United States v. Hinckley

UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF COLUMBIA

)

UNITED STATES OF AMERICA )

) Criminal No. 81-306 (PLF)

v. )

, )

JOHN W. HINCKLEY, JR. )

)

)

CONSENT ORDER

This matter came before the Court upon an agreement by the Government and Mr. John

Hinckley for his unconditional release from his commitment. On September 27, 2021, the Court

held a status conference at which counsel for the Government and counsel for Mr. Hinckley

discussed Mr. Hinckley’s present mental stability and his compliance with the conditions of his

convalescent leave, described their agreement regarding Mr. Hinckley’s unconditional release

from commitment, and jointly recommended this Consent Order.

The parties and the Court have considered the Department of Behavioral Health’s

recommendations for unconditional release dated August 21, 2020, and May 10, 2021, as well as

the Department of Behavioral Health’s monthly reports to the Court and counsel stating, in part,

that Mr. Hinckley is and has been in full compliance with all of the conditions of release and is

and has been mentally stable, with his disease in full and sustained remission, and the expert reports

and risk assessments of Dr. Samantha Benesh and Dr. Mitchell Hugonnet stating that the risk of

his violence is “low” and “remote.”

' The Department of Behavioral Health letters, dated August 21, 2020, and May 10, 2021, as well as the

reports of Dr. Benesh, dated July 2, 2020, and September 16, 2021, and Dr. Hugonnet, dated September 2,

2021, are attached hereto.

On June 21, 1982, ajury found Mr. Hinckley not guilty by reason of insanity on numerous

charges related to the attempted assassination and severe wounding of President Ronald Reagan

as well as the severe wounding of Presidential Press Secretary James Brady, Secret Service Agent

Timothy McCarthy, and Metropolitan Police Officer Thomas Delahanty. He was committed to

Saint Elizabeths Hospital for an indeterminate period of time following a Bolton hearing.”

On December 17, 2003, Mr. Hinckley was granted his first conditional release for

privileges in the community. Since that date, his conditional release privileges have been gradually

expanded by the Court.? The most recent hearing occurred over several days in April and May

2015. Thereafter, on July 27, 2016, this Court issued an Opinion and Order granting Mr. Hinckley

convalescent leave to reside full-time in the community. See United States v. Hinckley, 200 I’.

Supp. 3d 1, 63 (D.D.C. 2016).

Pursuant to that Order, on September 10, 2016, Mr. Hinckley was placed on convalescent

leave to reside full-time with his mother in Williamsburg, Virginia. Since then, pursuant to the

Court’s Order, the Department of Behavioral Health has submitted monthly compliance reports to

the Court and counsel. Those reports have consistently indicated that Mr. Hinckley has been

compliant with all the conditions of his release and has remained mentally stable and asymptomatic

for mental disease. Also, pursuant to Condition 32 of the Court’s Order, the Department of

? Bolton v. Harris, 395 F.2d 642 (D.C. Cir. 1968).

* This Court has held several evidentiary hearings after which it has issued lengthy opinions detailing Mr.

Hinckley’s mental condition, treatment compliance, and progression towards full convalescent leave in the

community. See United States v. Hinckley, 292 F. Supp. 2d 125 (D.D.C. 2003); United States v.

(D.D.C. 2005); United States v. Hinckley, 462 F. Supp. 2d 42 (D.D.C. 2006); United States v.

Hinckley, 493 F. Supp. 2d 65 (D.D.C. 2007); United States v. Hinckley, 625 F. Supp. 2d 3 (D.D.C. 2009);

(D.D.C. 2016).

Behavioral Health completed an updated risk assessment of Mr. Hinckley on July 27, 2018.4

Thereafter, it recommended several modifications, reducing the conditions to Mr. Hinckley’s

convalescent leave privileges in an August 2018 letter to the Court and counsel.

The Government retained two independent experts, Dr. Raymond Patterson, a forensic

psychiatrist, and Dr. Mitchell Hugonnet, a forensic psychologist, to review the Department of

Behavioral Health’s risk assessment and proposed modifications that would eliminate certain

conditions of Mr. Hinckley’s convalescent leave. On October 16, 2018, Dr. Patterson submitted

his response in support of the proposed modifications to Mr. Hinckley’s convalescent leave.

Thereafter, on October 22, 2018, Dr. Hugonnet submitted his risk assessment of Mr. Hinckley,

which also supported the proposed elimination of certain conditions of Mr. Hinckley’s

convalescent leave.°

Condition 32 of the Court’s July 27, 2016 Order required the parties to “meet and come to

mutual agreement regarding proposed reductions in the conditions of convalescent leave and/or

the frequency of Mr. Hinckley’s appointments to be submitted to the Court for approval.” United

States v. Hinckley, 200 F. Supp. 3d at 70. Accordingly, based upon a review of the Department

of Behavioral Health’s monthly status letters, risk assessment, and recommendation for

modifications to Mr. Hinckley’s convalescent leave privileges; the Government’s expert reports;

and the proposed Consent Order jointly submitted by counsel for the Government and counsel for

* Condition 32 of the Court’s July 27, 2016 Order required the Department of Behavioral Health to conduct

an updated risk assessment within 18 months of the Court’s Order to address Mr. Hinckley’s compliance

and whether any changes in the conditions of his release were warranted. The completion of the risk

assessment was delayed after Dr. Katherine Murphy, a forensic psychologist who conducted the 2015 risk

assessment of Mr. Hinckley, became unavailable. A new evaluator, Dr. Samantha Benesh, was retained by

the Department of Behavioral Health and produced the required updated risk assessment.

° Both experts opposed the Department of Behavioral Health’s recommendation to eliminate the

requirement for Mr. Hinckley to maintain a daily log of his activities, finding that the logs were clinically

and therapeutically beneficial to Mr. Hinckley.

3

Mr. Hinckley, this Court found that Mr. Hinckley would not pose a danger to himself or others if

he was permitted to continue residing full-time in Williamsburg, Virginia, on convalescent leave

under the proposed conditions. Accordingly, the Court entered a modified Consent Order on

November 16, 2018. See Consent Order [Dkt. No. 663].

Thereafter, the Department of Behavioral Health continued to provide bi-monthly status

reports on Mr. Hinckley’s mental condition and his compliance with the conditions of release. On

August 21, 2020, it submitted a letter to the Court and counsel recommending further reduction of

conditions to Mr. Hinckley’s convalescent leave privileges and, after a period of 6 to 12 months,

unconditional release from his commitment. The letter indicated that an updated risk assessment

conducted by Dr. Samantha Benesh on July 2, 2020, concluded that Mr. Hinckley posed a low risk

for future violence under the proposed conditions. See July 2, 2020 Violence Risk Assessment

Update [Dkt. Nos. 696-1, 696-2],

Upon review of the Department of Behavioral Health’s recommendation, the updated Risk

Assessment and the prior bi-monthly status letters to the Court, the Government opposed Mr.

Hinckley’s unconditional release but did not oppose modifications to the conditions of his release

consistent with the recommendations in the Department of Behavioral Health’s August 21, 2020

letter. Accordingly, following a September 23, 2020 status hearing, counsel for the Government

and counsel for Mr. Hinckley submitted a proposed Consent Order.

Upon review of the Department of Behavioral Health’s recommendation and after review

of the proposed Consent Order as well as representations by the parties, the Court, on October 28,

2020, entered the Consent Order with modifications reducing the conditions of Mr. Hinckley’s

Pommalescent leave. See Consent Order [Dkt. No. 696]. In part, the modified Consent Order

expanded the distance Mr. Hinckley could travel, reduced his reporting requirements, and perhaps

most importantly to him at the time, allowed him to post/publish his music and/or art under his

true name. The Court set a status hearing within approximately 7 months and an evidentiary

hearing approximately 9 months from the date of the Consent Order to consider whether Mr.

Hinckley should be unconditionally released.

Thereafter, a status hearing was scheduled for June 3, 2021. In advance of that hearing,

the Department of Behavioral Health submitted a new letter dated May 10, 2021, indicating its

continued support for Mr. Hinckley’s unconditional release, and the Government requested the

opportunity to have its own expert, Dr. Mitchell Hugonnet, evaluate Mr. Hinckley in advance of

an evidentiary hearing. At the June 3, 2021 status hearing, the Government indicated its continuing

opposition to unconditional release, and the Court set an evidentiary hearing date.

On September 2, 2021, the Government received Dr. Hugonnet’s report. He opined that

unconditional release was not appropriate immediately for two main reasons: 1) Mr. Hinckley’s

mother recently passed away on July 30, 2021, thus resulting in Mr. Hinckley living alone for the

first time since the offense; and 2) Mr. Hinckley’s long standing group therapy with Mr. Beffa is

going to be terminated because of Mr. Beffa’s retirement, and no replacement will be available, as

of January 2022. Dr. Hugonnet opined that, because Mr. Hinckley has a tendency toward isolating

in response to stress, monitoring Mr. Hinckley’s response to the significant changes of losing his

mother and his group therapy for a period of time is clinically appropriate. However, Dr. Hugonnet

also opined that Mr. Hinckley is doing exceedingly well so far and operating at a very high level.

Dr. Hugonnet anticipates that Mr. Hinckley will continue to do well through these changes and

opines that if that is the case (i.e., barring no change in circumstances and assuming Mr. Hinckley

continues to comply with the conditions of the existing Consent Order), he agrees that in June

2022 it will be appropriate for Mr. Hinckley to be unconditionally released.

Thereafter, on September 16, 2021, almost seven weeks after Mr. Hinckley’s mother

passed away, Dr. Benesh submitted an Addendum to her 2020 Risk Assessment. She continued

to opine that Mr. Hinckley was ready for unconditional release and did not believe an additional

period of monitoring as suggested by Dr. Hugonnet was necessary. She also opined that Mr.

Hinckley coped well with the stress caused by his father’s death on January 29, 2008, that he had

long prepared for the death of his mother as her health declined, and that he had coped well and

appropriately in the time following her death on July 30, 2021.

Following receipt of the expert reports, the Government consulted with officials within the

Department of Justice and subsequently proposed a settlement to defense counsel by which Mr.

Hinckley would be granted an unconditional release at this time with the Court making its findings

of facts and conclusions of law but staying the execution of the Order for unconditional release

until June 2022. During the interim, Mr. Hinckley would be required to continue to comply with

the conditions set forth in the October 28, 2020 Consent Order governing his convalescent leave.

Should the Government believe that either Mr. Hinckley’s mental health has materially

deteriorated or that Mr. Hinckley has failed to comply with the conditions of his release, it will

bring such matters to the attention of the Court by motion no later than June 6, 2022. At any

hearing on the Government’s motion, the Government will have the burden of establishing the

material nature of the deterioration or the noncompliance. Counsel for the parties informed the

Court at the September 27, 2021 status conference that they agree that if Mr. Hinckley continues

to comply with the conditions of the October 28, 2020 Consent Order and remains mentally stable

until June 2022, Mr. Hinckley would meet the requirements for unconditional release, and they

further agree that the Order for unconditional release will automatically become effective without

further Order of the Court. The parties have no objection to a status hearing being scheduled on a

date convenient to the Court in June 2022.

Upon careful consideration of the agreement of the parties and the lengthy forty-year record

in this case, including in particular the evidence presented to this Court in extensive evidentiary

hearings over the last eighteen years, the Court FINDS and CONCLUDES that:

1. Mr. Hinckley’s diagnosis of major depression (Axis I) has been in full and

sustained remission for more than twenty-five years, and perhaps more than

thirty-two years.

2. Mr. Hinckley’s diagnosis of psychotic disorder not otherwise specified (Axis I),

which was the linchpin of Mr. Hinckley’s overt expressions of violence in the

past, has been in full and sustained remission for more than twenty-five years,

and perhaps more than thirty-two years.

3. Mr. Hinckley’s diagnosis of narcissistic personality disorder (Axis II) continues

to be significantly attenuated from its previous state in the 1980s, when Mr.

Hinckley exhibited intense self-absorption and grandiosity.

4. In the five years that Mr. Hinckley has resided full-time in the Williamsburg,

Virginia community on convalescent leave, he has followed every condition

imposed by the Court. He has participated successfully in music, individual,

and group therapy, he has demonstrated self-awareness of and responsibility for

his mental illness and need for treatment, and he has exhibited no violent,

disruptive, or problematic behaviors.

5. Mr. Hinckley is currently compliant with recommended treatment and has

recovered his sanity such that he does not present a danger to himself or others

because of mental illness if unconditionally released on June 15, 2022.

+

Accordingly, it is by the Court this 30 “day of September, 2021, hereby

ORDERED that Mr. John Hinckley is unconditionally released; it is

FURTHER ORDERED that execution of the Order for unconditional release is stayed until

June 15, 2022; it is

FURTHER ORDERED that Mr. Hinckley shall continue to abide by the conditions set

forth in the October 28, 2020 Consent Order until execution of the Order for unconditional release

on June 15, 2022; it is

FURTHER ORDERED that upon termination of Mr. Hinckley’s current group therapy

with Mr. Beffa in approximately January 2022, Mr. Hinckley will no longer be required to

participate in group therapy, see Consent Order [Dkt. No. 696] at Condition #8; it is

FURTHER ORDERED that the Department of Behavioral Health shall submit a status

letter to the Court and counsel by May 2, 2022, regarding Mr. Hinckley’s compliance with the

conditions of release, his current mental condition, and its position regarding Mr. Hinckley’s

unconditional release from his commitment; it is

FURTHER ORDERED that should either party wish to respond to or comment on the

Department of Behavioral Health’s status letter, or to bring other matters to the Court’s attention,

it shall submit a status letter to the Court doing so on or before May 16, 2022; it is

FURTHER ORDERED that the Government shall submit a status letter to the Court on or

before May 23, 2022, informing the court of its position regarding Mr. Hinckley’s unconditional

release from his commitment; it is

FURTHER ORDERED that a status hearing shall be set for June 1, 2022, at 10:00 a.m., at

which counsel for the Government and counsel for Mr. Hinckley shall inform the Court of their

positions regarding Mr. Hinckley’s unconditional release from his commitment; and it is

FURTHER ORDERED that in the absence of violations of the conditions set forth in this

Consent Order as well as the October 28, 2020 Consent Order for conditional release, the instant

Order for unconditional release shall become effective on June 15, 2022, and the patient, Mr. John

Hinckley, shall be unconditionally released from his D.C. Code § 24-501(d) commitment effective

immediately.

