A Picture of Tragedy: The family of Mark Herczog, a father killed by his son, pleads for compassion as a court trial looms — (North Bay Bohemian)

SSRI Ed note: Man on "changing regimen of antidepressants" becomes delusional, kills father. Schizophrenia, not ADs, blamed. NCR, given neuroleptics, locked up indefinitely.

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North Bay Bohemian

April 10, 2013

By Rachel Dovey

In November of 2011, Mark Herczog wrote a short, desperate note on his calendar for the week of the 21st. It was about his son.

“It said, ‘Get help for Houston,'” his sister Annette Keys recalls.

It had been an increasingly difficult year for the Herczog family, during which 21-year-old Houston seemed to have been replaced by a different person. He had always been shy, but according to his aunt, he now shunned social interaction, waiting until after 11pm to go to the gym so he could work out alone. He stole his mom’s Adderall. He said strange things with an empty, vacant gaze that his family now refers to as “the look.” In early November, when he crashed his dad’s green Caravan and smashed his head into the windshield, he didn’t check to make sure his passengers were OK. Instead, his aunt, who was in the vehicle at the time, says he asked her about the sandwich he’d placed between them, in the center console of the car.

Houston’s family knew something was very wrong, but they didn’t know what it was. They didn’t know that three psychiatrists would eventually diagnose him with schizophrenia. They didn’t know that two of them would be appointed by Sonoma County Superior Court.

Around 1am on Nov. 21, Houston Herczog stabbed his father in the kitchen of his Rincon Valley home, using at least four knives to gash and puncture his body 60 times. He tried to cut off his head. He would later tell a court-appointed psychiatrist that he’d thought he was performing an exorcism with a cardboard version of his dad. When police arrived, he told them flatly, “I killed him.”

Mark was declared dead at 2:52am by Memorial Hospital, his face so tattered that, according to the coroner’s report, his right ear was barely attached.

He was never able to help his son.

Houston’s defense has pleaded not guilty by reason of insanity, a verdict that would likely allow him to be sent to a maximum-security facility for the criminally insane, such as Napa State Hospital. Three psychiatrists have backed up this claim. On the eve of Houston’s juried trial, however, the district attorney called for a rarely requested additional opinion, which contradicts the others’ assertions of insanity.

Herczog faces a possible murder charge that could land him in prison, where his family worries he won’t have access to the treatment they believe he needs.

Tragically, the Herczog family has landed in the criminal justice system partly because of their initial reluctance to use it. In 2007, Sonoma County police shot and killed 16-year-old Jeremiah Chass and 30-year-old Richard Desantis during psychotic episodes. Mark Herczog’s daughter, sister and ex-wife all say Mark refused to call police despite signs of Houston’s escalating violence for fear that officers would shoot his son.

As a judge prepares to sentence Houston in a Sonoma County courtroom, Mark’s surviving family is not crying for blood. Instead, they want treatment for Houston and changes in a system that too often criminalizes—and even kills—the mentally ill.

‘I’M SCARED’

Cameron McDowell, Mark’s oldest daughter, remembers a chilling moment of foresight soon before her dad was killed. At her home in North Carolina, she’d just gotten off the phone with her aunt, who’d described the vacant look that would slip over her half-brother sometimes, saying it almost seemed like he left his body and someone else came in and took his place.

“I told my husband, ‘I’m scared Houston is that kid who’s going to walk into a supermarket and open fire,'” she recalls.

This was in mid-November, but she’d suspected something was off for roughly a year and a half. The brother that she describes as shy, creative and gentle as a child had become quieter and more distant. He’d quit his band and instead spent hours playing guitar alone. McDowell’s dad once told her jokingly on the phone that her brother was such a loner, he wished Houston go out drinking if it meant he’d be with friends. On her son’s third birthday, McDowell received a card from the family that Houston had signed, “I hope you have a shitty birthday.”

McDowell wasn’t alone in her concern. Her aunt, Annette Keys, noticed him changing in 2010, after he graduated from Santa Rosa High School’s ArtQuest program and began taking classes at SRJC. He read Kant and Nietzsche obsessively. He would begin a movie with the family and then get up 30 minutes later to go sit by himself at the computer without explaining why.

