Dr. Ronald Castro stood in a courtroom April 8 and pointed sharply at the woman to his right.
"If Lucia is allowed to go free, and if she should relapse," Castro told Superior Court Judge Michael McVey, "I fear that the first indication of her relapse may be a bullet into my body. ... If Lucia is out on the streets again, and if she injures, kills or somehow harms somebody in society, you will be held accountable for that."
He then returned to his seat to hear McVey sentence 40-year-old Lucia America Diaz. The Mesa woman earlier had pleaded no contest to two felonies:
She'd stalked Castro and vandalized his office during the first nine months of 1997, after similar incidents that had started in 1994.
She'd fired bullets into the doctor's Glendale office on the evening of September 30, 1997, after breaking his windows with a sledgehammer. A woman cleaning the office ducked to avoid the gunfire.
McVey had the option of sending Diaz to prison for 12 years, but that was unlikely because of circumstances unique to her case. Even prosecutor Dyanne Greer told the judge that prison probably wasn't the best answer.
"... She would be out in a very short period of time with no supervision," Greer said, "and back in the mental-health system, which so brutally failed her before and failed Dr. Castro. I know [I've] indicated that I felt that, given the persistence of her delusions and the danger to Dr. Castro, that additional incarceration was the only answer to protect him. I'm not so sure. I don't have an answer, Judge. I don't know that you do, either."
Diaz is one of hundreds of seriously mentally ill Maricopa County residents who have been judged legally "competent" to face criminal charges.
Defense lawyer Michele Lawson avowed that Diaz's mental state has improved while incarcerated for more than two years awaiting trial, citing the use of antipsychotic drugs and other medications.
"Now, her delusions are past ... because she has insight into the fact that they are delusions and that she needs to take the medication and she feels better."
McVey asked Diaz if she had anything to say.
"If I wasn't being stalked, I would have never broken ..." she started.
Lawson immediately touched Diaz's shoulder and whispered into her ear.
The judge slumped slightly, and put a hand to his face.
It sounded as if Diaz still believed that Castro -- who had delivered the two youngest of her four children -- had been stalking her, not the other way around.
Seriously mentally ill people often don't know how sick they are, so it made sense that she'd expressed confusion about the doctor. But would McVey risk putting someone on probation who still harbored delusions about a man she'd already victimized?
Diaz took a far different tack with the judge after conversing with her lawyer.
"I'm going to start taking my medication every day," she said softly, apparently forgetting she'd been doing just that for months.
Looking small and scared in her striped jail suit, Diaz continued: "And I wanted to say that ... if he wouldn't have hired someone to follow me, I would have never done what I did. And I know what I did. I wasn't on medication. I didn't take my medication. That's all."
McVey took a short break, then returned to impose sentence.
"I have concluded that, but for this serious mental illness, in all likelihood this crime would not have happened," he said.
"Obviously, the comments you made a few minutes ago are some sign that you are not completely stabilized and completely cured. But I think you were talking about delusions of what happened in the past and not a current belief system as to Dr. Castro. ..."
McVey placed Diaz on intensive probation for five years. His orders forbid her to bisect specific streets in the area of Castro's office on West Thunderbird Road.
The judge also ordered additional jail time that will keep Diaz locked up until at least August 4. Then, if space is available, jail officials likely will release her to a halfway house for a "transitional" period back into society.
Diaz's probation officer must approve any permanent living situation, and it's uncertain what that might be.
If she doesn't comply with McVey's orders, he told Diaz, "this court will act swiftly and do everything it can to protect human safety and human life."
McVey concluded, "Ms. Diaz, everybody in this courtroom is pulling for you. Everybody wants you to succeed. I hope you do."
The Lucia Diaz case provides a textbook example of what happens when the criminal-justice system must deal with someone whom the mental-health-care system has failed.
Both primary characters in this tale are victims. Ronald Castro is a victim of Lucia Diaz, and Diaz is a victim of Maricopa County's often inept mental-health system.
Castro crossed paths with the wrong person at the wrong time, and, luckily, evaded injury or even death.
Diaz's brain had malfunctioned, and the help she'd needed so desperately from a system supposedly designed to protect her never materialized.