SO ORDERED.

G2. Lea

PAUL L, FRIEDMAN

United States District Judge

DATE:

Z| Zefa

15012 Craw Highway, Unit B 2430 ¢ Brandywine, Marland 20613

Phone: 202 8o8-0800 * Fax: 202-417-3948 ¢ forensicpsychia beneshveaw.com

l | Benesh & Yeaw Consulting LLC

Violence Risk Assessment Update

July 2, 2020

1. Identifying information

Mr. John W. Hinckley, Jr. is a 65-year-old (Date of Birth: May 29, 1955) male who was

committed to Saint Elizabeths Hospital (SEH) on June 22, 1982. He was found Not Guilty

by Reason of Insanity (NGRI) on June 21, 1982 on four counts of attempted murder, four

counts of criminal possession of a weapon, and four counts of possession of a prohibited

weapon after he attempted to assassinate President Ronald Reagan on March 30, 1981,

wounding the President and press secretary James Brady, Secret Service agent Timothy

McCarthy and District of Columbia (DC) police officer Thomas Delahanty. Mr. Hinckley

was discharged from SEH on convalescent leave (CL) status on September 10, 2016

pursuant to the court's conditional release (CR) order dated July 27, 2016.

Mr. Hinckley currently resides at the home of his mother, JoAnn Hinckley, in Williamsburg,

Virginia (VA) along with his brother, Scott Hinckley. He is under the supervision of the DC

Forensic Outpatient Department (FOPD) and receives care from a multidisciplinary

treatment team in Williamsburg consisting of a psychiatrist (Dr. Deborah Giorgi-

. Guamieri), individuai/group therapist (Mr. Car Beffa), case manager (Mr. Jonathan

Weiss), and music therapist (Ms. Nicole Drozd).

2. Reason for Referral

Mr. Hinckley was referred by FOPD for an updated risk assessment; the last risk

assessment | conducted for Mr. Hinckley was completed on July 27, 2018. Specifically,

‘ the Forensic Outpatient Review Board is seeking recommendations regarding

unconditional release (UCR) for Mr. Hinckley.

When asked about his current community supervision status, plans for professional

services and goals for the future, Mr. Hinckley stated, “I feel like it's time [to receive UCR}.

| have done everything asked of me...{and] | don't feel like the check-ins are necessary

anymore.” He further said that if he received UCR from the court, “it’s not like | would be

cut loose from everything.” He clarified this statement, indicating his intention to remain

in group therapy and continue taking his psychiatric medications. Mr. Hinckley also

expressed that his future plans include remaining in the Williamsburg area, continuing to

grow his antique business, and publishing his music and artwork under his own name,

with the hope of earning an income from his artistic endeavors.

3. Notification of the Limits of Confidentiality

Due to the COVID-19 pandemic, this evaluation was conducted on June 9, 2020 via Cisco

WebEx with coordination through Chad Tillbrook, PhD, Director, Forensic Services

Division, DC Department of Behavioral Health (DBH)/Mental Health Services Division

(MHSD). Mr. Hinckley was advised of the following:

2 ne

a. | was contracted by DBH/MHSD to complete this evaluation;

b. The evaluation was to gather information relevant to his risk for re-offending and

to assist the court in making decisions regarding the conditions of his release;

_ ¢. The evaluation would include a comprehensive psychological interview, collateral

interviews and review of medical and court records;

d. The evaluation was for legal purposes, and would not include a treatment

relationship;

e. A report of the evaluation would be made available to his treatment team,

defense attorney, government's attorney and the court;

f |f lam called to testify, the information obtained from this evaluation, as well as

other conclusions, could be made public in court,

g. Although the interview was being conducted via Cisco WebEx due to the COVID-

19 pandemic, no audio and/or video recording of the interview would be produced.

Mr. Hinckley voiced understanding of the parameters of the evaluation and agreed to

participate in the interview.

4. Evaluation Methodology

A forensic psychology evaluation involves answering a question relevant to the court

through the collection of information using several methods. This evaluation included the

following methods: interview of Mr. Hinckley about his personal and medical history for

approximately 80 minutes; review of Mr. Hinckley’s medical and court records; and

collateral interviews with Carl Beffa, LCSW, Mr. Hinckley’s individual and group therapist;

Deborah Giorgi-Guamieri (GG), MD, Mr. Hinckley’s psychiatrist; Jonathan Weiss, LCSW,

Mr. Hinckley's case manager; Nicole Drozd, MS, MC-BT, Mr. Hinckley’s music therapist;

and Chad Tillbrook, PhD, Mr. Hinckley’s point of contact from DBH/FOPD.

Specialized techniques were also used to assess Mr. Hinckley’s relative risk of

reoffending if granted UCR and to identify viable targets for rehabilitation. Similar to the

2018 evaluation of Mr. Hinckley | conducted, | utilized one actuarial tool, the Violence

Risk Appraisal Guide — Revised (VRAG-R), and one structured professional judgement

tool, the Historical Clinical Risk Management-20, Version 3 (HCR-20v3), as part of my

risk assessment. The findings of the risk assessment tools were combined with the

clinical evaluation into an integrated risk management assessment.

5. Sources of Information

All records were provided by FOPD staff members.

© October 16, 2018 - Forensic psychiatric report by Raymond Patterson, MD;

¢ October 22, 2018 - Psychological risk assessment update by Mitchell Hugonnet,

° November 16, 2018 - Court order for conditional release on convalescent leave by

US District Judge Paul L. Friedman;

« September 10, 2019 ~ Status hearing transcript

« August 16, 2018 to October 24, 2018 — Bi-monthly progress reports to the court

drafted by Nicole Johnson, MD;

¢ October 24, 2018 to January 30, 2020 — Bi-monthly progress reports to the court

drafted by Marc Dalton, PhD, and Chad Tillbrook, PhD;

* January 31, 2020 to May 29, 2020 — Bi-monthly progress reports to the court

drafted by Chad Tillbrook, PhD;

¢ August 2018 to May 2020 - Progress notes by Jonathan Weiss, LCSW: Carl Beffa,

LCSW; Deborah Giorgi-Guarnieri, MD; and Nicole Drozd, MSW, MT-BC;

¢ August 2018 to May 2020 - Handwritten daily logs of work and travel by Mr, John

Hinckley, Jr,;

° May 30, 2020 -

letter from Mr. Hinckley’s treatment team, drafted by Mr. Weiss,

emailed to Dr. Ti

librook and Mr. Barry Levine, attorney for Mr. Hinckley.

Also considered were the following:

a. Clinical interview with Mr. Hinckley on June 9, 2020:

b. Collateral interview with Carl Beffa, L

CSW, individual and group therapist, on June

9, 2020;

c. Collateral interview with Jonathan Weiss, LCSW, case manager, on June 10,

2020;

d. Collateral interview with Nicole Drozd, MS, MC-BT, music therapist, on June 10,

2020;

e. Collateral

2020;

f. Collateral interview with Chad Tillbrook, PhD, from OBH/FOPD on June 17, 2020;

g. Violence Risk Appraisal Guide-Revised (VRAG-R);

h

. The Historical, Clinical, Risk Management-20, Version 3 (HCR-20v3).

interview with Deborah Glorgi-Guarnieri, MD, psychiatrist, on June 15,

6. Summary of Recent Evaluations

On July 27, 2018, | completed a Violence Risk Asse

of DBH/FOPD. As part of that evaluation, | opined t

offend with a violent crime over the short and long

his prolonged psychiatric stability and consistent e

at low risk for another psychotic episode. In light

adjustment to the community and strict adherence

the two years he had been on CL, | recommended

of his release. These recommendations

visits with FOPD, reducing the frequen

the radius he was allowed to travel un

ssment for Mr, Hinckley at the request

hat Mr. Hinckley was at low risk to re-

term. In addition, | opined that given

ngagement in treatment, he was also

of his low risk for violence, excellent

to the conditions of his release during

several modifications to the conditions

included: reducing the frequency of his in-person

cy of his phone contacts with FOPD, increasing

accompanied from 30 miles to 75 miles, allowing

him to anonymously publish his music and/or art work, allowing him to reside

independently in approved housing, allowing him to sell his antiques online under the

supervision of his treatment team and discontinuing the daily logs of his activities. | also

recommended that he continue progress toward the following treatment objectives:

a. Utilize the treatment team and thera

while developing intimate relationshi

maintaining close friendships;

Py group as a resource in decision-making

ps and as support in establishing and

b. Maintain direct, honest communication with his treatment team, family members

and friends; and

c. Increase socialization through community engagement and participation in leisure

and educational activities.

On October 16, 2018, Robert Patterson, MD, DFAPA, completed an updated psychiatric

evaluation of Mr. Hinckley at the request of the government's attorney. In his report, Dr.

Patterson opined that Mr. Hinckley’s Unspecified Schizophrenia Spectrum Disorder and

Major Depressive Disorder were in full sustained remission and that his Narcissistic

Personality Disorder was “largely attenuated.” In addition, Dr. Patterson indicated that he

agreed with the recommendations set forth by DBH, which largely matched those

contained in my report, However, Dr. Patterson recommended that Mr. Hinckley should

continue drafting daily logs of his activities because, in his opinion, there were therapeutic

and forensic benefits inherent in the activity insofar as it assisted in the monitoring of his

progress toward increased socialization. Dr. Patterson also recommended that Mr.

Hinckley alternate in-person and remote (e.g., Skype or Cisco WebEx) face-to-face

contact with FOPD each month rather than a lack of face-to-face contact with FOPD

during the months he did not travel to Washington, DC.

On October 22, 2018, Mitchell Hugonnet, PhD, completed a psychological evaluation of

Mr. Hinckley at the request of the government's attorney. Dr. Hugonnet opined that Mr.

Hinckley’s mental illness had been in full remission for at least 20 years and that he had

been at low risk for psychiatric decompensation and acts of violence throughout that time.

Similar to Dr. Patterson’s opinion, Dr. Hugonnet indicated that he agreed with most of the

recommendations made by DBH but he also agreed with Dr. Patterson's

recommendations that Mr. Hinckley alternate in-person and video meetings with FOPD

each month and that he continue to maintain daily activity logs. In addition, Dr. Hugonnet

‘recommended Mr. Hinckley not be allowed to pursue publishing his music and art work

anonymously at the same time due to the “significant and time intensive challenges” it

would present. Dr. Hugonnet also opined that Mr. Hinckley obtaining a website to sell

items as part of his antique mall business was “too complex’ and not feasible.

7, Most Recent Outpatient Course

Given that this evaluation serves as an update to my July 2018 report, Mr. Hinckley’s

psychosocial and psychiatric history is not provided below. The summary below only

covers the events pertinent to Mr. Hinckley's progress on CL over the past two years, For

a more detailed account of Mr. Hinckley’s history, please refer to my prior report.

From August through October 2018 no significant changes occurred with regard to Mr.

Hinckley’s day-to-day activities or his adherence to the conditions of his release. In

October 2018, Mr. Weiss put Mr. Hincklay In touch with a realtor In the Williamsburg area,

Mr, Otey, and Mr. Hinckley began exploring local housing options within his budget. After

speaking with Mr. Otey and the company holding the reverse mortgage on his mother's

home, Mr. Hinckley verified that he and his brother, Scott, would be able to continue

fesiding in their mother's home up to 90 days after her death, Although Mrs. JoAnn

Hinckley, now aged 94, remains cognitively sharp, she has become increasing frail and

Mr. Hinckley, her primary caregiver, has repeatedly expressed that he has no desire to

move out until after her death. However, he utilized the realtor to find an affordable

apartment complex, The Flats of Williamsburg, that he could move into quickly if the need

arises. According to progress notes, a financial analysis conducted by Mr. Hinckley with

Mr. Weiss’ assistance indicated he would have enough money to cover expenses of daily

living and to maintain a used automobile if he moved into a one-bedroom apartment.

On November 16, 2018, a modified consent order was signed by Judge Friedman

- granting Mr, Hinckley permission to reside independently in approved housing within a

7S-mile radius of Williamsburg, alternate in-person and remote face-to-face meetings with

FOPD every month, reduce telephone contact with FOPD to twice per month, and travel

within a 75-mile radius of Williamsburg unaccompanied. The modified order also allowed

for Mr. Hinckley to display memorabilia, works of art or music created by him anonymously

on the internet, with the approval of his treatment team/FOPD, and under the supervision

of Ms, Drozd or Mr. Weiss. However, Mr. Hinckley continued to be restricted from

receiving any financial benefit from the displays, was not permitted to communicate with

anyone who commented on the displays, was not permitted to have his own website, and

was restricted from posting his private antique items online for financial gain.

On the same day the modified consent order was signed, Dr. Nicole Johnson, formerly

Mr. Hinckley’s primary point of contact at DBH/FOPD, informed Dr. Marc Dalton, the DBH

Chief Clinical Officer, that she would be on leave through January 1, 2019. As a result,

Dr. Dalton informed the court he would be taking over responsibility for Mr. Hinckley's

case along with Dr. Chad Tillbrook and Ms. Dana Brooks, LICSW, Supervisory Clinical

Administrator of the Forensic Division. In February 2020, Dr. Dalton separated from his

position and Dr. Tillbrook took over primary responsibility for Mr. Hinckley's case.

Throughout 2019, Mr. Hinckley continued to exhibit excellent adherence to the conditions

of his release. Although he looked for opportunities to volunteer in the community, as

outlined in the court order and recommended by his treatment team, he was turned down

by four different sites. As a result, he increased his focus on his antique business and

began utilizing the 75-mile travel radius to obtain items from estate sales, flea markets

and consignment shops to sell. He rented a larger booth to display his inventory and he

has had no difficulty paying his rent on the expanded space. Mr. Hinckley's work logs

indicate he worked between four and nine hours per day on his business prior to the

COVID-19 pandemic and progress notes detail his use of the antique mall as an avenue

for socialization, as well as employment.

