Voices and Silence

It was no secret that Jason Molacek heard voices telling him to murder. Cops, counselors, his parents--they all knew. So why didn't anyone stop him before he shot his mom to death?

PERSON/MENTAL/WEAPONS/

THREATS: MOLACEK, JASON LEONARD. DOB 030384. MENTAL/EMOTIONAL PROBLEMS. THOUGHTS OF KILLING PARENTS AS THEY SLEEP. THREATENED TO KILL TEACHER. ACCESS TO FIREARMS. AUTH/030201/SGT. RUETER

--A permanent warning to law enforcement appearing at the top of the 911 dispatcher's log the day Jason Molacek called to report that he'd shot his mother.

On June 11, Jason Molacek got up at about 8:30, got dressed, had a cigarette, went outside, and smoked some pot. Around 9:30, he started watching a movie. He stopped after a little while, though, and went to his parents' bedroom, where he began gathering "money and stuff." Under their bed, he found a box containing a Ruger handgun. The 19-year-old used a grinder to break the lock on the gun, but he couldn't find any ammunition for it. So he took a crowbar to the gun cabinet in the basement and removed a hunting rifle. He loaded the Remington .30-06 and laid it across a chair.

Molacek got out a red Igloo cooler and filled it with "stuff I could drink, namely Mountain Dew and not any alcohol," according to the police reports in his case. Then he packed a nylon backpack with a small amount of marijuana and paraphernalia, several psychiatric medications, and a few possessions. He filled a beer stein with change he'd collected from around the house. The coins were a sore spot for Jason--his parents, concerned that he was buying pot, had stopped giving him much money.

The plan, he later told officers, was to kill his mother, take her van, and go cash in the change. Later he would return and wait around to kill his father, too. Then he would pack up the van and flee.

For years, voices had commanded Molacek to kill people. Usually it was his parents or himself, sometimes teachers and classmates. Seeking to quiet the voices, he had seen countless doctors and undergone numerous hospitalizations. Once, in utter desperation, he'd even called the police on himself. In the last few days, however, Molacek had achieved a kind of peace: He accepted that he was going to give in to the voices.

At about 2:00 Cheryl Molacek called and said she was on her way home to Maple Grove from her job as a technician at Boston Scientific Sci-Med. Jason smoked another cigarette and some more pot, and spent a while learning to fire the gun, which was not an easy matter for him. When his mother got home, he was in the hallway walking toward the kitchen, he would later tell police, holding the rifle and "shaking real bad." She asked what he was doing, he recalled, and "I just started losing it." He shot her once, and she fell next to the bags he'd packed.

He sat down in a chair a few feet away. "I couldn't get myself together, I was crying so bad," he told police. "I could barely speak. I was trying to say I was sorry." Cheryl Molacek rolled over and asked her son to call 911. He dialed and talked to the dispatcher for a moment, but then threw the phone down next to his mother, walked out to the deck, and cocked the gun. He was going to kill himself, "'cause I thought I just killed my mother."

Police arrived less than two minutes later and started searching the premises for him. Several officers took positions behind the house alongside some power lines. One asked 911 dispatchers to call Elm Creek Elementary and lock down the school, even though classes for the day were about to end. Officers also locked down a nearby Kinder Care. A state police helicopter was requested.

In a downstairs family room, Officer Richard Radintz found the broken gun cabinet. After finding the house empty, Radintz went outside. He saw a young man sitting on the deck holding a rifle between his legs, pointed at his chin. Radintz ordered the man to drop the gun, but he "just sat there with his head down," according to the police report.

"I was finally able to get him to say his name to me," Radnitz reported. "He then asked about his mother. I advised that she would be fine, and again told him to drop the gun. He told me that if he dropped the gun, it would go off. I then instructed him to raise his left arm above his head. As he did this, Detective Strauch came around the corner of the upstairs patio door and did grab the barrel of the rifle out of the right hand of the suspect." (Later Jason Molacek would explain to a psychiatrist why he hadn't gone through with killing himself: "I know my mother wouldn't have liked that.")