Keys lives in Ohio, but she came to Santa Rosa to visit her brother Mark in early November, when she was in the car accident with Houston. On Nov. 11, the day before she flew back to Ohio, she asked Houston about the change she noticed in him.

“I said, ‘Honey, I feel like something happened to you. Did something happen that you’re not telling us about?’ And he gave me this sideways glance and said, ‘Maybe I’ll tell you about it sometime.’ It was the creepiest thing.”

In March of 2011, Houston’s mother and Mark’s ex-wife Marilyn Meschalk-Herczog began taking her son to see a private psychiatrist, Dr. Dennis Glick. Like other family members, Marilyn was increasingly concerned about her son. He was argumentative. He couldn’t keep a job. He would act out in bizarre ways, like refusing to follow his employers’ dress code.

The three psychiatrists who assessed Houston in jail reviewed Glick’s notes, which suggest several possible diagnoses for the then-20-year-old Houston—major depression, developmental issues and schizoaffective disorder. According to Dr. Alan Abrams’ review of Glick’s notes, the initial psychiatrist did not recognize that Houston was suffering symptoms of schizophrenia, despite his early note on schizoaffective disorder, and focused instead on his depression, prescribing him an antidepressant.

Glick also noted Houston’s substance-abuse history, which he writes included Adderall that Houston stole from his mom, along with alcohol, LSD, marijuana and other prescription medications. In his interview with Dr. Abrams, Houston said that he only took LSD once, in the ninth grade, and in his interview with Dr. Donald Apostle, he said he smoked pot in high school but stopped in the summer of 2009 because it made him feel psychotic.  According to the review of Glick’s notes, Houston stopped taking Adderall—after being prescribed an antidepressant—until June, with sporadic use through September.

Because Houston continued to steal his mother’s Adderall, Marilyn eventually told him he needed to leave her Forestville home and live with his dad. But on Nov. 19, she says, two days before he killed Mark, Houston came back to her house.

“He had that look in his eye, and he said, ‘I feel really violent,'” she recalls. “I said, ‘Are you afraid you’re going to hurt me?'”

Marilyn says that she followed Houston through her home, out to the attached garage. As she descended the steps leading into the garage, her son grabbed her by the arm and threw her. Then he locked her in, asking her through the door if she was afraid of him.

“I said, ‘No. You’re my child. I love you and I trust you, and I don’t think you’re going to hurt me,” she recalls, crying.

“I had told him, ‘If you’re feeling violent, go out and run. Run around. It’s dark out and nobody will see you. Just run as fast as you can. Go up the hill. Just run.'”

He unlocked the door and ran outside the house. In an interview with Dr. Abrams recounting the same night, Marilyn says that when she checked her purse, more Adderall was gone.

After he threw her across the garage that night, Marilyn says that she called her therapist, who told her to call the police.

In California, officers can take mentally ill people who are a danger to themselves or others into temporary custody in what’s known as a 5150, or involuntary psychiatric hold.

She called her ex-husband and told him what her therapist had said. “He said, ‘No, no, please don’t call the police,'” she recalls. “I said, ‘Why not?’ And he said, ‘They shoot those kids. Please don’t call them. That’s my son.'”

Mark’s sister and daughter report similar conversations. Both say that when the idea of a 5150 was brought up, Mark insisted that the family refrain from calling the police. McDowell says that in October, her dad told her he’d looked into an involuntary psychiatric hold.

“He said that there had been some cases where parents had done a 5150, and the police have shot and killed their kids,” she says.

In Sonoma County, two mentally ill individuals died after their families made distress calls to local law enforcement. During a 2007 psychotic break in which he sat on his little brother clutching a two-inch Leatherman knife, 16-year-old Sebastopol resident Jeremiah Chass was shot 11 times by the sheriff’s deputies who answered his mother’s distress call. He died in their driveway.

A month later, bipolar 30-year-old Richard Desantis was also shot as he ran out of his house toward the sergeant and two Santa Rosa officers who responded to his wife’s call. According to the Desantis family’s attorney, he was unarmed when he was shot. He also died in front of his home.

Not long afterward in January 2008, 24-year-old Jesse Hamilton, suffering from schizophrenia and holding a butcher knife, was shot and killed by a Santa Rosa police officer after a staffer at his group home called 911.

