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2016-03-24

Hay competent to stand trial – Part 5

By Judith Pannebaker BCC Editor

In February, a three-day trial was held in the 198th District Court to determine if Nathan Frederick Hay were competent to stand trial on felony child abuse and drug charges.
As his final witness, Assistant District Attorney Stephen Harpold called forensic psychologist Dr. Raleigh Wood to the stand.
As part of his testimony, Wood noted, “Mr. Hay appeared to have presented himself in overly pathological light. These clients tend to overplay their hands across the boards – more than you would see in (instances of) major mental illness.”
It appeared the jury agreed with Wood’s assessment. In just 15 minutes, they found Hay competent to stand trial.
‘Feigning &
malingering’
After an examination during a two-day period, Wood, a member of South Texas Forensic Psychology, PLLC, determined the defendant to be “feigning mental illness and malingering.”
According to Wood, during a forensic assessment, clinicians must remain skeptical and not take admissions by clients at face value. “I first examined Mr. Hay on Oct. 24, 2015, and a flag went up when he announced he had a mental illness,” Wood said.
During the evaluation, Wood said Hay appeared anxious, but had no problem communicating and exhibited no psychoses. “Mr. Hay also provided adequate responses to questions about the legal process,” Wood said.
Wood administered the Personality Assessment Inventory (PAI) to Hay, which gives information about possible mental illness. The test also includes validity scales as well as clinical scales.
“Having a mental illness doesn’t necessarily render one incompetent,” Wood said. “I look for symptoms of mental illness that impact an ability to work with an attorney.”
Instead, according to Wood, he found in Hay a validity scale that indicated a high degree of pathology, which would invalidate the clinical scales.
‘Overly
pathological light’
“Mr. Hay appeared to have presented himself in overly pathological light,” Wood said. “What occurs is that these clients tend to overplay their hands across the boards – more than you would see in major mental illness.”
However, according to Wood since a diagnosis of feigning is prejudicial, clinicians must rely on more than a single piece of data or test before rendering a diagnosis.
To check results of the PAI and to test for response consistency, Wood used collateral information and administered Structured Interview of Reported Symptoms (SIRS) and IQ tests.
“Mr. Hay’s IQ was in the normal range and the SIRS manual indicated there was a 100 percent probability he was feigning,” Wood said. “When feigning mental illness, people often overplay their hand. It’s difficult for them to feign consistently on a continual basis, such as in phone conversations. This type of behavior has to be consistent and it wasn’t.”
Dx impression
Wood's diagnostic impression was that Hay had an amphetamine-use disorder, long-standing pattern of maladjustment, a personality disorder and malingering.
Regarding Hay’s capacity to understand the charges, in a question and answer session Hay said he faced 25 to 99 years due to “drugs and sex” charges. The defendant also, according to Wood, exhibited “good knowledge” of courtroom procedures. Additionally, during one interview, Hay allegedly told Wood, “Tony says we’re not stable enough to go to court.”
In conclusion, Wood said, “Mr. Hay may not want to assist (with his defense), but that is their decision. It is a choice.”
‘Rare as hen’s teeth’
During his cross examination, Hay’s defense attorney Anton “Tony” Hackebeil questioned Wood about a previous diagnosis of Dissociative Identity Disorder (DID), which was previously known as Multiple Personality Disorder and Split Personality.
According to the website medicinenet.com, diagnosis of DID is often difficult and people who may benefit either emotionally or legally from having DID sometimes pretend to have it such as those accused of molesting children.
“Do you recall discussions about DID?” Hackebeil asked.
“As one of my former professors once commented, ‘It’s as rare as hen’s teeth’,” Wood replied. “DID is a rare and controversial diagnosis. I try to have an open mind, but there is a lot of controversy in a DID diagnosis in a forensic setting.”
Wood however admitted that the mental disorder is contained in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Published by the American Psychiatric Association, the DSM lists definitions, diagnoses and explanations of a host of mental disorders.
According to Wood, DID can arise as a result of childhood trauma in which a patient deals with the trauma by compartmentalizing. Wood described himself as qualified to diagnose DID in a clinical setting.
Contrived
presentation
“Mr. Hay talked openly about alternate personalities, but his presentation in that area appeared contrived,” Wood said. “He self-reported trauma and abuse as a child, but there were no substantiating hospital reports.”
Hackebeil asked, “Would a structured clinical setting be better to reach a conclusion about Nathan’s mental health?”
Wood indicated that confinement in a hospital setting could possibly lay the groundwork for an eventual verdict of not guilty by reason of insanity on the felony charges.
To a query from Hackebeil regarding Hay’s ability to consult with his attorney and prepare a defense, Wood responded, “I have no direct knowledge of your interaction with Mr. Hay.”
Additionally, Wood noted that in the 2,500 to 3,000 evaluations of competency he’s conducted during his 25 years of practice, he’s found only 16 to 25 percent to have been incompetent – and not all the patients presented with the same symptoms and behaviors.
“Most individuals had significant degrees of pathology which affected their ability to communicate,” he said, adding, “In 25 years of practice, I have seen only one patient who experienced symptoms of DID.”

(Editor’s note: In the Thursday, March 31, edition, the Bandera County Courier will report on closing arguments.)