At Maple Grove police headquarters, Molacek was questioned by a detective and by Dan Hamann, an officer who had been at his house two years earlier. Police had gone to the Molacek house 19 times in the years preceding the shooting; the call Hamann answered was placed by Jason Molacek himself. He told Hamann then that he had urges to hurt his parents and that he stood over his mother with a pillow while she slept. Now Molacek and Hamann revisited that talk. Hamann pointed out that Molacek had never talked about using any of the guns kept in the house. It had never occurred to him, Molacek replied, until the week before.

Cheryl Molacek was taken to North Memorial Hospital with a hole in her side the size of a fist. She died two months later, at the age of 59. Court records suggest that in the interim, she was concerned about Jason Molacek's well-being.

 

"T here's a long history of effort by many people here. They appear to be good faith efforts to deal with these problems, but from the result it's hardly deniable that the system failed disastrously. If the information we have here is correct, and I see no reason to doubt it, we have a prototypical example of a probably preventable disaster permitted to happen by an unwillingness to spend the necessary money to prevent [it].

"I hope someone will call the attention to the governor, the other politicians who are in the process of curtailing resources available to law enforcement agencies, police departments, courts, probation officers, prosecutors, public defenders, and the agencies responsible for properly addressing mental illness and to the attention of the people, at least some of whom are the same, that propose using limited and diminishing public resources for such things as athletic stadiums, light rail lines, tax reductions, and other expenditures which, at least in my view, ought to be of a lower priority than preventing children from murdering their parents."

--Hennepin County District Court Judge Jack Nordby at Jason Molacek's first sentencing hearing

Jason Molacek grew up in a brown and tan ranch-style house on a quiet street in Maple Grove, the second son of two technicians in the medical devices industry. But Jason reportedly was never close to his brother, 15 years his elder. He was essentially the only child in a second family. Religion played a large role in the family's life. Cheryl and Richard Molacek were practicing Catholics when Jason was little; later, they joined an evangelical church. Court testimony, exhibits, police reports, and other official documents describe scenes of Jason praying frequently with his parents.

He didn't have a lot of friends, and after Cheryl Molacek's shooting neighbors would tell police that they didn't really know him, that he had only been living at home for a few weeks. At 6 foot 3 and 250 pounds, he must have been hard to miss, however.

The best physical description of Molacek comes from Dr. Carl Malmquist, the forensic psychiatrist who evaluated the youth at the request of his attorney. Molacek, Malmquist reported, wears glasses, has acne, and moves awkwardly. He speaks coherently, even though he seems ill at ease. "A remoteness is present with Jason which I do not think is consciously intended," Malmquist notes, "but rather the way he has learned to adapt over the past years of confusion that he has experienced."

According to the report, as a child Molacek saw himself as sensitive and "not emotionally strong." He felt ill-equipped to cope when kids were mean to him. Sometimes he'd say he was sick so that he could get sent to the school nurse's office. He was first treated for mental health problems at the age of six or seven.

As he grew older, he began spending summers with his aunt, who lived in a small town northwest of Detroit Lakes. He later remembered her as a "religious nut" who pushed her kids to study the Bible. When he was 13, he started smoking pot. That same summer, "he began to have experiences of hearing a voice telling him what he was reading."

One day in April 1999, Molacek, then 15, was in study hall when he began to dwell on the thought that one of his teachers had singled him out for criticism. "If I had a gun," he told her, "I'd blow your head off." He was sent to the school counselor; there he said he wanted to break into his father's gun cabinet and kill two of his teachers because they were "harassing him." He also planned to hang himself. The Columbine school shooting had occurred two months earlier, and authorities at Osseo High School reacted swiftly. Molacek was taken to Health East St. Joseph Hospital, where he admitted that he had been thinking about killing himself for several weeks.

After five days, he was discharged with a diagnosis of major depression and attention deficit disorder, given a prescription for Wellbutrin, an antidepressant, and told to follow up with Fairview University Medical Center. When he was seen a few days later for testing, a psychologist diagnosed him with dysthymia (garden-variety depression) and oppositional behavior, and expressed concern over his "avoidant personality traits" and potential for chemical abuse.