In March 2019, the treatment team described Mr. Hinckley as more positive, optimistic

and happier with himself and his life. He worked with Ms. Drozd to develop a plan to post

his music online through SoundCloud, wherein she would maintain control of the account

and post his music for him. However, very few people accessed Mr. Hinckley’s music

_through SoundCloud and Ms. Drozd suggested posting compositions on YouTube as

well, After registering for an account, she assisted him in creating videos using stock

Images to go with his music and posted the videos under an anonymous band name.

5

Despite switching platforms, views of Mr. Hinckley's songs continued to be low and he

expressed disappointment in the lack of feedback he was receiving. During 2019, Mr.

_ Hinckley also explored with Ms. Drozd future options for earning an income through a

career related to music, such as working in a music store, giving music lessons or selling

jingles. He has not pursued any of these options beyond these preliminary discussions.

During this same timeframe, Mr. Hinckley began dating Ms. H. He first met Ms. H during

_ group therapy but, given that group rules prohibited social relationships among members,

she decided to leave the group in order to pursue a romantic relationship with Mr.

Hinckley. Initially the treatment team reported the relationship as being “beneficial for the

whole family” and described Ms. H as “supportive” and “caring.” Mr. Hinckley was also

noted to be more involved in social activities and began traveling to new venues for

cultural activities within the 75-mile radius. However, after a few weeks, Mr. Hinckley

. @xpressed to his treatment team that Ms. H was demanding too much of his time (i.e., 7-

8 hours per day) and he wanted to set limits within the relationship. Ms. H reportedly did

not respond well to his request to reduce their time together. Subsequently, Mr. Hinckley

reported to his treatment team that Ms. H had “developed a demanding, irritable, angry

and unpredictable disposition.” After seeking guidance and support in individual and

group therapy, Mr. Hinckley ended his relationship with Ms. H on or about June 20, 2019.

‘ According to progress notes, Mr. Hinckley handled the ending of the relationship

“exceptionally well’ and in the aftermath, he was described as having increased self-

confidence and more engagement with the community.

Since his relationship with Ms. H ended, Mr. Hinckley has not engaged in any further

romantic relationships. Although he has remained in daily telephonic contact with Ms. CB,

their relationship continued to be platonic in nature. In early 2019, Mr. Hinckley expressed

to his treatment team a desire to have Ms. CB visit him in Williamsburg given

improvements in her clinical status. The treatment team recommended that prior to Ms.

CB visiting, her case manager be contacted to determine her readiness to travel.

However, no further coordination occurred and Ms. CB has never visited Mr. Hinckley in

_ Williamsburg. ,

On April 10, 2019, Colonial Behavioral Health (CBH), the public mental health provider in

the Willlamsburg area, sent a letter to Mr. Hinckley declining to be involved in his mental

health care. They cited their limited staffing and inability to fulfill the numerous reporting

requirements listed in the current consent order as reasons for refusing him care.

However, they noted that their decision was not related to Mr. Hinckley himself or their

inability to meet his treatment needs generally. After Mr. Weiss investigated the issue

further, it was determined that Mr. Hinckley needed to personaily appeal the decision by

CBH to the appropriate governing agency in Virginia. However, in light of his current

treatment team members indicating their intent to provide care for him through at least

the end of 2020, Mr. Hinckley did not seek an appeal.

In August 2019, after seeking advice from Mr. Beffa and Mr. Weiss, Mr. Hinckley assisted

his brother in seeking medical care and inpatient psychiatric care after his psychological

condition deteriorated and he developed several medical complications. In light of his

4

felicia AeiactiAA LenS ties Sa Pasay Jka neni abalinaivalaat 1 os

- worsening condition, Mr. Scott Hinckley reportedly explored moving to New Jersey to live

closer to his daughter. However, as his mental and physical health improved over the

intervening months, he recommitted to remaining in the Williamsburg area indefinitely.

Records indicate that Mr. Hinckley and his brother remain close and often run errands

together.

In March 2020, the antique mall where Mr, Hinckley has been working closed due to the

COVID-19 pandemic. Shortly thereafter, all of his treatment providers, with the exception

of Dr. Giorgi-Guarnieri, moved from in-person visits to video or telephonic contact. On

April 28, 2020, Dr. Tillbroak informed the court that FOPD would suspend in-person

meetings with Mr. Hinckley and his treatment team; meetings were conducted via Cisco

_WebEx. In progress notes, Mr. Hinckley was described as missing his group therapy and

socialization opportunities at the antique mall. However, the treatment team also noted

that he appeared to be coping well with the increased social isolation during the stay-at-

home order. The antique mall eventually reopened on May 1, 2020 and Mr, Hinckley was

able to sell enough items to cover his rent for the month. He is due to resume group

therapy in late June or early July 2020.

Interview with Mr. John Hinckley, Jr,

Mr. Hinckley expressed his opinion that he has “done very well the last four years” and

he is ready for UCR. He indicated he initially was not in favor of requesting UCR at this

time but, after learning that his treatment team was supportive of such a motion, he

informed Mr. Levine that he should proceed with the filing. Although Mr. Hinckley felt

‘ready to be granted UCR, he believed it would be “futile” to pursue such an action without

the support of his treatment team. He stated he has tried to follow every step required of

him over the last several years and that, at this point, he is unsure what other actions

would prove his readiness for UCR to the court, He further said, “| have never let the

judge down one time...If 1 received UCR | would not let him (i.e., Judge Friedman) down.”

Mr. Hinckley noted that “not a whole lot would change’ if he were granted UCR. He plans

to continue to reside in the Williamsburg area, work at the antique mall, attend group

therapy and take his current psychiatric medications. Mr. Hinckley described himself as

“optimistic” about life and said that over the past two years since | last interviewed him,

he has “felt just great.,.emotionally | just feel fine.” He noted that he “can’t say it’s all the

meds but | think [the Sertraline and Risperidone] is helpful.” Mr. Hinckley said he has

discussed with Dr. Giorgi-Guarnierl transferring his medications to his primary care doctor

in the future due to the fact that he has not changed any medications in several years and

is not experiencing any problematic side effects. However, Mr. Hinckley also indicated he

intends to continue attending appointments with Dr. Giorgl-Guarnieri as long as she is still

providing psychiatric services in the Williamsburg area.

Mr. Hinckley stated that if granted UCR he “would like to make money from my music and

art.” He expounded on this idea, saying "I create things | think are good and like any other

artist | would Ilke to profit from it and contribute more to my family, | feel like | could help

my mother and brother out if] could make money from my art.” Mr. Hinckley said he has

heard from other artists that he might be able to sell his artwork on websites such as Etsy

4

seas ada lea ite aren se tte OF mat in crea a ea:

and he has spoken to Ms. Drozd about various streaming websites where he could post

his music. His intent is to sell his artistic creations under his own name, although he

acknowledged there is “notoriety associated with anything | do under my own name.” In

addition to the financial motivation, which appears to be a secondary consideration for

him, Mr. Hinckley expressed a strong desire to share his work with other people and

receive feedback. He has been frustrated by his difficulty in sharing his work with others

and with the limited comments he has received on the work he has shared to date. When

questioned about how he would handle negative feedback or individuals seeking his work

solely due to his notoriety, Mr. Hinckley said he has dealt with rejection repeatedly over

the past few years without issue and that he works hard to maintain a “low-key” presence

‘in the community. He also insisted that he is not interested in fame, but rather a desire be

able to share his creative endeavors with a wider audience and support his family

financially.

When asked if he had considered a move to California to pursue a career in music if he

is granted UCR, as was mentioned at the status hearing in September 2019, Mr. Hinckley

denied any intent to relocate outside of Virginia. He stated, “I am not going to relocate. |

like it here. It's a peaceful community and | feel comfortable here.” He further said, “With

being online, | wouldn't need to move; you can do that (i.e., pursue a career in art or

music) anywhere.” Mr. Hinckley said he was unsure where the idea of moving to California

came from but that it did not originate with him. When asked further about travel plans,

Mr. Hinckley expressed he has no desire to “do a lot of travel.” He said he has considered

visiting his niece, who is his brother's daughter, in New Jersey but otherwise he has no

plans to travel. He indicated he is generally “not a person who likes to travel” and “with

the way the country is [now with the COVID-19 pandemic] it is not an opportune time for

a 65-year-old man to travel. | prefer to stay at home.”

If granted UCR, Mr. Hinckley said he looks forward to no longer driving to Washington,

DC for in-person meetings with DBH/FOPD, which he dislikes due to traffic and the time

commitment. Mr. Hinckley also expressed that he would have more free time and

schedule flexibility if he were no longer required to conduct telephonic check-ins,

participate in video meetings or complete daily activity logs, In addition, he indicated he

would likely discontinue music therapy and reduce or discontinue individual therapy if he

‘were granted UCR, with the latter being dependent on Mr. Beffa’s recommendation. With

regard to music therapy, Mr. Hinckley sald although working with Ms. Drozd has been

“very helpful,” her work with him has been less about the therapeutic aspect of music for

the past year and more about learning how to record and post his music. This is an area

in which Mr. Hinckley sees himself progressing independently in the future.

In contrast to his desire to discontinue individual and music therapy due to a feeling of

having progressed to a stopping point, Mr. Hinckley was enthusiastic about his

participation in group therapy and adamant that it was something he wanted to continue.

He stated he receives helpful feedback through group therapy and leaves sessions

feeling “better.” He described group members as “nice,” “welcoming,” and non-

judgmental. ; as

» 1 aobaoashitesi aspen Maeda ie ae ala!

When asked about socialization outside of group therapy, Mr. Hinckley cited his

interactions with people at the antique mall, classes he took last year through the

Christopher Wren Association (now called the Osher Lifelong Learning Institute), his

telephone contact with Ms, CB, and his romantic relationship with Ms. H. Mr. Hinckley

said his relationship with Ms. H lasted approximately three months in early 2019 before

he ended it. He described the initial weeks of the relationship in positive terms but said

he began to notice Ms. H was “developing anger at people for no good reason.” According

to Mr. Hinckley, Ms. H had Bipolar Disorder and refused to take her psychiatric

medication. Mr. Hinckley said he encouraged her to attend appointments with her

psychiatrist and resume medication, but she had “no insight into her illness.” As the

relationship progressed, Mr. Hinckley became concerned Ms. H would “create a scene in

public” that would draw negative attention to him. He viewed her behavior as counter to

his attempts to “be low key.” After consultation with Mr. Beffa during individual therapy

and discussing the relationship in group therapy, Mr. Hinckley said he concluded that “for

my wellbeing it was necessary” to end the relationship. Since ending the relationship, he

“never regretted it a day” and he believes that his decision reflected “good judgment.”

Mr. Hinckley said he has enjoyed his work at the antique mall over the past two years and

plans to continue running a booth in the future. He recently rented a storage unit to reduce

the clutter in his mother’s home and allow for him to retain a larger inventory of items to

sell. He estimated that on a “good month" his sales are “in the $1000 range,” allowing him

to easily cover the rent on the space and contribute to household expenses. He noted

that the closure of the antique mall in April due to the COVID-19 pandemic reduced his

income and that he missed the social aspect of his work. Since the re-opening of the mall

on May 1, 2020, his sales have begun to rebound and he has been happy to have a social

outlet outside of his home again. However, Mr. Hinckley also said that he “didn’t feel too

isolated” during the stay-at-home order due to his daily contact with his mother, brother

and cat, Theo.

Over the past two years, Mr. Hinckley has moved into the role of caretaker for both his

mother and his brother. He noted that although his mother’s physical health is quite good,

she is 94 years old and “would be in a nursing home’ if he were not present to take care

of her. Similar to the last time | interviewed Mr. Hinckley, he stated he does not find it

overwhelming to take care of his mother and he is happy to be able to care for her after

all the years she spent caring for him. With regard to his brother, Mr. Hinckley said Scott's

depressive symptoms increased in severity approximately one year ago to the point

where he determined he needed assistance getting treatment for Scott. He reached out

to Mr. Beffa and Mr, Weiss to discuss his plan for seeking treatment; with their assistance,

Mr. Hinckley arranged for his brother to be transported to the hospital to address his

medical issues and then later arranged for him to be admitted to The Pavilion at

Williamsburg Place for psychiatric treatment. Mr. Hinckley said his brother is “doing great

now,” has his “energy back” and “takes care of himself.” However, Mr. Hinckley noted that

he administers his brother's medications each day, which “may not be necessary but !

don't want him to get depressed.”

aA alhewen ey Ver talineeet ike ELLE AN cipal nbz ie iar benlieelaadas

Mr. Hinckley did not identify any financial problems presently. Along with his brother, he

contributes to paying for groceries and “some of the bills." However, he described feeling

“inadequate” because he does not “have much money” to be able to contribute to the

household. Despite his limited finances, he Indicated he has located an apartment

complex he likes nearby his mother's home that would be “affordable” and meet his

needs. Mr. Hinckley stressed he does not want to leave while his mother still needs his

help, although he acknowledged he would be required to move out within 90 days of her

death,

Interview with Carl Beffa, LCSW

Mr. Beffa indicated he supports UCR for Mr. Hinckley at this time because

“he continues to really exhibit none of the symptoms for which he was

hospitalized...in addition, he has continued to display unusual responsibility not

only in terms of doing what he says he’s going to do,...[he] shows extreme

responsibility with his appointments, his job, the business,...but caring for his

mother and taking care of her needs.”

Mr. Beffa also discussed Mr. Hinckley taking on the responsibility of caring for his brother

when he had a “depressive episode” In 2019: “John was the one who intervened..,.got

him to Riverside Hospital and was instrumental at getting him hospitalized at Pavilion.” In

addition, Mr. Beffa opined that Mr. Hinckley demonstrated personal responsibility and

good judgment by taking the initiative to end his relationship with Ms. H “because her

Bipolar symptoms were getting In the way of their having a productive relationship.” Mr.