While few national statistics on the subject exist, the nonprofit Treatment Advocacy Center reports that police kill mentally ill people in so-called justifiable homicides four times as often as they kill people who are not mentally ill.

According to McDowell, her father told her in October that he was too unsure about what Houston might do if he called the police, and that he didn’t want to lose his son.

INTO THE NIGHT

Several hours before Mark died, Marilyn says that her youngest daughter, 17-year-old Savannah Herczog, called to warn her that the strange, vacant look was coming over Houston again. She recalls thinking that he might come over to her house, safe in the knowledge that she had changed the locks.

The next phone call Marilyn received was after midnight. It was her daughter again, saying that Houston had stabbed their father.

Marilyn says she raced to Rincon Valley, still unaware of the magnitude of the crime. She remembers thinking the attack had probably resulted in some kind of minor injury, like scissor wounds in her ex-husband’s arm. But as she approached Mark’s Parkhurst Drive home, she saw police cars and paramedics surrounding the yellow house with brown trim. She says that her daughter ran into her arms, crying. She told her that Mark had been taken away, and that he hadn’t been moving at all.

The two women were taken into police custody for questioning. Several hours later, still in custody, they learned that Mark was dead.

After she was let out of police custody, Marilyn says that she went back to the house and went inside. The kitchen walls were covered in blood. She saw a denim jacket sitting on the back of a chair that was also covered in splatters of blood. She picked it up and put it on.

According to Mark Herczog’s autopsy report, a chop wound on his scalp exposed his skull. His left eyelid was punctured. Most of his right ear dangled from his face. Ten horizontal, overlapping stab wounds surrounded his neck just above his thyroid, where Houston tried to remove his head. His entire body down to the soles of his feet was covered in blood.

McDowell says the condition of Mark’s remains meant she wasn’t able to say goodbye to her father’s body; although she flew to Santa Rosa from North Carolina, she had to say goodbye to his hand. She remembers entering the funeral home, where her dad had been laid out in a body bag with one scratched-up hand poking out. A flesh-colored blanket had been draped over the body bag. She remembers thinking that it looked oddly like a Muppet, and that because her dad had a twisted sense of humor, she felt like he was with her as she had this thought.

A Picture of Tragedy | News | North Bay Bohemian

‘OH, DEAR. OH, GOD.’

Three psychiatrists have diagnosed Houston Herczog with paranoid schizophrenia, arguing that he killed his father in the midst of a psychotic break.

As Dr. Robbin Broadman writes: “There is no non-psychotic motive that I can see for the violence that occurred. He and his father may have had a disagreement, but the extent of violence goes beyond what one would expect from a stabbing in anger. There were 60 stab wounds.”

The National Institute of Mental Health (NIMH) defines schizophrenia as a chronic brain disorder that afflicts roughly 1 percent of the American population. It stems from a combination of genetic and environmental factors, and is often characterized by paranoia, hallucinations and a lack of interest in socialization. It typically exhibits between the ages of 16 and 30. Although NIMH cautions that most people with schizophrenia are not violent, certain tendencies, like delusions of persecution, can lead to violence.

“If a person with schizophrenia becomes violent, the violence is usually directed at family members and tends to take place at home,” NIMH’s website states.

Considering the match-up between Houston’s behaviors the year before he killed Mark and his ongoing paranoid delusions in prison—of everything from TVs speaking directly to him to the prison being a concentration camp—Dr. Abrams writes in a report dated Nov. 1, 2012: “With a very high degree of medical certainty, I believe that Mr. Herczog was insane at the time of the killing.”

Dr. Abrams was retained by Houston’s defense, public defender Karen Silver, and the two psychiatrists brought in by the impartial court agreed. Dr. Donald Apostle and Dr. Broadman examined Houston in reports dated Dec. 3, 2012, and Feb. 18, 2013, and both concluded that a verdict of not guilty by reason of insanity is applicable. Along with Houston’s behavioral patterns and the sudden and gruesome nature of his crime, the psychiatrists also interviewed him about what he believed was happening while he was stabbing his dad. The two accounts match up: he thought his father was trying to speak metaphorically to him about incest. He says he thought his dad was speaking symbolically and “in code.”