The hospital stay marked the start of a cycle of doctors, diagnoses, and treatments that would continue all through Molacek's high school years. According to Malmquist's report and other court documents, his serial encounters with the system resulted in a laundry list of varying diagnoses, and numerous changes in Molacek's medication regime. (Remarkably, unlike many teenagers with mental health problems, Molacek took his medication faithfully.) What's missing from the records is any discussion of a long-term plan for the young man's care.

This doesn't surprise Kevin Turnquist, a local psychiatrist who has written about the mental health system's many failures in dealing with troubled youths. "Anyone looking for instances where the mental health system has failed young people miserably doesn't have to look too far or too hard," says Turnquist. "Unfortunately, we offer these young adults the same hodgepodge of shifting diagnoses--with a pronounced tendency to eventually call them schizoaffective--that we offer everyone else. In fact, making an accurate diagnosis in young people is even more fraught with error than in other populations. Mental illnesses often have to be given time to declare themselves. Good long-term data are needed to make reliable diagnoses or provide a meaningful prognosis. Many of these kids just haven't been ill long enough to have that sort of track record to go on. And separating out behaviors, problems, and attitudes that are attributable to mental illness from those that commonly arise in anyone's teenage years can be difficult indeed.

"The kids and their parents are commonly angry with the system by the time they reach us," he adds. "Of course, concomitant substance abuse is the norm. And our folks feel that it's their duty to make the kids stop smoking pot or whatever, so conflicts get set up right away."

Indeed, three weeks after his initial hospitalization, Molacek was admitted to Fairview University Medical Center for a chemical dependency assessment stemming from his marijuana use. He was there for five days, and was discharged with a diagnosis of cannabis dependency and depressive disorder. In the following months, he was kept out of school, saw a social worker at Health Partners, and underwent further psychological testing. The following November, his doctor wrote to Osseo High School saying it was in Molacek's best interest to start back to class as soon as possible. However, she noted, "I must state that I cannot guarantee that Jason will not make further threats or engage in violence in the future."

In April 2000, Molacek was again admitted to Fairview University. For six days the voices in his head had been telling him to hurt or kill people. "He had a very specific and concrete plan about using a machete that his father had purchased to kill his father and mother," Malmquist reported. "[He] also considered calling his older brother over so that he could kill his brother and take the brother's van."

According to Malmquist, Molacek chopped through the door to his parents' bedroom with an axe and trashed it, looking for money so he could run away. "His mother came home late and found him curled up on the floor complaining of a lion in the house that was going to eat him and he was having difficulties with his perceptions," the report states. "He felt he was hearing someone tell him to kill his parents and get away.... When he ignored the voices, they got louder and when he finally gave in and agreed to kill his family, they went down a notch. When he used pot, the voices would go down a notch but the whispers would increase. And when he used PCP, he could not control the voices."

He was discharged with a diagnosis of bipolar affective disorder with cannabis and nicotine dependence, given three psychiatric medications, and sent to a day therapy program, where he was seen for three weeks.

In February 2001, Molacek was again admitted to Fairview University. This time, Malmquist reported, "Jason himself was calling the police with worries about his thoughts of hurting his parents. His history was that he could not get rid of the 'racing thoughts' in his mind of hurting his parents, and he was having images of picking up something sharp and stabbing his parents." He was stabilized and discharged, but then admitted again on March 7, and again on April 5. At the time of his last admission, when he was in the hospital for two weeks, he had been cutting his arms with a knife.

Meanwhile, he'd become the subject of delinquency proceedings in juvenile court. On March 30, he allegedly took his father's car. On April 2, Osseo High School reported he had stolen a bicycle. On June 23, he allegedly stole his mother's car. He had been reported as a runaway several times.

Together with his social worker and his parents, Molacek decided to try living at a group home. The experience, he told Malmquist, "was a disaster." The other kids there teased him. It reminded him of when he was little. "The result was that after three days, he took car keys which were on the counter for the car the group home had and proceeded to drive around in it for three days endlessly with no sleep and a sense of being speeded up. Since he had no money, he was getting gas by siphoning off gas from other cars. Once he drank too much of it, got sick, and was vomiting, and appeared back home."