"At the time of the offense," court psychiatrist Jack Potts wrote in an October 1998 report, "[Diaz's] doctors did not fulfill their responsibility to her by involuntarily medicating her while it was clear that she needed that to be done. ... Had that been done, the defendant quite likely would not have committed the alleged offenses."
Diaz's case also exposes broader problems that first arose in the late 1960s, when officials nationwide started to move as many mentally ill people as possible from warehouselike institutions back into communities.
Conceptually laudable, the practice often has had dire consequences, says E. Fuller Torrey of the National Alliance for the Mentally Ill.
"It failed not because the vast majority of released individuals cannot live in the community, but because we did not ensure that they receive the medications and aftercare that they need to do so successfully."
In Lucia Diaz's case, a court commissioner in March 1997 ordered Diaz to undergo involuntary medical treatment for one year. The order said Diaz posed a danger to herself and was a "persistently, acutely disabled" person.
Commissioner Gary Donahoe committed Diaz to Maricopa Medical Center, with plans to release her within a month if her mental condition "stabilized."
The effects of such court orders are profound: It gives doctors the right to medicate someone as they see fit and, if appropriate, to lock that person in a psychiatric ward for an extended period.
Because of her mental illness, Diaz fell under the wing of ComCare, a regional umbrella agency that then ran Maricopa County's mental-health system.
ComCare's main mission was to look after the welfare of its troubled clients. Its legal duty was much the same as a parent or guardian's.
The agency failed in its duty.
Doctors released Diaz from the county hospital after less than a month, pronouncing her "stable." They instructed her to take her medications, and to report to a ComCare psychiatrist monthly.
But records show she told ComCare doctors soon after her release that she wasn't taking her medications, and wasn't going to.
"[Diaz] has not been taking her medication," a psychiatrist wrote in an April 7, 1997, ComCare "progress note." "Today, she is upset and complaining that Dr. Castro is using a computer to change people's minds. Patient refused any medication."
He then circled the word "DECOMPENSATED." That means Diaz's mental state had deteriorated since her release from the hospital.
What's most outrageous about this is that Diaz was under court-ordered treatment. She already had lost her rights to refuse medication. But ComCare wasn't enforcing the court orders. The agency had several alternatives, including rehospitalizing her and involuntarily medicating her.
Instead, ComCare left Diaz to her own devices -- and delusions.
One night in late May 1997, someone broke four windows at Dr. Castro's office. Castro told Glendale police that he suspected the vandal had been an ex-patient and longtime tormenter of his, Lucia Diaz.
Beginning in 1994, Glendale police reports describe interactions between Diaz and Castro that would escalate into gunfire in September 1997.
Lucia Diaz's descent into mental illness didn't become apparent until after her 35th birthday in 1994.
Before then, police and court records show, she'd never had even a brush with the law or the mental-health system.
Born in Texas, Lucia Guerrero was the second oldest of 13 children born to Ramon and Josefina Guerrero. Her parents were migrant farm workers whose home base was the town of Surprise in the northwest Valley. She dropped out of school after sixth grade, then married Juan Diaz when she was 16.
No one knows why serious mental illness overwhelmed Diaz years later. Doctors suspect a contributing factor may have been the weeks she spent in a coma as a teen after a car wreck that killed two of her siblings.
Lucia and Juan Diaz raised four children. Lucia Diaz says she never got into alcohol or illegal drugs and worked many jobs -- including stints as a school-bus driver, supermarket cashier and nurse's aide.
She earned her GED at age 23 before taking classes at Glendale Community College for two years.
"I never had much, but I used to be pretty happy," Diaz tells New Times in a recent jailhouse interview. "I had my kids, and I never got into trouble with no one. Then things got messed up."
Responsive to questions, but diffident, she shows the most emotion when discussing her late father. It still pains her that sheriff's officials didn't allow her to attend his funeral a few months after her October 1997 arrest.
As for Dr. Castro, she says tersely, "He is a person in my past. I don't want to see him or to think about him, because I don't have to anymore."
Castro had served as Diaz's OB/GYN for the births of her two youngest children, in 1984 and 1993. Her medical records show Diaz suffered from postpartum depression after the latter delivery. It was during that time that she started to express a growing obsession with the doctor.