“Evil was frantic, squeezing my mind. I had to stop it. It wasn’t my dad,” he told Dr. Broadman.

Houston told Dr. Apostle that was when he grabbed a knife and began stabbing his father, who seemed to him to be plastic and unreal.

Both psychiatrists note that Houston was shaking while he talked. Dr. Apostle writes that after recounting the stabbing, he stopped, sighed and said, “Oh, dear. Oh, God.”

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What happens after a defendant is found not guilty by reason of insanity? Often the answer is involuntary confinement in a state psychiatric hospital — with no end in sight.

On Nov. 21, 2011, after months of having delusions about aliens, conspiracies and poison, Houston Herczog, then 21, partly decapitated his father, Mark. Six days earlier, Mark Herczog had written a letter to God (“God — Help!”) asking him to save his newly unrecognizable son. After Houston was arrested in the bloodied family kitchen, he told the police: “The look in his eyes! I had to!”

I heard about the murder from my mother. Houston is my distant cousin, though I had never met him or his immediate family. During his trial, as psychiatrists testified about a psychotic break related to an onset of schizophrenia, his family — my family — prayed that he would be found not guilty by reason of insanity and sent somewhere for treatment. Charged with first-degree murder, Houston was facing 25 years to life. When he was found N.G.R.I. and sent to nearby Napa State Hospital, it was a relief.

It wasn’t until he was inside that any of us realized, from the mounting anxiety in his phone calls, the rules and restrictions that governed the possibility of his getting out.

Houston has now been in the hospital for four years. In 2015, I visited him there for the first time. After passing through a prison fence and four locked doors, I sat with him in an all-beige room. Schizoaffective disorder is the current diagnosis, and he is stable on medication, though he has periods of deep hopelessness. He struggles with what he has done; at the beginning of his incarceration, when, pharmacologically stabilized for the first time, he was suddenly lucid, he couldn’t do anything but lie in bed and cry. But he also struggles with the uncertainty of how long his confinement will last. Had he been convicted and received the minimum sentence, he would be out before his 50th birthday. His “top date,” according to his hospital paperwork, is Dec. 31, 2600 — 587 years after he was admitted.

Houston doesn’t dispute that he did what he did, but he does dispute the basis for his continued detention. “What are they rehabilitating?” he asked me that day, shaking his legs up and down when the caffeine from a Mountain Dew Code Red kicked in, his blue eyes wide behind wire glasses. He held his hand up, ticking the points off on his fingers. “Not a pattern of violent behavior, since I have no record of violent behavior before my crime. Is it my insanity? Because the treatment for my disease is medication, and I’m medicated and stable now.” And he is — high-functioning as you please. Before we began talking about his incarceration, he kept trying to engage me in a debate about feminist theory.

When he calls, Houston sometimes apologizes for not having much to say about his life — what would he have to say? — in limbo as it is. He would love to have a girlfriend, his first, but it seems unlikely to happen at the hospital. (“You know, I came here for the women,” he joked once.) He spends a portion of his unnumbered, many-numbered days arguing with staff about how many packets of sweetener he’s allowed to use at a time. (Patients are restricted to two at lunch; he likes his tea quite sweet.) His schedule consists of shuffling from group activity to group activity in a beige uniform, between feedings of institutional food three times a day, mind-numbing TV in the background, no internet or cellphones.

Houston’s plan is to wait until he has been hospitalized for at least five years before he bothers to file any writs or petitions for release. That number has nothing to do with what he thinks of his mental state but with comments his first social worker at Napa made: that because of what he did, he can’t possibly be let go for a long time. (When reached for comment about whether this was a plausible conversation, a spokesman for the hospital said, “A patient with a determinate sentence length of life for a high-profile crime might end up staying in the hospital for many years. It is reasonable and therapeutic for a treatment team to discuss these realities with patients.”)

Houston’s sister Savannah says that she gets it — the urge to confine forever someone who did something horrific. Savannah was home the night her brother killed their father. Only 17 at the time, she “had to walk past them to get the phone” to call 911. When she ran to her room to dial, Houston followed her, still holding a knife, but stopped when she shut the door on him. “Part of me thinks he should still have to pay in some way, whether he was in his right mind or not,” she says. “It’s hard though, too, because it is ‘not guilty.’ I have to remind myself of that a lot. I think that’s because I was there. I saw it happen.” But, she went on, “it’s my brother, and obviously I don’t want him to spend his whole life there, because even seeing what he has to eat makes me want to cry. Being there just deteriorates him more and breaks his spirit. He realizes what he did and where he is, and he’s depressed.”