His parents called the police. He was taken first to the Hennepin County Juvenile Detention Center, and then to St. Joseph's Children's Home. He left the home on a 15-minute pass to go to the store, passed a gas station, and saw a van being gassed up. He got in the van and drove off, feeling "speeded up" again. He tried to drive back to Maple Grove, but couldn't figure out how to get there. Ultimately, he was sent back to juvenile detention.

In September 2001, he was admitted to St. Cloud Children's Home on a court order. Six weeks later, he lost control of himself in the activity yard one day. He kicked open the gate to the fence surrounding the locked unit and climbed to the roof. Before he could be gotten down, Molacek broke numerous windows, cut his wrist with a piece of broken glass, and threatened to jump.

He was transferred to the hospital, and then back to juvenile detention. A couple of weeks later, he was placed at the Willmar Regional Treatment Center, where he stayed until January. At that point, he was sent to Bar None Residential Treatment Services, where he would stay for the next 13 months.

"The plans at Bar None as he understood them were for him to finish his school year there and graduate from high school in June," Malmquist reported. "He also stated there were other plans on the agenda where he would be set up with a plan for the summer, such as achieving a driver's license, planning and arranging for him to get a job, being able to continue with his group therapy and his weekly therapy sessions at the AA program, along with his medications."

The fact that Molacek, his family, and his caregivers were all optimistic is remarkable given the number of admissions and placements that hadn't resulted in any real progress. It's not hard to imagine that trusting the system one more time had required a tremendous leap of faith.

"We in the mental health system are very prone to scrutinizing people," writes Turnquist. "Visits with us can feel like a microscopic examination aimed at discovering every little flaw. We often overlook how painful this scrutiny can be for mentally ill people, who are already terribly self-conscious. Sad to say, much of our scrutinizing is ultimately based in self-interest. We want our clients to reflect well on us. We want them to have goals and show progress and attend treatment programs regularly. We particularly don't want them to misbehave in ways that we can be blamed for.

"So there is a broad tendency to label any anger or irritability as evidence of symptoms of the underlying illness, with a resultant push for more medication to control the symptoms," he adds. "Talk to any group of mentally ill consumers and the complaint that 'I can never get angry for any reason without someone asking me if I'm taking my medications' is likely to emerge. And, of course, mentally ill people often have a lot of perfectly good reasons to be angry."

"I wanted to say that Jason probably should have stayed at Bar None a little bit longer. He was scheduled, we were talking about having him stay there until June. Then when he turned 19, Hennepin County said, 'Well, we're not going to pay for it,' essentially, so we had to get him out of there. That was the end of February. His birth date was March 3rd, and we did.... Well, we were kind of disappointed. We were talking about having him stay overnight and things like that. We never had an opportunity for him to do that, stay overnight.

"Anyway, of the little things I just wanted to say is that when he was at Bar None, Jason was on the basketball team. He used to do the laundry. There was some younger kids there, Jason knows how to coach, he used to get up and coach. He was doing good in school, he was getting pats on the back, doing good."

--Richard Molacek at his son's first sentencing hearing last December.

When Jason Molacek learned he was to be sent home from Bar None, he was "stunned," according to his psychiatric report. "One part of him felt he would be 'free,' but another part of him felt 'in a state of shock'.... He stated that he liked the structure they had, such as the definiteness in the policies, and knowing if he violated a rule he would be locked in his room. Although there were some episodes there over the one and one-quarter years he stayed there, he saw it as a period when he had achieved some settling down, especially relative to the period before that."

Using a 100-point scale called the Global Assessment of Functioning--designed to offer a standardized numeric measure of how well a patient is coping socially and psychologically--Malmquist placed Molacek's level of functioning at Bar None to be 60. (By comparison, most people's scores fluctuate in the 70 to 90 range.) In the weeks following his release, it would fall to 30, according to the psychiatrist.

With a few strictly defined exceptions involving major crimes, the law decrees that the juvenile justice system's jurisdiction over delinquents ends on their 19th birthday. And unless someone is committed to a psychiatric facility as mentally ill, adults in this country have the right to refuse mental health services. Molacek's juvenile record is sealed, of course, but there's nothing in Malmquist's summary to suggest that he would have turned down further services--such as the chance to complete his Bar None treatment plan.

