LINCOLN — The psychiatrist who diagnosed Erwin Charles Simants with mental illness in 1975 almost certainly saved the mass killer from the electric chair.
Now, after nearly four decades, the opinion of Dr. Jack Anderson has saved the public from Simants walking the streets.
Last week a judge relied on the doctor’s diagnosis to keep Simants in a state mental hospital, where he has been locked away for the 1975 fatal shootings of six members of the Henry and Marie Kellie family in Sutherland, Neb.
In so doing, Lincoln County Judge Donald Rowlands rejected the opinions of four other clinicians who recently said Simants exhibits no “signs or symptoms of active mental illness.” They agreed that Simants is a recovering alcoholic whose excessive drinking likely prompted a psychotic break on the night of the killings.
How can psychiatric experts paint such different pictures of the same patient?
The judge offered this explanation: “After 34 years at the Lincoln Regional Center, the defendant has clearly learned what answers to give during evaluations which will be favorable to his prognosis.”
Gov. Dave Heineman expressed a similar opinion last week, saying he was “very concerned” that killers, such as Simants, figure how to “game” institutions to gain their releases.
“You’ve got to realize, these individuals are skillful at playing the system,” the governor said.
Two forensic psychologists The World-Herald contacted flatly rejected the theory of Simants as manipulator, although they understand why such an explanation seems logical.
The psychologists said the possibility is remote that a truly mentally ill person could mask his disorder from multiple trained clinicians over a period of many years.
“It would be extremely unusual for someone to fake an appearance for so long,” said Mario Scalora, who is also a professor at the University of Nebraska-Lincoln. “To do that, one would have to be extremely gifted.”
In court, a younger Simants was described as a semi-literate middle-school dropout with below-average intelligence. Now 68, he works in a kitchen at the regional center.
Forensic psychologist Matthew Huss, a professor at Creighton University, said psychiatric evaluations involve observations of the patient’s behavior, not just question-and-answer sessions. He offered what he called more plausible reasons for why Simants’ diagnosis has changed over the years.
For starters, the outward symptoms and effects of mental illness can change in patients, just as they do with physical ailments. Generally speaking, however, most mental diseases are treated or controlled, not cured. Schizophrenia, the diagnosis originally given to Simants in 1975, is almost always a chronic medical condition that requires lifelong treatment.
Simants currently takes no anti-psychotic medications.
Huss, therefore, suggested the original schizophrenia diagnosis may have been incorrect.
The professor said that if Simants suffered an alcohol-induced psychotic break in 1975, the symptoms could have resembled those of schizophrenia.
“I think the doctor had a very difficult job to do at that time,” Huss said. “The (regional center) staff now has 30 or 40 years of behavior to go off of, and that makes it easier to make an accurate diagnosis.”
The judge’s 17-page order revealed details of Simants’ mental status that have long been shrouded in confidentiality. He referred to at least 20 different evaluations over the years, which gradually moved further away from mental diagnoses.
Dr. Anderson, who in 1975 worked in North Platte, was the first psychiatrist to interview Simants, shortly after the murders. Anderson saw Simants at least eight times between then and 2005.
Though Anderson said he saw improvement in Simants over the years, he never wavered on his diagnosis of schizophrenia.
Anderson testified about the diagnosis as a defense expert at Simants’ trials. Psychiatrists for the prosecution also took the stand, telling jurors they found Simants to be sane.
The first jury agreed with the prosecution and convicted Simants, who was sentenced to death row. On appeal, however, the Nebraska Supreme Court granted Simants a new trial. The second jury found him not guilty by reason of insanity in 1979.
Anderson said Simants was a loner who exhibited symptoms of schizophrenia: delusions, hallucinations and imaginary friends. Though the symptoms would subside in the center’s controlled environment, unexpected stress could force Simants to lose his grip on reality again.
The doctor also said Simants — who sexually assaulted his 57-year-old victim and her 10-year-old granddaughter after killing them — has pedophilia and necrophilia, which is a sexual attraction to the dead. Simants told the doctor that for at least six months before the shootings, he had experienced fantasies of killing and raping older women and young girls.
If Simants were released, he eventually would withdraw from others and abuse alcohol, and the delusions and dark fantasies would return, Anderson said. The risk of a violent relapse would be “very high,” he concluded.
Simants arrived at the regional center shortly after his second trial ended in late 1979. Under the law, he is entitled to annual reviews to gauge his mental health. State statute requires he be found both mentally ill and dangerous to remain at the center’s locked forensic unit.
Within two years, center clinicians had changed his diagnosis to drug and alcohol abuse, pedophilia and personality disorder.
By 1983, Simants told evaluators for the first time that he was intoxicated when he killed the family.
Interestingly, Dr. Ernest Matuschka, who analyzed the patient in 1987, said Simants had been in therapy long enough “to know what he has to say.”
By the end of his first decade at the center, doctors had ruled out personality disorder, pedophilia and necrophilia. Judge Rowlands noted those changes essentially came about between 1987 and 1989.
“I find it inconceivable that in a space of two years, the defendant was miraculously cured of his extreme mental illness,” Rowlands said.
By 2000, the reports stated Simants had no signs of active mental illness. In 2005, the Lincoln County attorney hired Anderson to conduct what would be his final analysis of Simants. Anderson, terminally ill with cancer, emphasized that Simants will remain mentally ill and dangerous for the rest of his life, according to the judge’s order.
Regional center doctors, however, continued to reach other conclusions.
By 2007, they recommended for the first time that Simants be considered a candidate for supervised release into the community. Judge Rowlands rejected the recommendation.
By 2011, his diagnosis was alcohol dependence in remission. Simants was recommended for placement in a home where 24-hour supervision would include wearing a GPS bracelet.
Nearly a month after a Sept. 24 hearing in Lincoln, Judge Rowlands issued his order. Though he said he respects the center’s employees and the work they do, he rejected their diagnosis. Instead, he said he finds Anderson’s opinion the most credible.
“This court is not inclined to gamble with the safety of the public,” the judge wrote.
Both Huss and Scalora, the forensic psychologists, emphasized they were not arguing that Simants should be released. As one doctor put it in a recent evaluation, if Simants started drinking again, “all bets are off.”
“It’s a very legitimate argument,” Huss said. “But that doesn’t go to his mental illness, it goes to his risk. That goes to his dangerousness.”
The role of psychiatric professionals in the process is to provide expert opinions, said Scalora, who has formerly consulted at the regional center. In the end, the court decides what weight to give those opinions.
“This isn’t (the regional center) being soft on risk,” Scalora said. “In general, I can assure you, the staff there are very conservative about these things.”