In August 1993, Diaz showed up at Castro's office and was bitterly disappointed when he wouldn't see her. In the months that followed, she sent him barely coherent letters and continued to appear unannounced at his office.
By 1994, she had separated from her husband, on the way to divorce. Early that May, Diaz crawled on her hands and knees past Castro's receptionist, spotted the doctor, and announced, "I just want you all to know he is mine," before leaving.
One week later, on May 20, 1994, Castro phoned Glendale police after Diaz stormed into the office.
"I'm going to have your baby," she told him loudly.
Police arrested Diaz on a disorderly conduct charge. A judge sentenced her that July to one year of probation. Within a few months, however, Diaz again was phoning the doctor.
On Halloween night, Glendale police again responded to Castro's office. This time, Diaz had come by and fixed the doctor in a relentless bear hug.
Diaz told an officer that Castro had been controlling her life since the birth of her fourth child. She said he'd "created" a woman in her image with whom he could have intimate relations.
Now she faced a misdemeanor assault charge. In December 1994, a judge again put Diaz on a year's probation and warned her to stay away from Castro's office.
Three days later, Tolleson police arrested her after a high-speed car chase. It happened after Diaz couldn't find her estranged husband at his job site.
"There's a lot that I don't remember about that time," she says. "I just know I wasn't feeling good."
Diaz pleaded guilty to resisting arrest, and was put on two years' probation (that made three concurrent probation sentences).
She apparently steered clear of Dr. Castro for about a year. In 1996, Diaz successfully completed probation on the resisting-arrest charge. She was working as a supermarket cashier.
But on December 31, 1996, someone broke the front window to Castro's office. He suspected Diaz, but police didn't pursue the matter.
A few months later, in late February 1997, Maricopa Medical Center (MMC) officials admitted Diaz to the hospital psychiatric ward on a petition for a court-ordered mental evaluation.
That's one legal step short of court-ordered treatment.
Doctors filed the petition after Diaz overdosed on Tylenol, then left a hospital against medical advice.
According to a document filed by an MMC doctor, "[Diaz] later called 911 and asked for help, describing to police and urgent care clinical staff about a delusional system involving an OB/GYN doctor, mannequins, robots and computer controls."
Diaz vehemently denied that she was sick, and refused to take any medications at the hospital. By law, she had the right to do so until a judge committed her to undergo treatment.
But Diaz was released just two weeks later, though she still was "psychotic," according to MMC documents. She went to stay in Glendale with a man with whom she had become involved.
Diaz met with a ComCare doctor within a few days of her release. On March 24, 1997, that doctor wrote:
"[Diaz] shows no insights. Insists she is not ill, that the info given the judge was lies. She says the medicine is ruining her life and health. She does reveal continuing delusional thinking, but denies auditory hallucinations. Refill meds."
Exactly a week later, someone again broke Dr. Castro's office windows, and police found a sledgehammer at the scene. Castro obtained a restraining order against Diaz from Glendale City Court.
That April 7, a ComCare doctor wrote, "[Diaz] has not been taking the medication. Today, she is upset and complaining that Dr. Castro is using a computer to change people's minds. Patient refused any medication."
Still, none of these mental-health officials took steps to rehospitalize Diaz.
On May 28, a ComCare doctor again indicated Diaz wasn't taking her medication. The next evening, someone smashed four windows at Castro's office. More windows were broken two weeks later. Glendale police named Diaz as a suspect, but didn't track her down for questioning.
Convinced that the police and mental-health systems were doing nothing to protect him, Castro hired a security guard and installed video cameras outside his office. A few of his frightened employees quit.
"Fear leaves a bitter taste in your mouth," he later told Judge McVey. "It leaves a lifelong taste in your mouth."
After two more window-breaking incidents in August 1997, Castro arrived August 29 to find his exterior office walls spray-painted in black.
Someone -- he was sure it was Lucia Diaz -- also painted the following words over the doctor's sign: "I did it because I love."
On September 9, Diaz made her monthly trek to the ComCare offices for a short visit with a staff psychiatrist.