Hinckley discussed his relationship problems with Mr. Beffa in individual therapy and

brought it up as a topic in group therapy for “several sessions.” Despite his desire for a

romantic relationship, Mr. Hinckley came to the conclusion that “he was wearing out trying

to accommodate her” rather than the relationship being mutually beneficial.

The only area Mr. Beffa identified as an issue for Mr, Hinckley was socialization. Similar

to the last we spoke, Mr. Beffa stated that Mr. Hinckley “doesn't seem to take

responsibility socially, involving himself or taking advantage of opportunities for different

social things going on.” In Mr. Beffa's opinion, Mr, Hinckley has demonstrated “no

ambition or Interest’ in increasing his socialization. Mr. Beffa acknowledged that Mr.

Hinckley had taken advantage of some education classes and has traveled to flea

markets regularly, however, he believed that Mr. Hinckley’s desire to seek out community

events had dwindled over time,

With regard to the increased freedoms and lifting of restrictions that would come with

UCR, Mr. Beffa did not identify any specific areas of concern other than Mr. Hinckley’s

relationship with Ms. CB. According to Mr. Beffa, Ms. CB “calls daily and they talk for a

minute or two...that’s about it.” However, Mr. Hinckley has previously discussed Ms. CB

visiting him in Williamsburg and “he may wall invite her to visit if he is granted UCR.”

Although Mr. Hinckley “knows the ins and outs if something were te happen and he knows

where to refer her if something happens,” Mr. Beffa still sees this relationship as “a

question mark but not a big one,”

10

Otherwise, Mr. Beffa said he has no concerns about Mr. Hinckley living independently,

does not see unrestricted travel as a problem and is “in favor of him being able to make

money through the different sources” of his artistic endeavors. Per Mr. Beffa, Mr. Hinckley

has not only demonstrated the ability to independently care for himself over the past few

years but also to care for others (e.g., his mother and brother). Furthermore, Mr, Hinckley

has shown little interest in travel and has not reacted or responded negatively when he

has been approached by the press while residing in the community, leading Mr. Beffa to

conclude that it would not pose an issue for Mr. Hinckley’s travel restrictions to be lifted.

With regard to displaying his music and art, Mr. Beffa stated,

“| would very much like to see him be able to make an income from his artwork or

his music, If it coincidentally happens his name is attached to it, | don't see it would

be an issue.,.| would be surprised if it reverted back to this narcissism he had with

Jodie Foster because it has not been present in any way whatsoever.”

Finally, in regard to Mr. Hinckley's plan to stop or decrease individual therapy while

remaining in group therapy, Mr. Beffa concurred. Mr. Beffa indicated Mr. Hinckley benefits

less from individual therapy than he does from group therapy and he is supportive of Mr.

Hinckley decreasing individual therapy to a “check-in every three or four months.”

However, Mr. Beffa said he plans to retire in the next few years and, at that time, he would

-no longer be conducting group therapy. In Mr. Beffa’s opinion, there are no other suitable

therapy groups for Mr. Hinckley to join in the Williamsburg area at this time.

Interview with Deborah Giorgi-Guamieri, MD

According to Dr. Giorgi-Guarnieri, during his time on CL Mr. Hinckley has “transitioned

from being the one looked after and cared for to the one who looks after and cares for.”

This had led him to experience some situational stress, but in Dr. Giorgi-Guamieri’s

opinion “he has done very well.” There have been no changes in Mr. Hinckley’s psychiatric

medications since his release on CL; he continues to take 125mg Zoloft® every morning

and 25 mg Zoloft® and img Risperdal® every night. Although Dr. Giorgi-Guarnien

discussed adding Buspar® to this regimen two years ago to address mild side effects,

Mr. Hinckley informed her he was content with his current medications.

When asked about Mr. Hinckley’s future psychiatric care, Dr. Giorgi-Guarnieri said

although she has “no plan to transfer his care in the near future” she is not opposed to a

primary care doctor managing his psychiatric medications. Although she expressed that

most primary care doctors are as not as knowledgeable as psychiatrists about the side

effects of psychiatric medications, Mr. Hinckley does not identify any problems managing

side effects and has been stable on his current medication regimen for many years. In

addition, she noted that a primary care doctor could easily consult with a psychiatrist or

refer Mr. Hinckley to a psychiatrist in the community should an issue arise with his

medications.

Dr, Giorgi-Guarnieri said she is aware of Mr. Hinckley’s plan to pursue an “artistic career’

if he is granted UCR, including publishing music in his own name. In her discussions with

11

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mmmllye

UNknown of how Mr,

indicated she has a co

She Stated, “I don't think h

490. So, | don't k a

Hinckley he is" now how he would handle it if people wanted that

trictions, Dr, Giorgi-Guarnieri stated, “I don’t

really know that would presenta risk but then again we haven't really explored that...travel

can be stressful in its own right.” She has discussed possible stressors and negative

interactions that could occur with Mr. Hinckley but his response remains consistent that

he “wouldn't Pay attention to it.” Although Dr. Giorgi-Guarnieri said the confined spaces

associated with air travel may challenge Mr. Hinckley’

Stress associated with travel are likely to remain untested for the foreseeable future given

the COVID-19 pandemic and his general lack of interest in traveling,

Dr. Giorgi-Guarnieri said she did not support UCR for Mr. Hinc

after going through the conditions of his release item by item with the rest of the treatment

team earlier this year, she came to the conclusion that, while the risks associated with

unrestricted travel and pursuing artistic endeavors freely were untested, if Mr. Hinckley

was granted UCR he was unlikely to pose a risk to himself or the community. She opined

that his affective and thought disorders are “nice and Stable...his Narcissistic Personality

Disorder is well buffered” and “he has as strong defenses as he can have right now.”

Although she acknowledged it is possible for Mr. Hinckley to experience a significant

event that could “break through those defenses,” he has already experienced a number

of setbacks and losses without a related relapse in symptoms. She further expressed that

Mr. Hinckley remaining under court supervision for another year would be unlikely to

provide additional useful information regarding his long-term risk for violence.

Interview with Jonathan Weiss, LCSW

kley prior to 2020, However,

12

Amiel ie ry ] Lie eaves hoe ee De

Mr, Weiss stated that in the “past few years since we last spoke, | have just continued to

see John become more in touch with himself and his life here in the community.” In

contrast to the rest of the treatment team, Mr. Weiss indicated that he does not see “the

socialization [or lack thereof] as big an issue as they do” with regard to Mr. Hinckley’s

progress and adjustment to the community. In Mr. Weiss’ opinion, “John's nature and his

experience in life in being rejected have colored and informed his socialization. | know he

is tired of being rejected.” However, Mr. Weiss’ perception is that Mr. Hinckley is “happy

_and content” and “doesn’t seem to have a ton of other social needs” outside of his work

at the antique mall and his relationships with family members. Mr. Weiss believes “he [Mr.

Hinckley] has the right to form this world the way he wants now that he's out of the

hospital’ and given Mr. Hinckley's shyness, he may not desire or need more socialization

than he has currently.

Mr. Weiss indicated that the one social aspect of his life Mr. Hinckley has expressed a

desire to improve is with regard to romantic relationships. According to Mr. Weiss, Mr.

Hinckley has indicated he would like to meet someone he could date but that he has

found it difficult to do so. Mr. Weiss discussed Mr. Hinckley's relationship with Ms. H in

2019, stating “John loved having a relationship, the intimacy, but he came to the decision

this [relationship] was not good for him.” Mr. Weiss said he had lunch with Mr. Hinckley

and Ms. H on one occasion and that Mr. Hinckley also discussed his relationship with Ms.

H with him. Mr. Wiess described Ms. H as someone who “would flip from being very kind

to hostile and intense.” Mr. Hinckley eventually “became more concerned” that Ms. H

would “potentially cause him problems’ because she was making accusations of other

people and calling negative attention to herself in public. As a result, Mr. Hinckley decided

to end the relationship, a decision Mr. Weiss opined was “not easy” but “wise.” Mr. Weiss

said since the ending of this relationship in mid-2019, he is not aware of Mr. Hinckley

dating anyone else.

Mr. Weiss indicated that since the modified court order was put in place in late 2018, he

attempted to assist Mr. Hinckley in showing some of his art work anonymously. However,

“the anonymous thing had too many challenges” and “we have not moved down that road

a whole lot.” When asked his opinion about Mr. Hinckley publishing his music or art work

under his own name in the future, Mr. Weiss said he did not believe it would present any

significant problems. In Mr. Weiss’ view, Mr. Hinckley has dealt with the notoriety of his

name for many years without issue and would likely continue to do so in the future. Mr.

Weiss opined, “It (i.e., publishing his music and art) may not go the way he wants but he

will handle it well.” He explained further by saying,

“The one piece of him that is very dear is his belief in his own artistic ability. He

wants to see that through before God takes him. It’s been very frustrating.

{However}, if the court would allow him [to publish in his own name] ... | believe he

will be fine. | don't know if he will be successful [but] that's an answer to a question

that John needs to have.”

With regard to Mr. Hinckley galning financially from his artistic endeavors, Mr. Weiss said,

“My sense of John is he likes money like everyone does, He works hard to make money

13

at the antique mall {and} part of making money would be to help his family. They are really

tight now.”

Despite his assertion that the Hinckley family is on a tight budget, Mr. Weiss indicated

that Mr. Hinckley would be able to financially support himself after his mother dies. Mr.

Weiss has visited the apartment complex Mr. Hinckley is planning to move into (i.e., The

Flats of Williamsburg) within 90 days of his mother's death and itis a suitable place for

him to reside, although “it's basi

c." In Mr. Weiss’ opinion, Mr, Hinckley has managed his

finances well and the combination of his income from the antique mall and his benefits

would allow him to cover rent, food, transportation and other ne iti

However, Mr. Weiss indicated that if his brother were to reside with him, as is currently

the plan, he could likely afford a larger apartment with more amenities.

Mr. Weiss said he regularly visits Mr, Hinckley at home and there have been “no

indications of problems” in the Hinckley home. Mr. Hinckley continues to get along well

with his mother and brother

: ‘they are a happy family” from Mr. Weiss’ perspective, Mr.

Weiss reported that Mr. Hinckley has become the primary caretaker of his mother, and

also his brother to some degre

or negative feelings in Mr, Hi

as caretaker and expressed his

opinion that Mr. Hinckley has

handled the responsibility well.

Mr. Weiss Stated that he is in support of Mr, Hinckley being granted UCR at this time

because he has the “belief that John is ready for it.” He noted the progress Mr. Hinckley

has made over time, particul

arly his move toward independence, In addition, Mr. Weiss

expressed that Mr. Hinckley is “su

ch a different man” than when he met him six years

ago, He described Mr, Hinckley as “depressed and uncertain" at that time but he has not

shown any indication of major thought or affective disorders for years. In addition, Mr.

Weiss opined that Mr. Hinckley's

“narcissism is certainly muted," as evidenced by his

ability to listen and relate more easily to other people. According to Mr. Weiss,

“John is ready [for UCR]. He can handle it. | have no concerns if he {s granted

UCR...He is not the man he was before. He makes good decisions, has empathy

and compassion. He's a smart man. He's a caring man, To me

he’s healthy,

mentally healthy. | don't see any problems in John being able to make it and be an

asset to the community and do a good job for himself and his family should the

court allow him."

Mr. Weiss indicated that if the court grants Mr. Hinckley UCR, he would continue to be

available to Mr. Hinckley on an as needed basis. He Stated that he has not functioned as

a traditional case manager for several

years in light of Mr. Hinckley’s ability to function

independently at a high level, He sees his role over the past two years as being “a

sounding board” for Mr, Hinckley, ,

Interview with Nicole Drozd, MS. MT-BC

Ms. Drozd indicated that over th

€ past two years she has primarily been working with Mr.

Hinckley on sharing his music

with others anonymously through media streaming. She

14

aaa availa Nha a team socitiees

views the change in the court order in 2018 as a positive step for Mr. Hinckley because

prior to the modification his inability to share his music had become a “barrier In music

making.” Since late 2018, Ms. Drozd assisted Mr. Hinckley in posting his music to

SoundCloud and YouTube anonymously without the ability to view or post comments.

However, she noted that the number of views has been “extremely small” and Mr.

Hinckley has been “disappointed” in the lack of feedback he has received.

Due to the COVID-19 pandemic, Ms. Drozd conducted her appointments with Mr.

Hinckley on Skype for the months of April and May. During this timeframe, the focus of

the sessions was primarily on “encouraging him to learn a couple of things

technologically...as far as sending an attachment or doing something creative through

Google Docs.” Ms. Drozd noted that since his ability to work In his antique business was

limited during these months, Mr. Hinckley was creating more music and had greater

opportunity to become more technologically knowledgeable. However, in her opinion, his

knowledge of technology and social media remains limited and will-be a hurdle for him to

overcome in the future should he be allowed to independently post his music. She

explained, “John is really behind generationally being hospitalized so long. He doesn't

understand Facebook, YouTube or Instagram. Social media is a barrier and a struggle.”

With regard to sharing his music under his own name, Ms. Drozd stated her “biggest

concern about it is that it won’t be well received.” She indicated she has spoken with Mr.

Hinckley about this issue at length because “I worry he’s a well-known figure and | worry

about someone trolling him.” Mr. Hinckley responded to these discussions with some

frustration, pointing out that he has had to deal with people seeking him out for his

notoriety for many years. Despite this concern, Ms. Drozd said she believes “it's important

he has an outlet to share; it’s his creation and it’s how he engages in a creative way.” She

acknowledged that Mr. Hinckley being able to earn money from his music “can be very

controversial” but she said in her opinion, “| don’t think it would be a huge issue.” Ms.

Drozd has explored various avenues for Mr. Hinckley working in a music-related career

field but said the options are very limited given Mr. Hinckley’s lack of educational

background in music and the ease of creating music online, which has decreased

opportunities for full-time employment writing music (e.g., jingles for advertisements).

When asked about recommendations for continuing music therapy, Ms. Drozd is in

agreement with Mr. Hinckley's desire to discontinue therapy should he receive UCR. She

stated, “From my paint of view | don’t think he needs a music therapist at this point. He'll

need help with posting [his music] but that's not something a music therapist has to do.”