Michael Belton, head of Hennepin County Juvenile Probation Services, can't comment on Molacek's juvenile cases. His department is generally considered by those who work in child welfare and in the court system to be quite good. It boasts its own mental health clinic and several community outposts. At least two adults are typically responsible for monitoring the progress of children in the community who are under its jurisdiction. Probation Services ends up providing services to kids who have been bounced from one social service agency or mental health clinic to another.

"Frequently the kids who come in with the lowest offense levels have the greatest need for support," says Belton. "The mental health community and service providers have to some degree failed the kids in the corrections system."

In addition to children dumped on the legal system by health insurance companies, he says, probation gets kids no one wants to treat. "You have to work to get them to show. You can't close their cases out if they refuse to show up. A lot of [providers] don't want to work with kids tagged as delinquent--they're afraid."

In the last two years, however, Belton's budget--part of the corrections system, which falls under the umbrella of the state Health and Human Services budget--has been slashed by the administration of Gov. Tim Pawlenty. Last year Belton lost 10 percent of his staff; this year, the overall budget was reduced another 7 to 8 percent. The budget for the County Home School, the long-term juvenile detention facility (and a different department), was cut even more drastically. Belton won't comment, but others in the juvenile court system say cost is increasingly a factor in considering a child's placement.

According to Richard Molacek's testimony, it was less than three weeks before Jason's 19th birthday when his son's probation officer told the family he would be released. Both father and son were upset that there wasn't enough time to begin the gradual re-acclimation to the home that was supposed to happen over a period of months.

Molacek went home on a Saturday, scared. He enrolled in an alternative high school and started seeing a counselor at Health Partners.

He chafed at his parents' restrictions, though. His mother wanted him home by 9:00 at night, and he was given an allowance of just $15 a week. He stole $140. When his parents confronted him, Jason told them the money was to pay off drug dealers he owed from before going to Bar None. In fact, he had hooked back up with a boy he used to get stoned with and had started smoking "nugs," or high-grade marijuana, even though he was taking five psychiatric drugs.

In early May, Cheryl Molacek called the counselor to report finding a pipe in Jason's room. The counselor suggested that he try deep breathing to help reduce stress, or some positive distractions such as humming his favorite song. A referral was made to "chemical health," where a counselor suggested Jason start going to AA or NA.

On May 29, Jason saw the counselor again. He hadn't been smoking pot, he said, but he hadn't gone to any meetings. "It was agreed upon at this time that the patient would come back [on an] as-needed basis."

To the contrary, by the first week of June, Molacek was smoking so much he "became like a zombie, using bowl after bowl with a pipe and a joint," he told Malmquist. "Things didn't seem real to me anymore...my reality kept slipping away." He started to hear voices again. This time they said: "It has to be done."

"The thought about shooting his parents was described as coming into his head for a split second," the psychiatrist reported, "and then he would get into a 'different state of mind,' but he started to think about it more and more 'and then it was just like, I'm actually gonna do this.' The thought had been coming in and out of his head for the past two days."

On Friday, June 9, Molacek graduated from high school. The next day, the family held a big party in his honor. Jason helped his mother get ready, moving an old dishwasher into the family van. That Sunday, Jason began to hear voices saying, "Do it!" over and over. That night he and his father watched TV together and talked until about 10 o'clock. There was no hint, Richard Molacek would later insist to police, that anything was amiss.

T HE COURT: Have you ever seen in your practice or in the literature a case where a person who ultimately killed somebody had announced specifically an intention or impulses to do that over a period of time as long and as repeatedly as in this record?

THE WITNESS: Not this long. I've seen it in some cases for briefer periods where they are having psychotic episodes and then it remits and it recurs, but not for this length of time where it comes and goes.

--Judge Jack Nordby questioning Dr. Carl Malmquist in court

Who is really to blame in the death of Cheryl Molacek? Jason Molacek pulled the trigger on the gun, certainly.

However, consider this: When an airplane goes down, we don't just look for the jackscrew or gasket that failed, but the maintenance system that allowed that failure to go undetected. If someone dies in a convenience store heist, it's not just the trigger-puller who can be charged with murder; the getaway driver can be held liable as well. If a drunk driver kills someone, the bar that served him his last shots can be found negligent.

