YOUNGSTOWN — Though not every defendant in a major murder case in recent years has raised the issue of their competency to stand trial, many have.

In most cases in which a competency evaluation is requested, the judge grants one to determine whether the accused person is capable of understanding the nature of the proceedings against him or her and is able to assist in his or her defense.

The public’s reaction to defendants asking for a competency evaluation can frequently be skepticism, an assumption that the defendant is hoping to avoid punishment for a heinous act by blaming it on his or her mental health.

The family of Gena Wade, 44, who was murdered in her home near Beloit in October of 2023, was frustrated in May of 2024 after the man accused in Wade’s death, Nicholas Cunningham, now 33, was sent to a state mental hospital in Massillon to be treated for mental illness with the goal of restoring him to competency to stand trial.

He was restored to competency, but more recently his attorney asked for another evaluation, saying Cunningham’s mental health seemed to have declined again. Two evaluations were ordered and will be paid for by the State — one for the defense and one for the State.

Wade’s sister, Michelle Hively, said in May 2024 she thought Cunningham was escaping punishment for heinous behavior for a second time with his competency claims in Gena Wade’s murder, saying she thinks Cunningham escaped the punishment he deserved in 2015 for sex offenses because of his mental health issues.

Other people, including Mahoning County Prosecutor Lynn Maro, have argued that there are problems with the mental health system, and another type of mental health facility needs to be created in the Youngstown area “where courts can send individuals with needs. They don’t belong in our county jail. They don’t belong in our state prisons,” she said this September.

Her remarks followed news that a man from Austintown stole the gun of a hospital policeman at St. Elizabeth Youngstown and killed himself with it. He had also gone to a hospital in Warren the day before for mental health issues and was discharged with a prescription, his sister told The Vindicator.

Her brother “thought he was on a mission from God. He thought he was God,” she said of her brother’s mental state at the time he went to the two hospitals seeking help.

INSANITY DEFENSE

In recent years, only one defendant appears to have been committed to a state mental hospital for longer than a year with a finding of not guilty by reason of insanity.

Mahoning County Common Pleas Court Judge Anthony D’Apolito found Jillian Russell, 42, not guilty by reason of insanity in May of 2024, in the April 12, 2020, killing of Marcus D. Turnage, 38, of Kent at Russell’s home on Lakewood Avenue on the South Side.

D’Apolito held another hearing in June and ordered her continued commitment for the next two years until her next mandated court hearing.

Lawyers for several other Mahoning County murder defendants have argued that their client deserved a lesser punishment for their crimes because of the mental illness that was shown during mental health evaluations for competency to stand trial and not guilty by reason of insanity.

One such defendant was JaBrae Perry, now 48, who Mahoning County Common Pleas Court Judge John Durkin ruled in June 2024 was no longer eligible for the death penalty because Perry was diagnosed with schizoaffective disorder and qualified under the requirements of Ohio’s 2021 Serious Mental Illness statute.

In December 2024, Durkin sentenced Perry to 23 years to life in prison for killing his girlfriend, Ayanna Mills, 49, and her son, Brandon Bell, 28, at Mills’ home on Salt Springs Road in Youngstown Aug. 24, 2021. In June of 2022, Durkin read from a report stating that Perry knew the wrongfulness of his actions and was not a candidate for a not-guilty-by-reason of insanity.

Numerous defendants have been evaluated for insanity and competency in Mahoning County in recent years and argued at sentencing that their severe mental illness — as shown in the reports of their evaluations — was a factor in their criminal conduct.

NATIONAL TREND

A 2023 research paper by Murrie, Gowensmith, Kois and Packer states that the demand for mental health experts to conduct evaluations on defendants in criminal cases for competency to stand trial and sanity has increased to a point of being called by some a national “Competency Crisis.”

The study used Colorado as an example, stating that “From 2009 to 2021, the number of Colorado incompetent-to-stand-trial adjudications increased more than tenfold — from 200 to 2400,” according to one study.