She noted that she has worked with Mr. Hinckley “for a while” and the barrier to him

creating music freely has always been his inability to perform the music he creates. In

Ms. Drozd’s opinion, Mr. Hinckley is able to independently use music to cope with stress

and express himself. Therefore, “it's not so much being a therapist for him as being an

advocate for him as far as what he can do with his music. If he was free to do what he

wanted (i.e., being granted UCR), he wouldn't need me.” .

Interview with Chad Tillbrook, PhD

15

ame involved i j

as the Directo ft eae Hinckle

y'S case in November

bones: he Bis orensic § vices Division for DBH. is rls in a ae wa ee

inckley : Course o 019 an at the eng of J Mary 29029 he took ov rane

a, Hinde p Mary Point Of contact at DB FOP r Tillbrook has b in : a,

Ree ey eve two Weeks vj either telephon rCj ebEx me tt od

? ser eeti QS in Was INgton, D ery other H prior to D 19 sis, if

Forme . ang issued IN March 2020. Dr. Tillbrook | Nducte © home Visits

CKiey's pr Qréss an linical Status Stated } 7

Whatsoeve egardi 9 Mr. H Nckley's IVINg Situation UriNg these on describing ®

Clean and tidy.” Dr. Tillbrook Said both Mr. Hinckley’ snare

an Welcoming” and “

"he laboratag

eir next Meeting and will

D should be informed

ital). In addition,

ey “is maintaining his employment, Participating in individual and

group therapy, is Medication adherent, and has Primary responsibility for the well-bejn

Of his family. He is higher fu

Nctioning and has some insight and js ve

about what he Needs to do,” In Ti inion, it j

John is doing right now to UCR.”

* g Ss

'

; ‘ : k

ing publishing his music and artwor

. ' j with Mr. Hinckley regarding P a“ imited because

Dr. Tillbrook's and camming an income from these iota ten aoe said

in his own nam Is due to his court order. Gr, Ur. is hawee

t ue these goals : 7 iffi ulty getting his music

he knows he can purs been “frustrated” by his diffic ized to Dr, Tillbrook

he is aware Mr. sant received, Mr, Hinckley has al hag viewpoint

a ae a “how | measure up against my peers.” From Dr,

his interest in se '

16

it is this aspect, rather than any financial incentive, that Is driving Mr. Hinckley's desire to

display his music and artwork more freely.

According to records, Mr. Hinckley has never submitted a request to FOPD for travel

outside the area specified in the court order. When queried about this issue, Dr. Tillbrook

indicated that, outside of expressing an interest to attend his niece’s wedding in New

Jersey, Mr. Hinckley has not made any comments suggesting he desires to travel. in Dr.

Tillbrook's opinion, Mr. Hinckley’s lack of interest in traveling is partially due to his concern

about leaving his mother alone for an extended period of time given that he is her primary

caregiver. With regard to future relocation, Mr. Hinckley informed Dr. Tillorook that he has

no interest in moving outside of Virginia and further said, he can pursue his interests in

art and music “from the comfort of home.”

Given the repeated discussions over the past four years regarding the retirements of

several members of Mr. Hinckley’s current treatment team, Or. Tillbrook suggested that

plans should be put in place for ongoing care for Mr. Hinckley. CBH initially was projected

as the most straightforward choice for transitioning Mr. Hinckley’s care. Dr. Tillbrook

expressed some frustration with CBH and their unwillingness to provide mental health

care for Mr. Hinckley. However, he observed that Mr. Hinckley forms relationships with

his treatment providers easily and “could form similar (treatment) relationships with other

people” should members of his treatment team retire.

8. Current Mental Status

Mr. John Hinckley, Jr. was a male of average stature and above average weight who

appeared his stated age. He was dressed appropriately and he evidenced adequate

grooming. During the interview, Mr. Hinckley was alert and oriented to person, place, and

time. Throughout the evaluation, he was calm, pleasant and cooperative. His eye contact

was very good, He demonstrated no significant psychomotor agitation or slowing. His

rate, tone and volume of speech were normal. He has consistently demonstrated average

to high average intellectual functioning on past formal testing and during the current

evaluation his cognitive functioning appeared intact.

When asked to describe hls mood, he stated, “I always feel good through the day.”

Throughout the evaluation, he demonstrated a full range of emotional expression that

‘was appropriate to the conversation content. He did not demonstrate flat or blunted affect,

as has been noted In prior evaluations. His thought processes were goal directed and

flowed logically, with no evidence of abnormalities of perception, delusions (erroneous

fixed beliefs) or grandiosity. He did not endorse experiencing auditory, visual, tactile or

olfactory hallucinations during his lifetime. His judgment appeared non-impaired although

it has historically been poor, particularly early in his hospitalization at SEH. His insight

was good. He did not endorse any suicidal thoughts since 1983 or homicidal thoughts

since the time of the instant offenses, He was able to report the names and dosages of

his medications, as well as the purpose of his medications.

9, Current Psychiatric Medications

Zoloft® 125mg every morning/25mg every evening

17

Risperdal® img every evening

10.DSM-5 Diagnoses

296.36 Major Depressive Disorder, Recurrent, In Full Remission

298.8 Other Specified Schizophrenia Spectrum and Other Psychotic Disorders, In Full

Remission

301.81 Narcissistic Personality Disorder

301.20 Schizoid Personality Disorder, premorbid

11.Risk Assessment

Actuarial Assessment of Violence Risk: VRAG-R

Actuarial assessments of risk give estimates of risk for general violence; they do not

provide predictions of how serious the violent recidivism would be if it did occur.

Furthermore, assessments of risk are a measure of individuals’ risk when they are given

the opportunity to reoffend such as when placed in the community upon release, In a

minimum-security psychiatric hospital or at a halfway house. The VRAG-Revised'! was

first published in 2013, with wider release in 2015.

Given the actuarial nature of the VRAG-R, Mr. Hinckley’s score remains unchanged at -

22, placing him in the 2™ category of 9 total risk levels (with the 9" category being highest

risk), Offenders in this category violently recidivated at an average rate of 12% aver five

years and 24% over twelve years. This places him at a low likelihood of recidivism

compared to violent offenders generally. Given the standard error of measurement (SEM)

for the VRAG-R (+/- 2.19 points), Mr. Hinckley’s risk score could be as low as -24 or as

high as -20, with the former score moving him down to the 1% risk category with an

average rate of violent recidivism of 9% over five years and 15% over twelve years.

However, as noted in my last assessment in 2018, follow-up research on the VRAG-R

has demonstrated lower recidivism rates across all nine risk levels as time in community

offense-free increases. Hence, conservatively adjusting Mr. Hinckley's VRAG-R scores

for only the past four years he has had full-time access to the community results in

expected recidivism rates consistent with the lowest category of risk (l.e., 6-16%).

4. Lived with both biological parents to age of 16 (yes) = -2

2. Elementary schoo! maladjustment (no) = -3

3. History of alcohol or drug problems (0 out 6) = -2

4. Marital status (never married) = +4

5. Criminal history score for nonviolent offenses prior to

the index offense (score of 1) = ~4

6. Failure on prior cond. release (no) = 2

7. Age at index offense (26) = +4

8. Criminal history score for violent offenses prior tothe

index offense (score of 0) _ 8 -2

9. Number of prior admissions to correctional institutions (0) = 2

1 Harris, G.T, Rica, M.E., Quinsey, V.L., Cormier, ©.A, (2015). Violent Offenders: Appraising and

Managing Risk, Third Edition. Washington, DC: American Psychological Association.

18

410. Conduct Disorder before age 15 (0 point) = -2

41.Sex offending history (no known hands-on offenses) = -2

42.PCL-R Facet 4 score (score of 0) = -6

TOTAL VRAG-R SCORE = -22

Structured Professional Judgment of Risk Factors: HCR-20 Version 3

In order to further delineate and describe the risk level Mr. Hinckley may pose, he was

rated on the 20 items of the HCR-20 Version 32. In my opinion, Mr. Hinckley’s ratings on

the HCR-20v3 suggest he is in the low range of risk for Future Violence, Serious Physical

Harm and Imminent Violence.

My ratings of Mr. Hinckley on these items are listed in the table below.

ITEM RATING | RELEVANCE

Hi. Violence Y High

H2. Other Antisocial Behavior N Low

H3. Relationship Instability _ Y Moderate

|_H4. Employment Problems Y Moderate

H5. Substance Use Problems N Low

H6. Major Mental Disorders Y High

H7. Personality Disorder Y Moderate

H8. Traumatic Experiences N Low

H9. Violent Attitudes N Low

H10. Treatment Response Y Moderate

C1. Lack of Insight N Low

C2. Violent ideation or Intent N Low

C3. Active Symptoms of Major Mental Illness N Low

C4. Instability N Low

| C5. Treatment or Supervision Response N Low

OUT

R1. Professional Services and Plans N Low

R2, Living Situation P Low

R3. Personal Support P Moderate

-R4. Treatment or Supervision Response N Low

R5. Stress or Coping N Low

The above ratings are largely consistent with the risk assessment | conducted in 2078.

However, please note changes in the areas of Professional Services and Plans, Living

Situation, and Personal Support, which are further described below. The following HCR-

-20v3 factors have been identified as being relevant in assessing Mr. Hinckley’s risk for

future violence:

2 Douglas, K.S,, Hart, S.D,, Webster, C,D., Belfrage, H, (2013). HCR-20"3: Assessing Risk for Violence.

Vancouver, Canada: Mental Health, Law and Palicy institute: Simon Fraser University.

19

History of Violence/Access to Weapons

Mr. Hinckley's instant offenses were his first serious acts of violence and increase hls risk

for future violence. However, he has not engaged In any further acts of violence since the

instant offenses, nor has he evidenced any other antisocial behaviors. Mr. Hinckley's past

acts of violence occurred in the context of a lengthy period of serious mental illness,

. marked by prolonged social isolation, depression and grandiose delusions. However,

these symptoms of mental illness have been in remission for decades (see next section).

Mr. Hinckley committed his violent acts using firearms he had spent several months

acquiring. There is no indication Mr. Hinckley has sought access to weapons since the

instant offenses and both his mother and brother have consistently reported that there

are no firearms in his residence, in compliance with the court order.

Major Mental and Personality Disorders

Mr. Hinckley is diagnosed with Major Depressive Disorder (MDD), Other Specified

Schizophrenia Spectrum and Other Psychotic Disorders, and Narcissistic Personality

Disorder. His major depressive and psychotic disorders have been in full remission for

over 30 years. In addition, Mr. Hinckley has not verbalized or shown evidence of suicidal

ideation since 1983, when he last attempted suicide. Although Mr. Hinckley has

demonstrated some fluctuations in mood in the past, this has primarily occurred in the

context of stressful life events. Mr. Hinckley has not had any notable periods of low mood

or hopelessness since his release on CL. In fact, his treatment team and family have

noticed marked improvements in his mood and emotional expression; he was repeatedly

described as appearing “happy” and “optimistic” since his discharge on CL.

The death of Mrs. Hinckley has the potential to be traumatic for Mr. Hinckley when it

occurs. However, he has managed other significant losses (e.g., the death of his father

in 2008) appropriately, demonstrating normal bereavement reactions rather than

symptoms of a major depressive episode. It is evident that Mr. Hinckley has thought about

his mother’s death and has been preparing himself for its eventuality through discussions

with his treatment team and members of his therapy group, as well as planning for future

housing. In addition, he has previously informed his SEH treatment providers when he

was experiencing increased anxiety and requested changes In medication to manage his

mood symptoms. Therefore, he is likely to reach out to his treatment team in the future

' should he experience an increase in anxiety or depressive symptoms in the context of his

mother’s death or any other stressful life event.

Although Mr. Hinckley Is diagnosed with Narcissistic Personality Disorder, treating

providers and other evaluators have noted that Mr. Hinckley’s narcissism has been

significantly attenuated over the past three decades. Consistent with prior risk

assessments, there were no overt signs of this disorder present during the current

evaluation. Furthermore, Narcissistic Personality Disorder is not by Itself directly

correlated in the scientific literature with increased risk for violence. Rather increased risk

is associated with antisocial personality traits and characteristics of hostility and

dominance, which are not demonstrated by Mr. Hinckley. .

Relationship Instability

Mr. Hinckley did not have a history of reciprocal romantic relationships prior to the Instant

offenses and had distanced himself from his parents and siblings. Furthermore, his

obsession with Jodie Foster, including his grandiose delusion of winning her love and

respect, was a significant component of his conduct In the instant Offenses. These issues

suggest that interpersonal relationships are a relevant factor in assessing Mr. Hinckley's

risk for future violence,

While hospitalized at SEH, Mr. Hinckley engaged In several romantic relationships, with

varying lavels of stability and longevity. At times he demonstrated difficulty adhering to

appropriate boundaries, particularly with female staff members, and engaged in poor

decision making by failing to disclose relevant information to his treatment team (e.g., Ms.

LD purchasing a book on Jodie Foster in 1998). However, over the past two decades

there has been no evidence that he has behaved inappropriately toward women or that

he has experienced any obsessions or delusions relating to women.

Mr. Hinckley’s most recent romantic relationship occurred approximately one year ago

with Ms. H, While this relationship only lasted three manths, his treatment team observed

an Increase In his self-confidence and willingness to interact with people in the community

in the aftermath of the relationship. In addition, Mr. Hinckley's decision making with regard

to attempting to set limits with Ms. H and ending the relationship due to her escalating

behavior demonstrated Improved insight and judgment in comparison to his Interactions

with women earlier in his life. While Mr. Hinckley has not entered into another romantic

relationship over the past year, he continues to express a desire to date in the future and

appeared more optimistic about this aspect of his life than when | spoke with him two

years ago.

