Judge strips mental patient who was subject of manhunt of right to live away from hospital

YAKIMA — A state judge ruled Friday that Phillip A. Paul, the criminally committed Eastern State Hospital patient whose escape during a September field trip to the Spokane County Interstate Fair outraged residents and led to changes in state policy, should be stripped of his right to live away from the hospital campus.

Paul, who has been diagnosed with paranoid schizophrenia, had been in and out of the hospital on court-approved conditional release several times since killing a 78-year-old Sunnyside, Wash., woman in 1987 during a psychotic episode.

His last conditional release ended in January 2009, when the managers of the Carlyle Care Center asked the state to remove Paul from the downtown Spokane halfway house. His behavior had become erratic and aggressive because he was not taking his medications.

Yakima County Superior Court Judge Michael Schwab formally revoked Paul's conditional release, citing the potential for Paul to become dangerous if he fails to take his medication. He did not rule out that Paul could one day be released again, however.

Paul doesn't acknowledge he suffers from mental illness and has long resisted some of the efforts of his psychiatrists.

He is openly critical of the mental health system and craves freedom, according to the lawyer who represented him Friday.

The Judge also found Paul to be in danger of "elopement," legal parlance for an escape risk.

Since he won't likely take his medications and could become dangerous and flee, the judge ruled in favor of the state.

While the doctors offered some differing opinions on Paul, they all agreed that he has a "lack of insight" about his paranoid schizophrenia — a necessary step to accept and control his mental illness.

In the past several months, for instance, Paul has insisted that he suffered from drug-induced psychosis from taking PCP earlier in his life.

Dr. J.R. Henry, director of forensics at Eastern State, testified that Paul believes in the possibility of magical events and that he can be treated by taking alternative remedies such as fish oil and herbal vitamins — rather than the powerful pharmaceuticals prescribed by his doctors.

Another psychiatrist also testified about some of Paul's unusual behaviors.

Eastern State psychiatrist Dr. Dodds Simangan, who sees Paul regularly, said he has been storing and drinking his urine during the past year and continues to do so as "part of his urine therapy."

Dr. Imelda Borromeo, another hospital psychiatrist who visits with Paul on a monthly basis and testified that she has altered his medication regimen with good results during the past several months, said Paul told her that drinking his urine "calms his nerves."

There's no harm in drinking fresh urine, she testified under cross-examination by Paul's attorney, Daniel Fessler, and explained that the practice is known as an alternative folk remedy to keep healthy. She said the practice is not a symptom of mental illness.

In his plea for some kind of possibility that he might again by a candidate for at least conditional release, Paul said in the hearing Friday that he knew his victim for many years and believes she would want what's best for him.

"The woman I killed wouldn't want me to rot away like this," he said.

But Ann Mottley-Whitney, the daughter of Ruth Mottley, Paul's victim, said her mother did not know Paul well and she wants him locked away for safety.

Paul strangled Ruth Mottley in 1987, poured gasoline over her body and hid it after voices in his head told them she was a witch, according to court records.

During the massive statewide manhunt for Paul last September, Mottley-Whitney said she feared for elderly people Paul might find. She has shied from media coverage but has attended all of Paul's court hearings for two decades.

Fessler, the attorney for Paul, argued that had Paul been convicted of first-degree murder in Mottley's death, he likely would likely have been released from prison by now. But his commitment to Eastern State Hospital upon his verdict of not guilty by reason of mental illness has ensnared him in the state's Byzantine mental health system, Fessler said.

State psychiatrists, policymakers, and the courts all have a role in what degree of freedom Paul can enjoy.

The privileges he earned through treatment allowed him to return to Yakima County for extended periods just years after he killed Mottley. When Yakima officials asked to have him removed, Paul was eventually allowed to live in the Carlyle.

With that option erased, even if Paul qualified for conditional release the state has few options for housing.

The judge told Paul that his decision to revoke his conditional release should not be interpreted as hopelessness.

Judge Schwab reiterated that the state has an obligation to protect the public, but also to protect and serve mental health patients.

Paul's high-profile escape and capture last September brought the spotlight to the state's therapeutic practices of allowing patients to go on field trips.

Many changes have followed, including the resignation of Eastern State's top administrator, said John Wiley, spokesman for the Department of Social and Health Services.

Staff training has been revamped and new policies and procedures are in place to tighten security if the therapy practice of field trips resumes.

When the field trips resume, new rules on who goes and the ratio of patients to staff have been implemented.