Certainly Jason Molacek should not have been smoking marijuana while taking powerful psychiatric drugs, and his parents might have done well to get rid of the weapons in their house. (Richard Molacek did not return phone calls for this article.) But otherwise, the public record suggests there is both plenty of blame to be spread around and no one to hold responsible.

Sometimes people with severe mental illnesses can't be reached. Sometimes families, acting in concert with talented and dedicated professionals, cannot prevent situations from spiraling out of control and ending in addiction, homelessness, violence. And maybe that's what happened to Jason Molacek and his parents. It seems unlikely, however. It's hard not to think that a much larger problem is money. Specifically, residential mental health services for children can cost upward of $250,000 a year. Families, schools, insurance companies, and local governments frequently spar over who should foot the bills. Because it's so hard to get the care paid for, there aren't nearly enough good treatment facilities.

Because it was created while he was a minor, and because it involves his health care, the majority of Jason Molacek's official paper trail is secret. The privacy laws that make this so are designed to protect Molacek, but they also make it impossible to do more than raise questions about some crucial junctures in his case. Did the Molaceks' health insurer work hard to get appropriate care for Jason, or did it insist on the cheapest treatments? Was his family steered toward the child welfare and juvenile justice system as a back-door means of getting those services? There's a long history of both practices in Minnesota.

According to the General Accounting Office, 1,071 Minnesota children were placed in the child welfare system in 2001 solely to secure appropriate mental health services for them. The majority were teenaged boys. "Many of these children were violent and had tried to hurt themselves, their parents, or their siblings and often prevented their parents from meeting the needs of the other children in the family," the congressional agency reported. Although the families came from all walks of life, the agency found, "children from middle class families are more likely to be placed because they are not eligible for Medicaid and their families do not have the funds to pay for treatments not covered by insurance."

The agency surveyed child welfare authorities nationwide and visited six states, including Minnesota. "Almost all state child welfare directors and county juvenile justice officials who responded to our surveys reported that private health insurance limitations were increasing the number of child welfare and juvenile justice placements to obtain mental health services," the GAO reported. "For example, according to parents and state and local officials in all six states that we visited, many private insurance plans...offered limited coverage for traditional or clinical treatments, such as psychotherapy or psychiatric consultations, and did not cover residential treatment placements."

Minnesota's numbers are much higher than those of the other states surveyed. For example, Mississippi and Kentucky reported placing 13 and 14 children, respectively. Connecticut, the state with the next-highest numbers, reported 738 such placements, while North Carolina reported 440. Local government officials call those numbers misleading: Unlike all but two other states, Minnesota law allows parents to petition the court directly to provide services to their children. And to its credit, Minnesota's juvenile justice system is much more likely than those of other states to place delinquent children who can't stay at home in facilities that provide mental health care instead of in detention centers.

In October 2000, Minnesota Attorney General Mike Hatch sued Blue Cross Blue Shield of Minnesota, charging that the insurance company had a pattern of wrongfully denying treatment to children suffering from mental illness, eating disorders, or chemical dependency. The suit accused the company of attempting to shift "the cost of caring for such children to taxpayers and/or families, including instructing parents to have their children suffer 'legal consequences' or to make 'use of the juvenile justice system' instead of providing the care covered by the policy."

Hatch's suit detailed the efforts of a number of parents to get help. According to records in the lawsuit, six were told to turn to the juvenile justice system; this would help them "leverage" the care they needed. One was told to consider foster homes. State investigators talked to several insurance company employees who confirmed that they were told to refer patients to the juvenile justice and foster care systems. If treatment were court-ordered, the company could deny payment, one explained. If a child's diagnosis included attention deficit disorder or another learning disability, an attempt might be made to shift responsibility to the family's school district.

"There is no documentation that other forms of less intensive treatment options have been tried, such as foster placement, etc.," the insurance company's behavioral care management subsidiary explained in one case. "Conduct issues can be addressed in the legal system."