The benefits of interpersonal relationships have been repeatedly stressed to Mr. Hinckley

by his treatment team but limited progress has been made In this area since the last risk

assessment in 2018. Although Mr. Hinckley has acknowledged a need to make

improvements in this area and sald he is willing to work on his social sklils, his motivation

to seek out new opportunities for socialization is low. He is introverted and shy and has

experienced multiple rejections during his time residing in the community. These are

significant impediments to increasing his socialization. However, It Is clear from progress

notes and my Interview with Mr, Hinckley that he does socialize with Individuals at the

antique mall nearly every day and in group therapy on a weekly basis, He has also

developed close relationships with his mother and brother, aven stepping Into the role of

primary caregiver ~ a role he has handled very well. As a result, he Is no longer socially

isolated as he was prior the Instant offenses, and he appears to have benefited from the

limited social outlets he has developed over the last four years. .

Treatment Response - Minimization/Deception

Mr. Hinckley has a lengthy history of minimizing negative emotions, engaging In deceptive

behavior and failing to report pertinent Information (I.¢., balng secretive) to his treatment

team, particularly early in his hospitalization as it related to his relationships with women’

and correspondence with others. However, there have been no documented incidents of

ai

onal Aiea lla cerita Mil panel lesb iast Santie otk keeles 4 Heel

deceptive behavior since 2011, when Mr. Hinckle lied on two o

‘Whereabouts. In addition, since his discharge from SEH in 2016, hans Cae =

to comply with the conditions of his release, In fact family and

treatment providers have commended Mr. Hinckley for his rigid adherence to the rules

set out in his court order, particularly with regard to the travel restrictions. Mr. Hinckley

has maintained a daily log, as instructed by the court, and has consistently reported on

his activities to Mr. Weiss, Dr. Giorgi He has also developed

productive relationships with the members of his treatment team, who have noted his

honesty and increasing openness during both individual and group sessions. Mr, Hinckley

has repeatedly expressed that he finds his treatment beneficial and identifies his positive

response to treatment as a large factor in his psychiatric stability.

Insight

Poor insight has historically been a risk factor fo

throughout the first two decades he was at SE

and group therapy, Mr. Hinckley has increasingly demonstrated improved insight into his

emotions and behaviors. He reflects on feedback provided by his treatment team and

incorporates it in his decision-making, most notably in regard to his relationships with

women. Although Mr. Hinckley occasionally exhibited errors in judgment early during his

period of CL (e.g., approaching a woman in his therapy group outside of group), his

insight, overall, is quite good and is not presently a risk factor.

r Mr. Hinckley and was clearly present

H. However, through years of individual

Professional Plans and Services

It is anticipated that Mr. Hinckley will experience changes in the composition of his

treatment team and level of care over the next few years, regardless of whether he is

granted UCR or remains under court supervision. However, he has managed previous

changes of treatment providers well, without signs of psychiatric decompensation, and it

is not expected that changes in either the level of care or his providers will result in an

increase in his risk.

| discussed future plans for Mr, Hinckley's professional services with all members of his

current treatment team. Mr. Beffa was in support of Mr. Hinckley decreasing the frequency

of individual therapy to 3-4 times per year, Ms. Drozd agreed with Mr. Hinckley’s

assessment that he no longer required the services of a music therapist, and Mr. Weiss

indicated his willingness to be available to Mr. Hinckley on an as-needed basis and

agreed that Mr. Hinckley no longer requires traditional case management services, In

addition, Dr. Giorgi-Guarnieri acknowledged that Mr. Hinckley’s primary care doctor would

be able to manage his psychiatric medications given that he has been stable on his

current regimen for many years and does not identify any side effects that would need to

be addressed. Therefore, although CBH has declined to provide Mr. Hinckley services

and many members of his current treatment team will retire in the next few years, Mr. e

Hinckley’s plan for utilizing professional services in the future appears appropriate and in

line with the recommendations of his treatment team.

Living Situation

Mr. Hinckley's current living situation Is stable and also provides a source of sociallzation

for him, particularly since his brother moved into the home In June 2017, His brother's

presence and willingness to continue to reside with Mr, Hinckley after their mother's death

also increases the long-term stability of his living situation, reducing Mr. Hinckley’s future

tisk. Since the last risk assessment, Mr. Hinckley has confirmed that he has 90 days to

move out of his mother’s house after her death and he has identified affordable and

suitable apartment housing nearby in Williamsburg. In addition, Mr. Hinckley said he plans

to explore additional options in Newport News over the next year, given that rents are

generally lower in that area.

Personal Support

Mr. Hinckley’s family continues to be extremely supportive of him, both emotionally and

financially. Mr. Scott Hinckley moved to. Williamsburg in June 2017 and continues to

express his intent to live with his brother in Williamsburg after their mother’s death. Both

brothers and the treatment team reported that Scott and John’s relationship has grown

much closer over time and they routinely spend time together both running errands and

attending community events. In addition, Mr. Hinckley stepped Into the role of caregiver

for his brother in 2019, arranging for medical and psychiatric care for him and

administering his medications. With regard to financial support, although the famlly is on

a budget, they are comfortable with the current manner in which expenses are shared.

Furthermore, Mr. Hinckley's benefits and steady income from his antique mall business

increases his financial stability.

In addition to family support, Mr. Hinckley has also begun to establish relationships In the

community through his business endeavors and attendance at group therapy. However,

both Mr. Hinckley and his treatment team agree that this is an area in which Mr. Hinckley

needs to continue to make progress.

Social |solation

While social isolation is not a risk factor specifically delineated on the HCR-20v3, It is

related to relationship instability, employment instability, and personal support and has

been identified as a specific risk factor for psychiatric decompensation for Mr. Hinckley.

Although some members of the treatment team remain concerned that Mr, Hinckley does

not engage in enough social activities, there Is general agreement that he has increased

his level of socialization since his discharge from SEH nearly four years ago. He regularly

socializes with employees, customers and other vendors at the antique mall where he

has a booth and he expressed missing this social outlet during the COVID-19 shut-down

mn March and April 2020. In addition, he actively participates in group therapy and

occasionally attends events In the community, Including educational lectures and flea

markets. In addition, the presence of Mr, Scott Hinckley in Williamsburg has clearly

helped to decrease Mr. Hinckley's Isolation; they fraquently run errands together and have

attended community events. Mr. Hinckley’s relationship with Ms. H approximately one

year ago Is another indication of Increased socialization and his decision to end the

‘relationship suggests improvements In his insight and judgment with regard to

Interpersonal relationships.

Mr. Hinckley has expressed a desire to develop close friendships and a romantic

relationship, both of which he admitted are lacking in his life. Repeated social! rejection

has certainly impacted the manner in which Mr. Hinckley engages with others and leads

him to feel some trepidation participating in community events on his own. Although Mr.

Hinckley’s music and art were a point of connection for him in the past, his frustration with

his inability to openly share his work and obtain feedback from a broader audience has

negatively impacted his interest in pursuing creative endeavors, In my opinion, the

restrictions on Mr. Hinckley publicly performing and sharing his music represents a lost

opportunity for him to increase socialization through shared interests with others.

Currently, Mr. Hinckley is not displaying signs of the isolative behavior that marked the

years prior to the instant offenses and contributed to his psychiatric decompensation and

psychosis. He appears very engaged in his business endeavors and has welcomed the

opportunity to become a productive member of the community through the antique mall.

Although he does not take advantage of all Opportunities for social engagement

Suggested by his treatment team, he has clearly made efforts to socialize with members

of the community and has attended some events when he feels comfortable doing so.

12.Conclusions and Risk Management Recommendations

Mr. Hinckley’s potential to act out violently is primarily associated with prolonged social

isolation, major depressive episodes and psychosis marked by grandiose delusions. It

remains my opinion, in concordance with my last risk assessment, that he is at low risk

for another psychotic episode due to the fact that onset would follow a lengthy period of

social isolation concomitant with other depressive symptoms, which have been in

remission for over three decades. Mr. Hinckley’s scores on actuarial and structured

professional judgment risk tools suggest there is a low likelihood he will re-offend with a

violent crime over the short and long term. Furthermore, itis expected that his level of risk

will continue to decrease with time in light of his psychiatric stability, significant

improvements in his insight and judgment, and his excellent adjustment to residing in the

community over the past four years. Given these factors, it is my opinion that Mr. Hinckley

will not pose a danger to himself or others if he is granted unconditional release from the

court.

In assessing Mr. Hinckley’s suitability for unconditional release, the primary consideration

is the level of risk he would pose to others and himself if the 30 conditions detailed in the

November 16, 2018 court order were removed. In arriving at my recommendation that Mr.

Hinckley be considered for UCR, | evaluated how each of these conditions impact Mr,

Hinckley currently and potential issues that may arise in the future if restrictions are lifted.

1. Living Situation. Mr. Hinckley has been adamant that he will not move out of his

mother's home until after her death. He has been her primary caregiver for the past

four years and has shown a high level of dedication and responsibility in caring for

her, as well as his brother. Despite locating a suitable apartment nearby in which

he could live independently, he has chosen to remain in his mother's home where

he prepares many of the meals, cleans the home, runs errands and financially

24

contributes to household expenses. However, Mr. Hinckley is aware he would be

required to move out of the home within 90 days of his mother’s death and is

prepared to do so. .

During the September 2019 status hearing, the possibility of Mr. Hinckley

relocating to California to pursue a career in music was discussed. This idea does

not appear to have originated with Mr. Hinckley; he has repeatedly expressed that

he is not interested in relocating outside of the Williamsburg-Hampton Roads area.

Mr. Hinckley cited his age, his relationship with his brother, the antique business

he created, and his familiarity with the area as the primary reasons he does not

wish to relocate. In addition, he noted his ability to pursue his artistic interests from

his current location given the access afforded by internet.

If Mr. Hinckley were to move outside of the area in which he currently resides, he

would face a number of challenges, including establishing medical and psychiatric

care with new providers, changes to his finances and developing outlets for

socialization. However, Mr. Hinckley has already demonstrated the ability to

address several of these issues during his transition to residing in Williamsburg

full-time. He located a primary care doctor, applied for and received benefits from

government assistance programs, and developed a business selling antiques,

which has also become a source of socialization for him. In addition, even should

he remain in the Williamsburg-Hampton Roads area, he will need to establish care

with new providers in the future as members of his current treatment team retire.

Given Mr. Hinckley’s demonstrated ability to independently manage not only his

own affairs, but also to take care of both his mother and brother, as well as the

feasibility of his future plans for remaining in the Williamsburg-Hampton Roads

area, itis my opinion that removing the first condition in the court order would not

increase Mr. Hinckley’s risk of danger to himself or others.

. FOPD Supervision. Multiple conditions of the court order pertain to FOPD's

supervision of Mr. Hinckley and their reporting requirements to the Secret Service

and the court. Mr. Hinckley has not displayed a negative attitude toward

supervision during the four years he has been on CL, aside from expressing

frustration over the time commitment Inherent in driving to Washington, DC and

navigating traffic. In addition, Dr. Tillbrook has described Mr. Hinckley as proactive

and responsive in maintaining communication with FOPD and conscientious in

fallowing the conditions of his release. Following the reduction in the frequency of

FOPD's contact with Mr. Hinckley in November 2018, no issues with his adherence

to the court order or his mental status have arisen. Furthermore, since February

2020, in-person visits at FOPD were suspended due to the COVID-19 pandemic

without documented adverse impact. Therefore, it is my opinion that if Mr. Hinckley

is granted UCR, resulting In suspension of FOPD supervision, It would not increase

his risk of danger to himself or others. ny,

eotihads Lie te same

3. Case Management. In my opinion, Mr. Hinckley no longer requires formal case

management services given his psychiatric stability and level of functioning, Mr.

Weiss played an essential role early in Mr. Hinckley’s transition to the community

by connecting him to available resources, increasing his socialization through

attending community events together and advising him as he formed his business.

However, over the past two years Mr. Weiss’ role has primarily been to report on

Mr. Hinckley’s activities rather than assist him in pursuing opportunities. Although

Mr. Hinckley still utilizes Mr. Weiss as a “sounding board” when faced with

challenging situations, he does not require the same level of support he did

immediately after his discharge from SEH. Mr. Hinckley has demonstrated his

ability to manage his affairs independently, including making and attending

appointments, handling his finances, and running his antique business. In addition,

he has taken on the responsibility of caring for both his elderly mother and brother,

assisting them with health care needs and maintaining the household by cooking,

cleaning and running errands, Although he functions very independently, Hinckley

indicated he would {ike to remain in contact with Mr. Weiss after he is granted UCR

because he values Mr. Weiss’ guidance. When asked about his viewpoint on future

services, Mr. Weiss said he would be amenable to an “as needed” arrangement,

agreeing that Mr. Hinckley no longer requires regular case management services.

Therefore, itis my opinion that removing the sixth condition In the court order would

not increase Mr. Hinckley's risk of danger to himself or others.

4. Structured Activities. This condition of Mr. Hinckley's release has been met

consistently over the past three years. In September 2017, Mr. Hinckley started an

antique business by obtaining items from local consignment shops and estate

sales and renting a booth at a local antique mall in which to sell his inventory. He

has grown this business over time, renting a larger booth and obtaining a storage

unit in order to increase his inventory. He noted that the increase in his travel radius

from 30 to 75 miles has allowed him to obtain more items to sell and attend events

such as flea markets to look for merchandise. Prior to the COVID-19 pandemic,

Mr. Hinckley was working between four and nine hours per day in support of his

business and had an income of up to $1000 per month. However, even with

reduced business at the antique mall during the COVID-19 pandemic Mr. Hinckley

was able to pay rent on his booth, indicating that it is a sustainable business

endeavor even in the current economic climate. Mr. Hinckley has expressed his

intent to continue working in his antique business in the future and identified it as

an important source of socialization, as well as financial support. Given Mr.

Hinckley’s motivation to maintain employment, and by extension remain involved

in a structured activity, it ls my opinion that removing this condition would not

increase Mr, Hinckley’s danger to himself or others.

5. Psychiatric Treatment/Medication, Dr. Giorgi-Guarnieri has been Mr. Hinckley’s

psychiatrist since October 2010 and, as the only member of the Williamsburg

treatment team with formal forensic training, she has had primary responsibility for

monitoring Mr. Hinckley’s risk factors while he is on CL. Dr. Giorgi-Guamieri has

assessed Mr. Hinckley’s mental status not less than monthly, without noting any

26

signs of noncompliance or decompensation, including no psychosis, depression or

endangerment to self or others. She Is also responsible for prescribing Mr.

