By Charmayne Schmitz
Day six of the Daniel Marsh trial began with the testimony of the school counselor, Monica O’Brien. She first saw Daniel on January 16, 2013, for 50 minutes. The purpose of the first session was to build rapport. Daniel appeared depressed and did not make eye contact. When asked about family and friends, Daniel said he didn’t like his family. He hadn’t seen his father for some time and his mother did not give him support. He spoke of having a few friends and a girlfriend.
Daniel had no plans for the future. He had daily suicidal thoughts and his brain had stopped producing serotonin. He told Ms. O’Brien he had tried several antidepressants. None of them had worked. His mother was aware of his suicidal thoughts but he felt she didn’t care. Daniel also told the counselor about his homicidal thoughts regarding people at school, telling her he had been bullied and other students were egotistical. He had thoughts of torturing people, standing over them and telling them they are garbage until they believed it. Ms. O’Brien asked him if he had access to weapons. Daniel said yes, but not at home. She asked him if he had used drugs or alcohol. Daniel said he smoked marijuana daily but no longer had a drinking problem.
After the session, Ms. O’Brien informed the school therapist, Jordan Mulder, and called the Davis Police Department. This was not a breach of confidentiality because of the possibility of harming himself and the duty to warn potential victims. Ms. O’Brien wasn’t there when the officer arrived. Also, she did not have the authority to produce a 5150 (Welfare and Institutions section 5150) report, for an involuntary psychiatric hold, as it is a police responsibility.
Ms. O’Brien saw Daniel one other time, on January 29, 2013. At this session, the same topics were revisited. Daniel was upset about her break of confidentiality, but he showed up anyway. He denied plans to hurt anyone but later discussed details about how he could torture people. Daniel said he wouldn’t carry out any of these ideas because he wanted to be there for his friends and girlfriend. Daniel said he had had these feelings for many years. He used to fight them but had given up and was letting his mind take over. Daniel said he tried to tell a former counselor, but she looked scared so he stopped. Ms. O’Brien didn’t report this session because there was no intent or specifics given, only thoughts. She said Daniel seemed coherent and she wasn’t trained to assess if he were delusional.
The school counselor notified Daniel’s mother, who then notified Daniel’s therapist at Kaiser, Timothy Hesgard. The mother allowed Hesgard to discuss Daniel’s situation with Ms. O’Brien. The call between the counselor and the therapist took place on January 30, 2013.
On cross-examination by Deputy Public Defender Ron Johnson, Ms. O’Brien was asked if she had reviewed the notes of the previous counselor, to which she replied “not fully.” She knew Daniel was recently hospitalized but did not know exactly when. She later became aware of a “re-entry” meeting with Daniel’s case manager, teacher and psychologist, which occurred before his return to school. Ms. O’Brien did not see the notes and did not speak to the participants. She was a new employee and didn’t know about these meetings until a while later.
As Johnson continued to question Ms. O’Brien, she kept insisting that her only duties were to treat what affects the student’s education: truancy, difficulty with work production and coping skills. She was hired strictly to perform this function. Mr. Johnson asked if she saw his statements as reaching out and trying to test her. Why did she know his serotonin levels but didn’t pursue that avenue? Why didn’t she explore his homicidal thoughts, toward whom were they directed, where did he have access to weapons? The counselor said she wanted to build rapport and not question Daniel. Rapport building takes several sessions. She didn’t consider asking her colleagues for suggestions about building the relationship quicker. In the second session, she attempted to reach Daniel by suggesting he would soon have options, when he turned 18. Also, perhaps he could write music to cope. When asked why she wasn’t present when the police arrived, Ms. O’Brien said she wasn’t required to be there. Johnson asked, “You never do things outside of your duty?”
Officer Cardini testified next about responding to Ms. O’Brien’s call. He gets about 100 calls a year like this. Cardini spoke to Daniel but he doesn’t remember what was said and believes he mistakenly thought it was concerning an earlier incident.
A registered nurse from Sutter Davis Hospital, Patricia Prentice, testified that she was the psychiatric nurse who evaluated and admitted Daniel on December 12, 2012. Daniel told her when he woke up that day he was really angry. It was a different feeling from before. He had had problems since October of that year with truancy, studying and controlling his anger. He had stopped taking his medications. When his mother was asked, she said Daniel was adamant about not taking his medication. Daniel told Prentice of a volatile relationship with his mother, claimed he was abused by his father since he was a baby, and related the story about giving his father CPR. Recently his mother’s step-brother had died suddenly. Daniel told the nurse he tried three times to kill himself. Daniel appeared very sad and saw little future for himself.
Even though Daniel told Prentice that “if anybody gives him any s__, he will kill them” the nurse didn’t think it warranted notifying the police because it wasn’t specific and he had no weapons. Daniel was involuntarily admitted using a 5150, which allows a 72-hour hold. On cross-examination, the nurse admitted she didn’t know Daniel was already being treated at Kaiser for psychological issues. Daniel’s concern that day was uncontrollable anger.
Dr. David Walters, the Sutter Davis ER doctor who assisted in Daniel’s admittance on December 12, 2012, testified that he doesn’t remember Daniel. He didn’t find any organic brain dysfunctions that would cause hallucinations or delusions – that assessment was from his report. The doctor signed off on the transport authority but had no idea where Daniel was going to be sent.
The remainder of the day was spent on testimony by Dr. Lenore McKnight, a psychiatrist who treated Daniel when he was in an inpatient hospital eating disorder program. Daniel was at the Berkeley hospital from December 29, 2011 to January 25, 2012. The doctor does not remember Daniel by sight. Prosecutor Mike Cabral submitted a 700-page binder that detailed Daniel’s care at the hospital.
Daniel weighed 93 pounds when he was admitted, suffering from anorexia nervosa. It was considered a voluntary admission because Daniel’s parents gave permission. At the time, Daniel was taking Celexa, an anti-depressant. Dr. McKnight switched him to Lexapro because Celexa didn’t seem to be working. Later, she added Abilify, an anti-psychotic. The doctor noted that Daniel was suffering from major depressive disorder with many stressors in his life. Daniel was given psychological tests by another doctor at the hospital, Dr. Pollack. Daniel was found to have PTSD (post-traumatic stress disorder), but wouldn’t answer questions about what may be causing it. He was in denial about his eating disorder. Daniel had been starving himself, but not purging.
On cross-examination of Dr. McKnight, Mr. Johnson pointed out that he didn’t have access to the 700-page binder. His documents show a comment by Dr. Pollack that Daniel “seems to put ideas together in ways that violate reality,” and recommended further monitoring. Dr. McKnight said that is why she prescribed Abilify. Johnson again quoted Dr. Pollack: “Daniel frequently feels frightened even by his own thoughts.” Dr. McKnight responded that Daniel wouldn’t talk about it with her. Another part of Dr. Pollack’s document described nightmares, disturbed memories, and out-of-body experiences noted as feelings of de-realization. Dr. McKnight continued to say Daniel wouldn’t tell her about these feelings.
Daniel was discharged with recommendations for further out-patient care. Dr. McKnight didn’t follow up and has no knowledge of Daniel’s compliance with those recommendations.