Not everyone in the family is so sympathetic, says Houston’s half sister, Cameron McDowell, 43. “We have some family members who just hate him and will never forgive him. It was just such an awful thing. And I wish Dad were here every day. I can’t even imagine what he went through that night — oh, God, it was so awful.” But, she says, “he’s gone. And we have Houston now. We have to support him. This is going to sound strange, but I’ve not once been mad at him. I really, truly, passionately believe that it’s not the person that commits the crime. It’s the illness.”

Credit…From the family of Houston Herczog

At the same time, she understands why people are afraid. Cameron’s own husband isn’t yet comfortable with the idea of Houston’s hanging around their two young kids; though he loves Houston, he’s “a little bit freaked.” “I hope my husband will change his mind when Houston gets out,” she says. She, too, worries about what will happen after his release, though for entirely different reasons. “Is he going to be so institutionalized that he won’t know how to live? That’s what breaks my heart for him.”

Like Houston’s sisters, the judicial and medical systems struggle to find a balance between the blamelessness of N.G.R.I. patients and the gravity of many of their crimes. The rights of the patient are always weighed against the public good, a standard that may include a more or less explicit desire for retribution. Those who provide treatment for forensic patients, says Michael Norko, professor of psychiatry at Yale and director of forensic services for the Connecticut Department of Mental Health and Addiction Services, “still have to answer to a court, or to the board, or to the court of public opinion. Every facility has people in it who have so violated a community, a community that is so angry, so hurt, that they’re basically pariahs.” He recalls one patient who shot a police officer; at hearings for his release, a crowd of uniformed cops repeatedly showed up and stood silently, facing the review panel. The question of a patient’s hospitalization can be “reduced to people’s grief, people’s anger, people’s fear — and the complexity of the patient’s rights and their recovery, all of those complexities get overshadowed very quickly.” When I asked Norko what happened to the patient who shot the officer, he said, “Well — well, eventually, he died.”

Because diagnoses and treatment assessments cannot predict future behavior, the standards for involuntary confinement — degree of mental illness and dangerousness — are necessarily subjective. Emotions and prejudice easily come into play, even from experts. A 2003 study in The American Journal of Forensic Psychology, for example, showed that doctors are more likely to find minorities incompetent to stand trial and more likely to diagnose psychotic disorders in African-Americans. At Napa, I spoke with a patient, a friend of Houston’s, who pleaded N.G.R.I. to a murder charge and had been hospitalized for nearly 20 years. When he was granted a hearing in which, according to court transcripts, multiple clinicians recommended his release, one doctor dissented — a doctor with whom he had had an ugly dispute and who, another doctor testified, wasn’t objective. The patient’s release was denied.

Stephen Seager, a 67-year-old psychiatrist who was at Napa for five years, writes openly about his own reactions to his patients in his 2014 memoir, “Behind the Gates of Gomorrah: A Year With the Criminally Insane.” He describes being in the hallway with a group of them heading to lunch as being “engulfed in a wave of hungry psychopaths.” When one of his patients tells him a story about his childhood, he writes, “I didn’t like thinking that some of the men even had childhoods.” Asked in court about a patient’s diagnosis, he gave the admitting diagnosis — bipolar disorder, manic with psychotic features — though he writes that he knew he wasn’t currently mentally ill. But he did think he was dangerous. When I asked him about this, he said: “The point is they’re supposed to be dangerous because they’re mentally ill, but if they get better and they’re still dangerous, what do you do?” He is well aware of the import of expert testimony in retention decisions. “Most of the time,” he said, “judges take our opinion on it.

“I look for the safety of the community,” he went on. “I live here. Sometimes you just have to say something for everybody’s best interest, regardless of whether they’re mentally ill or not.”

Of patients who “just never quite get better,” in doctors’ estimations, Seager said: “Oh, they’ll be here till they die.”