Hinckley's psychiatric medications; these prescriptions have remained unchanged

since 2008 and Mr. Hinckley has reported minimal side effects associated with

them. Given the long-term stability of his psychiatric condition, Dr. Glorgi-Guarnieri

indicated that she is not in opposition to a primary care provider prescribing Mr.

Hinckley’s psychiatric medications in the future. However, Mr. Hinckley has

expressed that he does not wish to make any changes in his psychiatric care until

such time as Dr. Giorgi-Guamieri closes her practice in Newport News. Mr.

Hinckley has repeatedly expressed his intention to remain on psychiatric

medication for the remainder of his life and credits it, in part, for his long-term

stability and ability to successfully manage his life in the community. Given Mr.

Hinckley’s lengthy history of medication compliance, consistent engagement in

treatment, minimal medication side effects and the feasibility of his plans for future

treatment, it is my opinion that removing this condition would not increase Mr.

Hinckley’s danger to himself or others.

. Individual/Group Therapy. Mr. Hinckley has consistently been involved in some

form of group and/or individual therapy for the past 38 years. While his initial

progress in therapy while at SEH was slow, over the past four years he has been

on CL Mr. Hinckley has largely met the treatment objectives that have been set for

him. Although some treatment team members continue to express concern that

Mr. Hinckley does not engage in enough socialization, he is no longer socially

isolated and has expressed gaining enjoyment from, and motivation to continue to

purse, the few social outlets he has developed. In addition, he has clearly used

both Mr. Beffa and his therapy group as resources in decision-making with regard

to intimate relationships and as support in community integration. Several

members of the treatment team noted the positive benefits of Mr. Hinckley

attending group therapy in particular, describing him as an "active participant” who

responds openly and empathically to others. Mr, Beffa concurred with Mr. Hinckley

that he benefits more from group therapy than individual therapy. As a result, Mr.

Beffa recommended reducing Mr. Hinckley’s individual therapy appointments to

once every three or four months, as a “check-in.”

One potential issue with regard to Mr. Hinckley’s future involvement with therapy

pertains to Mr. Beffa's plan to retire and his assertion that there are no other

suitable therapy groups for Mr. Hinckley to Join in the Williamsburg area. However,

Mr. Hinckley has expressed a willingness to travel to Newport News to obtain

psychiatric care and appears motivated to seek out alternatives should his current

therapy group no longer be available. Given Mr. Hinckley’s treatment progress,

psychiatric stability and motivation to continue to engage In group therapy in

particular, it is my opinion that it would not substantially increase his risk for future

violence to remove this condition of hisrelease. ©. 8, 8 ae

_ Music Therapy. Ms. Drozd indicated that she agrees with Mr. Hinckley’s

assessment that he no longer requires the services of a music therapist. According

" 27

utael ceca ia ida ae a nid ae la alt NA rl ete

to Ms. Drozd, Mr. Hinckley has leamed how to use his music therapeutically to

cope with stress and has the skills to do so independently. Although she continues

to support him with the technological aspect of posting his music online and

oversees these activities as required by the court, as she noted, this role does not

need to be fulfilled by a music therapist. It is my opinion that removing the condition

requiring Mr. Hinckley to engage in music therapy would not increase his risk of

danger to himself or others.

8. Primary Care Physician, Mr. Hinckley has met this condition by establishing care

with a primary care physician and attending appointments as needed to manage

his health. No concerns have been expressed by Mr. Hinckley nor by his treatment

team regarding ongoing medical issues. In addition, as noted above, Mr. Hinckley

has given consideration to transferring his psychiatric medications to his primary

care physician upon Dr. Giorgi-Guarnieri's retirement. It is my opinion that

removing this condition would not increase Mr. Hinckley’'s risk of danger to himself

or others.

9. Government Assistance Programs. Within his first year of residing in Williamsburg,

Mr. Hinckley applied for and obtained Supplemental Security Income (SSI),

Medicaid, Medicare and Social Security Disability Insurance (SSD!) and was

approved to become his own payee. Mr. Hinckley also established an Achieving a

Better Life Experience (ABLE) account, which allows him to deposit money in

excess of $2000 without negatively impacting his SS!, Medicaid and SSDI benefits.

In addition, Mr. Hinckley is aware of the process for appealing CBH’s decision to

not offer him services, should he desire to do so in the future. Due to Mr. Hinckley’s

knowledge of government programs available, receipt of numerous benefits from

various government programs and his ability to save the additional income from

his business without adversely affecting his benefits, it is my opinion that removing

this condition will not increase his risk of danger to himself or others.

10. Displays of Artistic Work. As | noted in the 2018 risk assessment | completed,

granting increased freedom and flexibility in this area is a balance between the

clinical benefit associated with Mr. Hinckley sharing his artistic works and the risk

of fame-seeking and/or increased notoriety. It remains my opinion that the clinical

benefit of providing an emotional outlet for Mr. Hinckley and increasing his

opportunities for social connection substantially outweighs the risk of increasing

his narcissism, which has not been overtly apparent in many years.

Following the modification of the court order In November 2018, Mr. Hinckley was

permitted to physically display his artwork in public forums and share music

created by him via the internet, with the caveat that steps be taken by the treatment

team to ensure the displays were anonymous and there was no financial benefit

. associated with the activities. Mr. Weiss indicated that attempts at displaying Mr.

_ Hinckley’s artwork anonymously were unsuccessful, as it proved to be too

complicated to accomplish. However, Mr. Hinckley has posted his music

. anonymously over the past two years, with limited views and feedback. As a result,

28

Mr. Hinckley expressed frustration over his inability to share his music with a wider

audience, either through use of social media to generate interest or through

performing in public, Mr. Hinckley has repeatedly emphasized his belief that

sharing his music and being critiqued by others is part of the normal creative

process.

Mr. Hinckley has expressed he would like to publish and perform his music on his

own and attempt to eam some financial benefit from his music and artwork. The

concerns with these increased freedoms identified previously in risk assessments

and by the treatment team have primarily focused on whether Mr. Hinckley's

narcissism will be activated either positively or negatively if he gains attention and

monetary incentive through public displays of his art or music.

In my opinion, it is unlikely that success and financial benefits from Mr. Hinckley’s

artistic endeavors will increase his narcissism to the extent that it substantially

increases his risk of danger to self or others. First, Narcissistic Personality Disorder

is not by itself directly correlated in the scientific literature with increased risk for

violence; increased risk is associated with antisocial personality traits and

characteristics of hostility and dominance, which are not demonstrated by Mr.

Hinckley. Second, Mr. Hinckley’s narcissism has been significantly attenuated over

the past three decades. Although personality disorders are enduring patterns of

behavior and do not go into remission, Mr. Hinckley has developed insight and

defenses to manage his maladaptive personality traits. As a result, no overt signs

of narcissism have been observed in him by his treatment team and, despite

receiving praise and accolades for the quality of his artistic work and the success

of his business, Mr. Hinckley mental status has not been adversely impacted by

this success. Finally, the likelihood of Mr. Hinckley achieving high levels of success

or accruing large monetary benefits from his artistic endeavors is low. As Dr.

Giorgi-Guarnieri has pointed out, even taking into account Mr. Hinckley's notoriety,

the music industry is very competitive and the audience for the type of music Mr.

Hinckley writes is a very small subset of music listeners overall. In addition, Mr.

Hinckley must also overcome the obstacle of technology to bring his music to a

wider audience and, according to Ms. Drozd, Mr. Hinckley is technologically behind

due to his age, years spent hospitalized and the restrictions of the court order.

In addition to the Impact of success on Mr. Hinckley's risk, his response to rejection

and criticism of his artistic creations |s also a factor to consider in assessing his

future risk. Rejection has the potential to result In a narcissistic injury, which may

lead to depression and/or anger and subsequently increase risk of danger to self

or others. Should Mr. Hinckley’s music or art be poorly received, or if his notoriety

rather than the quality of his work becomes the primary focus of Interest by the

public, It Is possible that he will sustain a narcissistic Injury or otherwise react

negatively. However, Mr. Hinckley has already been rejacted on numerous

occasions by the community and potential romantic partners without exhibiting

feelings of hopelessness or depression. He also has not self-isolated or retaliated

in response to these rejections. In fact, Mr. Hinckley has continued to make efforts

29

11.

to be a productive member of the Williamsburg cornmunity through his business

and participation in community events (e.g., education classes), In addition, over

the past two decades, Mr. Hinckley has weathered negative scrutiny by both the

media and the public without demonstrating increased anxiety, depression or self-

isolation. Furthermore, with regard to Mr. Hinckley’s personal safety, there were

no Incidents of attempted malice or violence against him following the deaths of

President Regan and James Brady or after his release on convalescent leave. By

extension, the likelihood of an act of violence being directed at Mr. Hinckley if he

participated in a public musical performance or were present for a public display

of his artwork is low. However, the public’s reaction to Mr. Hinckley’s artistic

creations being readily available and identifiable is unknown and it is possible that

he will be the target of trolling, heckling or musical plagiarism. Despite these

potential for negative outcomes from publicly displaying his work, it remains my

opinion that the benefits of Mr. Hinckley pursuing his artistic endeavors outweighs

the risk of him sustaining a narcissistic injury, which appears to be low given Mr.

Hinckley’s responses to negative attention in the past.

Media Plan. Early during his hospitalization at SEH, Mr. Hinckley demonstrated an

excessive need for admiration and inflated sense of self-importance that

contributed to his preoccupation with his notoriety and a desire for media attention

to help him maintain his perceived relationship with Ms. Foster. However, these

traits of Narcissistic Personality Disorder have not been overtly in evidence for

many years and Mr. Hinckley has adhered to the media plan without any significant

issues during periods of CR. Furthermore, Mr. Hinckley has repeatedly expressed

his desire to maintain a low profile within the community and even ended his

romantic relationship with Ms. H partially out of concern that her actions would

draw attention to him. When his treatment team has queried whether he has seen

news stories about himself over the past four years, Mr. Hinckley has replied that

he avoids watching or reading media related to him or his crimes. Although it is

possible that Mr. Hinckley would submit to an interview or interact with the media

if he receives UCR, it is unlikely that he would be motivated to do so in an effort to

seek fame or admiration given the attenuation of his Narcissistic Personality

Disorder. In addition, Mr. Hinckley has repeatedly reflected to treatment providers

over the years that he desires to be judged for who he /s now, rather than for his

notoriety; rather than relishing his notoriety, Mr. Hinckley described it as something

he must overcome In order to establish relationships and be successful In the

community. In my opinion, removing the condition requiring Mr. Hinckley to follow

the media plan Is unlikely to substantially increase his risk of danger to himself or

others. reo

12. Substance Use. Mr. Hinckley previously reported using marijuana twice in college

but has no other history of illicit drug use. He reported occasional alcohol use prior

to the instant offenses but has not consumed alcohol since his admission to SEH

in 1982, He has submitted to periodic urine drug screenings over the course of the

past 38 years without a single positive result. In my opinion, substance use is not

30

a significant risk factor for Mr. Hinckley and removing this condition of his release

would not substantially increase his risk of danger to himself or others.

13. Contact with Identified Persons. Mr. Hinckley has not attempted to make contact

with any identified person since the 1980s, when he was continuing in his attempts

to reach Jodie Foster. Furthermore, he has not expressed interest in any of the

identified persons in decades, except to note the increased media attention on him

following the deaths of President Reagan and James Brady. Mr. Hinckley’s focus

on Ms. Foster and President Reagan was primarily related to grandiose delusions

associated with a major depressive episode; following remission of his symptoms,

his interest dissipated. In addition, his preoccupation with the notoriety of his

crimes against the identified individuals has not been in evidence since early

during his hospitalization. In my opinion, Mr. Hinckley is unlikely to seek out contact

with any identified person should he receive UCR and removing this condition will

not increase his level of risk.

14, Travel, Over the past two years, Mr. Hinckley has utilized the increased travel

radius of 75 miles appropriately. He has attended additional cultural events and

visited consignment shops, flea markets and estate sales to procure items for his

antique business. At no time have concerns been raised regarding his travel

movements; he has not ventured near any government buildings, political figures

or persons identified In the court order and he has appropriately notified his

treatment team/FOPD of his movements. Indeed, Mr. Weiss noted that Mr.

Hinckley appears hesitant to travel too far from his home, which he attributed to

Mr, Hinckley's concerns about getting lost and being away from his elderly mother

for an extended period of time. The latter concern has also been cited as a factor

in Mr. Hinckley’s lack of requests to travel outside the 75-mile radius.

Given that Mr. Hinckley has not traveled outside of the specified radius other than

for his appointments in Washington, DC with FOPD, his response to the situational

stressors often associated with travel, particularly air travel, is untested and is likely

to remain so. Mr. Hinckley has expressed very little interest in traveling in the

future, even if he is granted UCR. He indicated he would consider visiting his niece

in New Jersey but otherwise has no desire to visit other places. Furthermore, he

cited concerns regarding the COVID-19 pandemic, his age, and caring for his

elderly mother as factors in his unwillingness to travel. Therefore, it is my opinion

that removing this condition of his release will not increase his risk of danger to

himself or others.