She repeated irritably what she'd long been saying -- that she wasn't going to take her medications. He diagnosed her as a paranoid schizophrenic, among other mental maladies.
"Patient refused all meds," the doctor wrote. "Will pursue court-order[ed] medication."
Trouble was, Diaz already was under court-ordered treatment.
But no one in authority seemed to know or care about that.
At 10:30 p.m. September 20, 1997, Glendale police again responded to Ronald Castro's office. The stakes were higher this time.
A janitor there said she'd seen a Hispanic woman smashing the doctor's windows with a large object. The woman then fired a handgun at the doors and windows, at which time the janitor had ducked to avoid harm.
The police found nine bullet holes through the front windows and door, and eight bullet holes in the office's back door.
Ronald Castro soon showed up and retrieved a videotape from his security camera. It showed Diaz breaking the windows with a sledgehammer. He provided officers copies of harassing letters that Diaz had sent him, and of the seven prior police reports written in response to incidents and vandalism at his office.
A Sun City man for whom Diaz once worked told police that Diaz had a boyfriend who lived nearby. The man also said Diaz was a ComCare patient, which seemed to be news to investigators.
Diaz's boyfriend claimed he hadn't seen her.
ComCare didn't know where she was, either. The agency provided a Scottsdale address that turned out not to exist.
Days passed before the Sun City man informed police that Diaz was visiting his home. They arrested her there, then tried to piece together what had led to the shooting spree.
Among other things, investigators learned that Diaz's boyfriend had bought her a gun about a month earlier.
Diaz told Glendale detective Brad Moore that she'd broken windows at Castro's office three or four times, explaining she'd done so to protect herself. The doctor had created a robot of himself, she said, and had devised novel ways of talking to her -- through computers, radios and the like.
It immediately became clear to doctors and others at the county jail that Diaz was very ill. Arizona law allows judges to find mentally troubled defendants "incompetent, but restorable." The thinking is that treatment may allow people to improve mentally to the point where they are "competent" to stand trial.
Being "competent," by the way, does not mean one is legally sane: Competency refers to how someone is doing at the time. Sanity refers to a person's state of mind at the time of the offense, and considers criminal culpability.
One psychiatrist wrote of Diaz several months after her arrest, "She believes that, at night, her body is substituted by a mannequin who looks exactly like her. During that time, she spends time with "my rich husband, Dr. Castro,' whom she stated, "won't let me work and won't let me do anything.'"
Diaz spent three months at the Arizona State Hospital in the spring of 1998. She was treated there under a new court-ordered treatment plan, and was said to be "improving" slowly. In June 1998, hospital officials released her to the county jail. Soon after that, a court commissioner determined that Diaz had become competent to stand trial.
She faced felonies that could have landed her in prison for years if convicted. But the end of her convoluted case still was almost a year away.
L ucia Diaz spent months at the psychiatric ward of the jail facility on West Durango. Despite the spotty record of Maricopa County's jail system, the Durango unit has a fine reputation for its treatment of patients.
Even Diaz's attorney praises the job that counselor Lorraine Cali and psychologist Sarah Hill did with Diaz.
"Lucia had zero insight about herself and her problems when she first went over there," says Michele Lawson. "They worked closely with her, and also found an effective drug regimen that made her better and didn't turn her into a zombie. She's not the same person that I met a few years ago, and that's a positive."
Plea negotiations began in earnest early this year. An obstacle was County Attorney Rick Romley's policy that anyone convicted of using a gun during a crime should go to prison. But Romley does allow for deviations, and Lawson convinced prosecutors that this was an apt case for such an exception.
Ronald Castro, however, was outraged that Diaz might be set free. He wanted her sent to prison for life.
The janitor who avoided being hit by Diaz's gunfire in September 1997 took a more lenient view. Though she said she suffered "panic attacks" for months after the incident, the woman concluded that Diaz needs extensive mental help more than she needs prison.
By February 1999, the attorneys had fashioned a deal that allowed for Diaz to be placed on intensive probation, if the judge went along with it.
The Adult Probation Office has a small but well-respected team that works solely with seriously mentally ill probationers. A few days before Diaz's sentencing, probation officer Geri Gervais told Judge McVey by speaker phone about the meticulous monitoring of probationers that she and the team undertake.