One parent was told she was "paying" for her excesses of the 1970s and '80s. Several were told that what their children really needed was better parenting. One of the children named in the suit killed herself; another suffered permanent brain damage as the result of a failed attempt to hang himself. "Insurers know there's chaos in the [family's] house," Hatch says. "These families are too stressed. Eventually they just give up."

Blue Cross settled with the state in June 2001, agreeing to quickly and automatically forward all denied claims for mental health services to a panel of three retired judges. In addition, the company repaid the state $8.2 million for the care of children who had been denied help. Six months later, in an effort to fend off a similar suit, Health Partners joined the settlement and paid $2 million to the state. (Health Partners also happened to be Molacek's insurer.)

For his part, Hatch isn't completely satisfied. He says he's hearing reports that in the wake of the settlement, insurance companies are rewriting parts of their contracts with policyholders. Heroin addicts often are ordered by courts to take methadone, for instance. Under the terms of the settlement, insurers cannot refuse to cover a service because it's court-ordered. Instead, he says, some have simply rewritten their contracts to exclude methadone.

A professor of child and adolescent psychiatry at the University of Minnesota, Dr. George Realmuto, treated one of the children named in Hatch's lawsuit and has belonged to numerous panels and commissions charged with reforming Minnesota's child mental health system. The efforts, he quips bitterly, aren't unlike a child's experience with the system itself: With each new go-round, the patient is evaluated and given a new diagnosis. But the follow-through is terrible.

"These kids typically have really thick charts. These are long-term problems, and they require long-term treatment," he says. "It's not like a diabetes case. It impacts the family, the school, the community. But when you start saying these things to a policymaker, their eyes glaze over."

In Realmuto's opinion the root of the problem is an unwillingness to come up with the money: "If you don't capitalize the mental health system, it won't work. It's over. We're past the days when having a good heart is enough."

 

"Dr. Panciera noted that respodent claims and seems to be depressed. He indicated that he experiences vague suicidal ideation. Medical reports from the jail indicate that respondent is doing worse and his medication has been increased.... Dr. Panciera stated that respondent has been unable to function successfully outside of a structured setting and has been unable to maintain treatment and sobriety on his own. If released into the community, the respondent's functioning would soon deteriorate and he would pose a risk of violence. Dr. Panciera recommends commitment as mentally ill and dangerous to a treatment facility."

--Exhibit A, In the Matter of the Civil Commitment of Jason Molacek, March 2004

Since there was no doubt he pulled the trigger, and it was uncertain that he could meet Minnesota's narrow legal standard for insanity, Jason Molacek was found guilty of second-degree intentional murder in December during an abbreviated process known as a stipulated facts trial. If he had been found guilty of first-degree murder, Judge Nordby would have had no discretion as to his sentence: mandatory life.

As it stands, it's not entirely clear what Nordby's options are. He could not send Molacek to a state hospital, but a prison sentence seemed unlikely to do anything but worsen the young man's mental illness, the judge said during hearings on the matter. Richard Molacek petitioned a separate branch of the court system to have his son committed as mentally ill and dangerous. That commitment was ordered in March, and Molacek was to be sent to St. Peter Regional Treatment Center for a 60-day evaluation.

Not wanting him in prison, but not wanting to lose all leverage in the event Molacek is suddenly deemed cured and sent back into the community, Nordby has postponed his sentencing until later this month and has asked the attorneys on both sides of the case to research the case law on the court's options. (Because Molacek's legal case has not concluded, neither his attorney nor the county attorney's office was able to comment for this story.)

While in the Hennepin County Jail, Molacek prayed daily. According to Malmquist, he has come to view his crime in religious terms and blames himself for being too weak to resist Satan. He hopes that in the end he will be hospitalized.

"There isn't a day that goes by that I don't regret or have remorse, or that this should never have happened," Molacek wrote in a letter read before the court at his first sentencing hearing. "But horribly it did, and I have to face the consequences for something I can barely remember even doing. I feel that I have done the worst possible thing to a loved one, especially as loving and caring as my mother was.

"In some strange way I still can't get over the fact that all this isn't some horrible nightmare. That's why I'm asking to be put in a place such as St. Peter so I can have trained professionals look after me 24/7, monitor my meds. And mainly, help figure out why I did what I did on that day back in June."

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