Napa State hospital’s vast, drought-dry campus is roamed by a pack of screeching peacocks. At 1,255 beds, it is one of the largest state psychiatric hospitals in the country. For most of his time there, Houston has been on what’s called a discharge unit, with one to three roommates, where it’s possible to get privileges like walking to the visitors’ center alone. After a bout of suicidal thoughts, he was moved, indefinitely, to a locked unit where all activities and access to the courtyard are supervised.

Houston’s treatment consists of up to 20 hours of group classes a week. His schedule at one point included Emotional Management, Substance Recovery, Current Issues in Mental Health, Self-Esteem, Fitness/Easy Exercise, Leisure Skills/Computer, Fitness/Weight Lifting, Discharge Planning, Wellness Recovery Action Plan, Coping Skills/Fitness, Leisure Skills/Journal and Conditional Release Prep. He says they watch a lot of videos. I once talked to a fellow patient of Houston’s on the phone who said he was heading to a class where the day’s lesson was learning to make cheesecake.

“Cheesecake!” he said. “Imagine that.”

State forensic hospitals vary widely in size — anywhere from just one ward to 1,500 beds — and they also vary in the activities and treatments they offer. Public psychiatric hospitals across the country may be accredited by an independent nonprofit called the Joint Commission. But it doesn’t require, for a start, the use of evidence-based therapies. One-on-one psychotherapy can be hard to get. (Houston began receiving such therapy only after his mother spent two years asking for it, his family says. Napa declined to comment, citing privacy laws.) State mental-health agencies may not be required to report what kind of care hospitals are giving, unless something goes so wrong that it attracts the attention of federal authorities. (Many do, however, voluntarily participate in national data-collection systems.)

The American archetype of bad mental-health practices is the movie “One Flew Over the Cuckoo’s Nest”: doped-up patients locked away from society to suffer and, ultimately, to perish. Some advocates argue that the conditions at psychiatric institutions aren’t always much better. Until recently, Oregon State Hospital, where “Cuckoo’s Nest” was filmed, may in ways have been worse.

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Schizophrenic. Killer. My Cousin. — (MOTHER JONES)

GABRIEL MAC

May, 2013 Issue

It’s insanity to kill your father with a kitchen knife. It’s also insanity to close hospitals, fire therapists, and leave families to face mental illness on their own.

Mark with Houston at Houston’s high school graduation in 2009. Courtesy of the family

For more on this story, read Mac McClelland’s new chapter at the New York Times Magazine. It was also featured on the New York Times’ podcast, The Daily, which you can listen to below.

THE THING THAT STRUCK ME when I first met my cousin Houston was his size. He wasn’t much taller than me, if at all, and was slight of frame. On the other side of the visitors’ glass, he looked surprisingly small, young for his 22 years. The much more remarkable thing about him turned out to be his vocabulary, vast and lovely, lyrical almost—until it came to an agitated or distracted halt. In any case, all things considered, he seemed altogether extremely unlike a person who had recently murdered someone.

The symptoms displayed by Houston (in my family, a cousin of any degree is simply “a cousin”; technically, Houston is my third) in the year preceding this swift and horrific tragedy have since been classified as “a classic onset of schizophrenia.” At the time, it was just an alarming mystery. Houston had been attending Santa Rosa Junior College, living with his mom, playing guitar with his dad, when he became withdrawn and depressed. He slept all day; his band had broken up, and suddenly he had no friends. His dad, Mark, who had once struggled with depression and substance abuse but was now a pillar of the recovery community, and his mom, Marilyn, tried to help, took him to a psychiatrist. Houston didn’t have a drinking problem, but he mostly stopped drinking anyway. He didn’t smoke pot anymore, or even cigarettes. His psychiatrist indicated possible schizoaffective disorder in his notes, but put Houston on a changing regimen of antidepressants over the next eight months. It didn’t make any difference. Houston had started stealing his mom’s Adderall. He said it helped him feel better. He got fired from multiple jobs. Marilyn kicked him out, and he moved in with Mark.

“This was not my nephew,” my Aunt Annette, Mark’s sister, says of Houston’s behavior then. “He was always solicitous and loving and talkative with me. Now, he was anxious, quiet, said very strange things. He would say things that seemed not to come from him. I asked him how his therapy was going, and he said, ‘Terrible.’”