The proportion, not just the overall number — of criminal defendants found to be incompetent to stand trial increased 27.5 percent in studies published from 1960 to 2009, the study reported.

The study stated that state psychiatric hospitals have always been the primary setting for people found not competent to stand trial to be “restored” to competency through treatment. In the 1950s, there were more than 500,000 inpatient state hospital beds available across the United States.

“However, inpatient capacity began to decrease dramatically over a few decades, corresponding with the movement to de-institutionalize persons with mental illness in favor of community-based treatment,” the study noted.

“As one review summarized, U.S. psychiatric hospital capacity peaked at a rate of 337 beds per 100,000 persons in 1955, but dropped to 11.7 per 100,000 by early 2016,” the study states. But at the same time, “orders for competence restoration service grew and have continued to increase dramatically.”

AREA EXPERT

Over the years, Vince Arduin with the Forensic Psychiatric Center of Northeast Ohio has become a recognizable expert on competence to stand trial and not guilty by reason of insanity.

The nonprofit Forensic Psychiatric Center is routinely asked to perform such evaluations in Mahoning, Trumbull, Columbiana and other counties, though other organizations and companies also conduct them.

Arduin worked as forensic monitor for the Forensic Psychiatric Center for many years, meaning that he monitored the courts and the mental health recovery boards for individuals found not guilty by reason of insanity or incompetent to stand trial and was available to judges and attorneys to discuss the mental health conditions of people charged with serious offenses. He is now executive director of the organization, and Jayme Cruz now works as forensic monitor.

When Arduin was asked about the national increase in competency cases, he said Ohio is experiencing the same trend.

“If you look at the state hospital bed population (in Ohio), over the last two decades, it has shifted tremendously to forensic based patients,” Arduin said. Forensic cases are ones in which a person is sent to a state psychiatric hospital for restoration to competency to stand trial or when a person is committed to such a facility because they were deemed not guilty by reason of insanity at the time of the offense, he said.

In the past year, 92 percent of the psychiatric hospital beds in Ohio were filled with forensic-based patients, “which is a tremendous difference from, say two to three decades ago,” he said.

In earlier decades the proportion of people in psychiatric hospital beds would have been more evenly split between people with criminal charges and those committed to a psychiatric hospital because they are a danger to themselves, he said.

Ohio officials are addressing the growing number of people needing mental health treatment for competency “because it has caused a real problem — with wait lists, with people who are in emergency psychiatric conditions that need to be in that kind of facility and there is not a bed available,” Arduin said.

One way the state is addressing it is getting people with serious mental illness into structured treatment programs to help them avoid the criminal conduct that they sometimes engage in, he said.

“Sometimes we see a list of people who are well known to everyone running through the courts, running through the treatment agencies, winding up maybe on the street again. It’s not just Mahoning County. This is across the state,” he noted.

Arduin said the most common place for individuals to be evaluated for competency to stand trial or sanity is in the county jail. The Forensic Psychiatric Center started during the pandemic conducting those evaluations remotely at the Forensic Psychiatric Center with the inmate participating over a video hookup from the jail.

That has been “a big help” in handling the increasing number of cases “because we can get these done in a more timely way” than going physically to the jail, he said.

In some states — and Ohio has pilot programs to do this also — agencies are trying to carry out competency restoration in the jails. “There is a pilot program in Hamilton County that has been well received, and the state is looking at expanding that,” he said.

Another response in Ohio has been to hire forensic navigators, who stay in contact with inmates on the wait list for a competency evaluation and monitor how the inmate is doing, Arduin said.

Another method of managing the case load in Ohio is outpatient competency restoration done in the local community for those deemed not competent to stand trial. Arduin said that has been a “fairly modest program” in the Youngstown area. Some larger cities in Ohio have used outpatient competency restoration to send fewer people to Ohio’s six regional psychiatric hospitals.