatment in the community. It is also my understanding that after 3 visits with this person, they can determine that the person needs inpatient restoration. The CSB saw Angel twice before she was shot down in cold blood by the police that knew her so well. To add to this complete failure of a system, she had an involuntary psychiatric admission during this restoration process.”
That last line is disturbing.
While Angel was in the process of being “restored to competency,” she was hospitalized under an emergency custody order. Clearly, Angel was not doing well in a community setting. Rather than keeping her in the hospital and restoring her to competency there (and hopefully treating her symptoms as well), she was returned to the community still clearly ill.
Because of HIPAA patient confidentiality restrictions, obtaining Angel’s actual medical records is nearly impossible. So too is getting additional information from the police.
The Progress Index quoted Hopewell’s interim police chief Greg Taylor stating: “Members of the Hopewell Police Department understand the significant impact this tragic event has had on the friends and family of Ms. Decarlo, the department personnel involved and our community. As such, we appreciate the public’s patience through the ongoing investigate and review process.” Taylor said the matter had been turned over to the Virginia State Police for investigation.
I’ve depended on Dr. Decarlo, a well-respected minister in Hopewell where she has lived most of her life, and a mental health worker speaking confidentially, for the information in this blog.
Dr. Decarlo told me that Angel was an outstanding and popular student. “Angel was so much more than she was portrayed to be by the police. She loved to sing and dance and has made several recordings in studios. She sung with a group called “3Times Blessed” at one point in her life. She also modeled.”
While in her early twenties, she was invited to New York for an audition with the television show, America’s Top Model. It was while Angel was in Manhattan that she apparently suffered her first psychotic break. She became homeless and roamed the streets for six weeks until her mother got her home.
Angel began self-medicating after she was befriended by a “predatory’ drug user,” her mother said, who “misused and abused her.”
In 2017, Angel lost consciousness in nearby Henrico County because of a drug overdose.
Questions of Race Raised
“When I called the paramedics, the police rushed in and the young Henrico cop, with no concern for a young black girl’s life, began to interrogate me and had a whole crew of other officers searching for evidence,” Dr. Decarlo said. “We were definitely treated differently by this officer. One of Angel’s close friends, who is white, took an overdose, was rushed to the hospital and never arrested, but this officer came to the hospital and, before my daughter was fully recovered, put handcuffs on her and arrested her.”
After that arrest, Dr. Decarlo said Angel spent at least forty days in-and-out of hospitals.
During a manic episode last year, Angel jumped into traffic from the car that her mother was driving. “She should have been taken to the hospital for evaluation but instead she was taken to jail and booked on ‘failure to identify to a police officer.” Dr. DeCarlo told officials that her daughter had a mental illness and needed to be hospitalized. “They released her on her own recognizance to be made competent,” her mother said. “I thought they were going to help her.”
Dr. Decarlo said she was shocked when she was informed that Angel had been fatally shot by the police.
“My daughter did not own a gun. I asked the Hopewell police to show me the gun but they told me the State Police were handling the investigation. I was told by an eyewitness that my daughter was shot in the back while running away from this white officer,” Dr. Decarlo said. “I hold the policeman who killed Angel responsible. I don’t believe that she had a gun in her hand when he shot her. This has been substantiated by eyewitness reports to me.”
Dr. DeCarlo said she is waiting for the results of the State Police investigation.
One of the questions that her daughter’s case raises for me is what criteria is being used in Virginia to decide when persons should be released for competency restoration in a community rather than a hospital setting.
What are those standards?
UPDATE:
Shortly after I posted this blog, I received an email from the Virginia Department of Behavioral Health and Development Services, which is responsible for restoration training. I was told that the training consists of one and a half days of schooling with participants receiving tools, materials and a manual to help guide their work. The training is the same for workers who do competency restoration in hospitals and in community settings. Some of the tools were developed with guidance by the Institute of Law, Psychiatry and Public Policy at the University of Virginia. The training is conducted almost every year to account for turn-over at the CSBs. Outpatient restoration has existed in the Virginia Code for many years, but recently has been expanded. The state reimburses the CSBs for providing this service. On average there are about 190 outpatient restorations cases per year in Virginia. There is no data that shows how many clients are hospitalized while they are receiving restoration services in their own community. The department also offers training to judges and attorneys about who would be appropriate candidates for outpatient restoration. Among the benefits of community restoration: less cost versus inpatient beds, benefits not being terminated/suspended, and clients can remain in their home communities. The sate has data that shows good outcomes: 75% of persons who are restored do not need to further hospitalization.
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