Diaz sat on a couch between her attorney and Dr. Potts in the judge's chambers. McVey asked Potts if he considered Diaz a current danger to Dr. Castro and the community.
"No, I do not," Potts replied, quickly adding that his opinion was predicated on "appropriate community services" being available to Diaz.
Those services, Potts continued, should include "case management by [ComCare successor agency] ValueOptions on a fairly constant, frequent level" and other monitoring. He said authorities could initiate another court-ordered treatment plan if Diaz fails to take her medication after her release.
Gervais agreed that probation officers may not know for sure if someone is taking their meds or is dumping them down the sink.
"But you're going to see the behavior," she said. "It's really hard for them to hide that stuff, especially if they're SMI [seriously mentally ill]. Our job is to see the tip of the iceberg before it mushrooms."
The opposing attorneys at Lucia Diaz's sentencing passionately addressed the dilemma before them.
Deputy county attorney Dyanne Greer spoke words of warning.
"The system failed Lucia, and it failed Dr. Castro," said Greer, herself a former psychiatric social worker. "I wish the mental health system could adequately deal with people like Lucia. But it has proven that it cannot and will not do that. I have little to no faith in their follow-through with Ms. Diaz when she's released, without additional involvement of the criminal-justice system."
The Diaz case was Michele Lawson's last with the Public Defender's Office before she joined a private Phoenix law firm. She, too, spoke emotionally about the events that had ended in near tragedy.
"... I think the measure of a community is how it deals with people who are unable to take care of themselves," she told Judge McVey, "and included in that are mentally ill people, children, and elderly people. ... Lucia is one of the only clients that I have cried with and I have cried for. I think at this point, what is so important is to protect the community. And to protect the community means to treat Ms. Diaz in the least restrictive manner possible. There are a couple of reasons that I think prison is absolutely the wrong thing to do. One, the prison can't force-medicate her. So she goes to prison, [then] she's out in the community, and ... if for some reason the medications are discontinued, she'll deteriorate."
Dr. Castro had a far different perspective.
"Since she has refused her medication in the past and has had problems, it is only a matter of time before she relapses into that same sort of behavioral pattern, and then we will all be at risk again," he said.
Judge McVey, a thoughtful jurist who seemed anguished at times by his task, nodded slightly when Castro finished.
"This is one of the most difficult cases that we can deal with here in the criminal-justice system," McVey said later in the hearing, "because there are very real and competing interests. ... This court has an obligation to do justice and to balance the needs of the victim with the requirements of law. And in this case, there is a factor which this court can and should and must take into account, and that is the presence of mental illness as the driving force behind these crimes."
Then the judge told Diaz that he was putting her on intensive probation.
Lucia Diaz's outburst during her sentencing -- "If I wasn't being stalked ..." -- made some seriously doubt her chances of succeeding on intensive probation.
Success, of course, is relative.
For Dr. Castro, success in this instance will mean that Diaz stays far away from him and his office.
Diaz's probation officer, Geri Gervais, challenges Maricopa County's new mental-health authority -- ValueOptions and its subsidiary agency, Alternative Behavioral Systems (ABS) -- to do a better job.
If you like this story, consider signing up for our email newsletters.
SHOW ME HOW
You have successfully signed up for your selected newsletter(s) - please keep an eye on your mailbox, we're movin' in!
"There's much more involved in this than to give someone a pill and expect things to go voilá," she says. "Prescribing pills for 30 days, handing out bus passes and having an SMI person spend a few minutes with a shrink once a month doesn't do the trick. Not a lot has changed. Now, it's ABS that expects us to do too much of the work they're supposed to do. We see lots of cases where someone on court-ordered treatment is allowed to deteriorate to where he or she gets in serious trouble with the law."
Lucia Diaz says she now knows she's been cursed with mental illness. But she wants to find work when she gets out of jail, preferably at a supermarket, just like the old days.
"I don't think I'm a bad person because I got sick," she says. "I want to be a person who can do good things, not bad things. But it's kind of scary for me right now."
Contact Paul Rubin at his online address: firstname.lastname@example.org