15. Daily Log. Although the daily log initially served as a tool to support Mr. Hinckley’s

disclosure of activities, there have not been any reports of problems with his level

of disclosure nor have any inconsistencies between his report and his observed

activities been identified by Dr, Tillbrook, Mr. Weiss or the Secret Service

according to available records. Therefore, it is my opinion that removing the

requirement to complete a daily log will not increase the risk for deceptive behavior

by Mr. Hinckley. It is also my opinion that the daily log has had minimal therapeutic

31

impact in that it has not served to increased Mr. Hinckley's socialization but rather

consists mainly of an accounting of his work hours and errands. Therefore, it is my

opinion that removing this condition of his release will not increase his level of risk,

16.Access to the Internet. Mr. Hinckley is currently permitted access to the Internet

with limitations. During the last risk assessment, | recommended that he be

permitted to sell items from his antique business online. This was not included In

the revised consent order dated November 2018. It remains my opinion that it

would not increase his risk to sell items from his antique business online nor do |

believe it would increase his risk to be granted broader access to the internet and

social media. There have been no indications of inappropriate use of the internet

by Mr. Hinckley during his time on CL. In addition, Mr. Hinckley has not shown any

interest in information related to his crimes or victims in decades, expressing that

he feels like a different person than he was when he committed the instant

offenses. Furthermore, as discussed under the condition related to public displays

of artwork, his narcissistic traits are significantly buffered and are unlikely to

Increase should he be permitted to utilize social media and/or be granted

unrestricted access to the internet. Mr. Hinckley’s technological skills are also very

limited, as Ms. Drozd has pointed out, and his use of various social media platforms

is likely to be impacted by his level of knowledge. Therefore, it is my opinion that it

will not substantially increase his risk of danger to himself ar others if this condition

of his release is removed.

17.Professional Services. Based on my interviews with Mr, Hinckley’s current

treatment team, it does not appear that any changes in their roles and

responsibilities are expected over the next six months. Although Dr. Giorgi-

Guarnieri previously provided notice of her intent to step down as Mr. Hinckley’s

psychiatrist at the end of 2019 or early 2020, recently she has indicated she plans

to keep her practice open at least another year. Mr. Weiss and Mr. Beffa are both

planning to enter full retirement in the next few years; however, they did not have

specific dates set at the time this report was completed and both indicated their

intention to continue working with Mr. Hinckley through early 2021. When asked

about her future plans, Ms. Drozd said she will be working as a music therapist for

the foreseeable future and would be willing to continue meeting with Mr. Hinckley

for at least another year should the court order require ongoing music therapy.

In the 2018 risk assessment, | recommended transfer of Mr. Hinckley’s care to

CBH in light of the pending retirement of several members of his treatment team

and the high level of services required by the court order. However, CBH declined

to provide services to Mr. Hinckley citlng the numerous reporting requirements

specified in the court order. Although Mr. Hinckley has the ability to appeal this

decision, he has not done so due to his current treatment team remaining in place

through 2020. When Mr. Hinckley ultimately ls required to transfer his care to new

providers, It is not expected that he will decompensate psychiatrically in light of the

fact that he has experienced many transitions in his treatment providers over the

nearly four decades he has been In care without decompensating.

42

taser al alah data ee Sy atrurecdane ose e gun eee Seeman ae all nee bt

As already noted, it is my opinion that given Mr. Hinckley's successful community

reintegration and clinical stability, he no longer requires the level of care currently

provided by his treatment team and required by his court order. Furthermore, his

treatment team has variously expressed support for his plans to terminate music

therapy, terminate case management services, decrease individual therapy, and

transfer his psychiatric medication to his primary care physician in the future, Mr.

Hinckley’s plans for future professional services appear feasible and appropriate

given the recommendations of his treatment team, his psychiatric stability, level of

independence and increased insight. Therefore, it is my opinion that it will not

increase Mr. Hinckley's risk of danger to self or others if the conditions pertaining

to his treatment team and ongoing professional services are removed.

13.Limits on Conclusions Reached and Interpretation of Data

This report is based on a large amount of information obtained from multiple sources, |

believe that all information contained herein is accurate and provides an adequate basis

to form both clinical and forensic opinions. However, if any information is substantially

inaccurate, | would appreciate it if this were immediately called to my attention. In addition,

should | learn of any additional new information which casts substantial doubt upon either

my clinical or forensic opinions, I will immediately notify the FOPD and write an addendum

to this report.

ate A KA

SS July 2, 2020

Samantha M. Benesh, Psy.D., ABPP Date

Board-Certified Forensic Psychologist

Partner, Benesh & Yeaw Consulting LLC

SF nee mera ee pe

STP Ares Meee avi,

33

>

DB ie

DEPARTHENT OF

BPMAVICALAL HEALS

DOCUMENT UNDER SEAL

August 21, 2020

Our Reference: DBH/FOPD/CT John W. Hinckley, Jr. (#123,173)

Your Reference: Criminal Case Number 81-306

The Honorable Paul L. Friedman

United States District Court for the District of Columbia

333 Constitution Avenue, NW, Room 6012

Washington, D.C. 20001

Your Honor:

We wish to call your attention to Mr. John Hinckley, Jr., who was admitted to Saint Elizabeths

Hospital by Court order on June 22, 1982, pursuant to the provisions of Title 24, Section 501(e)

of the D.C. Code, after having been found Not Guilty by Reason of Insanity on four counts of

attempted murder, four counts of criminal possession of a weapon, and four counts of possession

of a prohibited weapon. Currently, Mr. Hinckley resides full time in Williamsburg, Virginia, after

this Court ordered him conditionally released for convalescent leave on July 27, 2016, and Saint

Elizabeths Hospital released him on September 10, 2016.

Reference is made to our most recent letter to the Court in which we provided a clinical summary

of Mr. Hinckley’s progress between May 30, 2020 and July 31, 2020!. At this time, itis the opinion

of DBH that Mr. Hinckley has recovered his sanity and will not in the reasonably foreseeable

future present a danger to self or others. However, DBH is not recommending immediate

Unconditional Release (UCR). Based on the fact that Mr. Hinckley’s freedoms in the past have

been tightly controlled with limited opportunity to observe him making his own treatment choices,

DBH does not support the immediate removal of all 30 conditions and immediate UCR. Instead,

DBH recommends that the Court approve UCR subject to Mr. Hinckley successfully completing

‘a final transition monitoring period of 6-12 months. The basis of this recommendation is to provide

DBH with the minimum necessary tools to monitor Mr. Hinckley as the final conditions of release

are removed. If Mr. Hinckley successfully completes this transition, as both his Williamsburg

treatment team and DBH team fully expect him to do, DBH recommends that Mr. Hinckley

transition to UCR pursuant to Title 24, Section 501(d)(1) of the D.C. Code upon DBH’s final report

to the Court. To be clear, DBH does not expect that Mr. Hinckley’s psychiatric stability will

' Stipulation of Mr. Hinckley’s most recent consent order, dated November 16, 2018.

1

deteriorate without DBH/Court oversight, but in keeping with best practice risk management

principles, DBH recommends a final transition period of 6-12 months? during which Mr. Hinckley

can make the changes he wishes to make in the short-term, while retaining DBH’s authority to

monitor his adjustment and psychiatric status. The details of DBH’s recommendation and

underlying rationale are explained herein.

Relevant History

Mr. Hinckley resided at Saint Elizabeths Hospital on full inpatient status from the time of his

‘commitment until December 2003. At that time, Mr. Hinckley received his first conditional release

for day visits with his parents locally (in the D. C. area), and he successfully completed six local

day visits and two local overnight visits by November 2004. His conditional release was thereafter

expanded in December 2005 to allow for seven conditional release visits to travel to his family’s

home in Williamsburg, VA. Between February and August 2006 he successfully completed three

of these visits, which were one night in duration and four visits, which were each four nights in

duration. In June 2009 Mr, Hinckley was granted an expansion of his conditional release to allow

for ten days and nine night visits. In 2010 Mr. Hinckley was permitted the ability to obtain his

driving license, and he was allowed to drive unaccompanied in the community. In December 2013

Mr. Hinckley was granted a 17-day visit to Williamsburg. He was allowed to drive there from SEH

and travel to his appointments. He was assigned a treatment team in Williamsburg. These 17-day

conditional release visits continued without incident until he was granted full convalescent leave

in July 2016.

As noted previously, Mr. Hinckley was placed on convalescent leave on September 10, 2016,

whereupon he resided full time in the home of his mother in Williamsburg, VA. He was granted

an expansion of his conditional release for convalescent leave on November 16, 2018. The

substantive changes to that consent order from his previous consent order are as follows:

1) Mr. Hinckley may reside independently in approved housing within a 75-mile radius of

Williamsburg

2) Mr. Hinckley may alternate in-person and remote face to face meetings with FOPD every

month

3) Mr. Hinckley may reduce telephone contact with FOPD to twice per month

4) Mr. Hinckley may travel within a 75-mile radius of Williamsburg unaccompanied

5) Mr. Hinckley may display memorabilia, works of art or music created by him anonymously

on the internet with the approval of his treatment team/FOPD and under the supervision of

his therapist or case manager

Since Mr. Hinckley’s November 2018 consent order was issued, DBH has submitted 11 bi-

monthly updates on his clinical status. These updates have consistently reported that Mr. Hinckley

maintains strict adherence to the conditions of his release. Furthermore, he has navigated important

life events, such as expanding his business, assisting his family members as they grappled with

medical and psychiatric difficulties, and exploring romantic relationships. While these events had

the potential to cause psychiatric decompensation for Mr. Hinckley, as communicated in our

2 This time period was selected in line with the timeframe for which changes in dynamic risk is assessed

in formal risk assessment

reports to the Court, he has handled these potentially stressful situations in a mature and

responsible manner, and has maintained his psychiatric stability. Given his ongoing progress, his

‘Williamsburg treatment team recommended Mr. Hinckley for an Unconditional Release from his

commitment to DBH. Following their treatment recommendation, FOPD sought an independent

risk assessment to assess Mr. Hinckley’s readiness for Unconditional Release.

Summary of Risk Assessment Findings*

In response to FOPD’s request, Dr. Samantha Benesh evaluated Mr. Hinckley for the purposes of

assessing his risk for violence in the context of Unconditional Release from his commitment to

DBH. In her report, she noted that Mr. Hinckley plans to continue to reside in the Williamsburg

area, maintain his business at the local antique mall, attend group therapy and take his current

psychiatric medications. He does not plan to travel, particularly in light of the pandemic. He would

‘like to discontinue music therapy, and either reduce or discontinue individual therapy, at the

recommendation of his therapist, Mr. Beffa. He also expressed the desire to continue with group

therapy, stating that he finds the feedback he receives to be helpful. Dr. Benesh noted that Mr.

Hinckley could develop further in the area of socialization, but has made some improvements in

this regard.

Dr. Benesh re-scored Mr. Hinckley on the Violence Risk Appraisal Guide, Revised (VRAG-R),

on which she adjusted his risk score based on the past two years during which he has demonstrated

offense-free time in the community. With this adjustment, she assessed Mr. Hinckley to fall with

the lowest category of risk, (i.e., 6-16%). On a structured professional judgement tool of risk

factors, the HCR-20V3, she assessed him to be at low range of risk for Future Violence, Serious

Physical Harm, and Imminent Violence. Historical risk factors she noted as present included

Violence (high relevance), Relationship Instability, Employment Problems, Major Mental

Disorders (high relevance), Personality Disorder, and Treatment Response. She did not note the

presence of any clinical risk factors. She noted that risk management issues included living

situation and personal support, neither of which were rated as highly relevant.

Dr. Benesh noted that, in assessing Mr. Hinckley’s suitability for Unconditional Release, she

specifically evaluated the impact of the removal of the 30 conditions detailed in his most recent

consent order, on his violence risk. In reviewing these conditions’, Dr. Benesh’s overall opinion

was that, in light of Mr. Hinckley’s successful community integration and clinical stability, that he

no longer requires the level of care currently provided by his treatment team and required by his

Court order. In the short term, changes to his treatment that he will likely implement (in the absence

of a Court order requiring it), will include 1) discontinuing music therapy; 2) decreasing individual

therapy; and 3) transitioning his psychiatric medication to a primary care physician in the near

future. Dr. Benesh opined that Mr. Hinckley’s risk of danger to self or others would not increase

as a result of removal of Court oversight, and her risk assessment was in support of his

Unconditional Release.

DBH Recommendation

3 Please see Risk Assessment report by Samantha Benesh, Ph. D, ABPP, dated July 2, 2020

4 Pages 24-32 of the Risk Assessment

On July 15, 2020, July 22, 2020, and August 5, 2020, the Outpatient Forensic Review Board

(OFRB), chaired by the undersigned, convened to discuss FOPD’s recommendation for Mr.

Hinckley’s Unconditional Release. In considering this request, the OFRB considered the

presentation given by Mr. Hinckley’s treatment team, as well as the most recent risk assessment

report authored by Dr. Benesh. Ultimately, the OFRB voted in favor of Unconditional Release for

-Mr. Hinckley after a specified period of time whereby he can make key transitions that he has

expressed interest in making, while continuing under DBH/Court oversight. Relevant factors that

were considered in this decision are as follows:

1)

2)

3)

4)

Major Mental Illness. Mr. Hinckley has not experienced symptoms of psychosis or

depression in over 30 years. Any fluctuations to his mood have been in the context of

situational factors, and have not risen to the level of a frank psychotic or mood episode. He

is voluntarily medication adherent, and his treating psychiatrist is confident that his mental

illness is well controlled on his current medication regimen.

History of Violence. Mr. Hinckley’s instant offense occurred in the context of a worsening

of his untreated psychiatric condition over five years, and contributed to an escalation of

his behaviors that resulted in severe, planned violence. Since his mental illness has been in

remission (thirty years), there have been no further incidents of violent behaviors, nor

evidence of violent ideation. As such, the imminence of potential violence is low and

contextually based. Empirically based assessment of his risk for violence places him at the

lowest category of estimated risk.

Personality Disorder. Mr. Hinckley’s diagnosis of Narcissistic Personality Disorder is

noted by his providers as well as Dr. Benesh to have significantly attenuated in the past 30

years, Whereas early in his admission to Saint Elizabeths Hospital, he presented with a

need for notoriety and expressed anger and agitation in the context of insults to his sense

of self, Mr. Hinckley today exhibits a very different presentation. He does not seek

notoriety, avoids media contact, and prefers to blend in. In fact, his treatment providers

note that he has to be encouraged to socialize with others, and is rather shy. His efforts are

focused on expanding his business and caring for his family members. There are no

indications that he would revert to grandiosity and his previous need for self-

aggrandizement. Furthermore, as noted by Dr. Benesh, Narcissistic Personality has not

been established in the empirical literature as a risk factor for violence.

Future Plans. Mr. Hinckley’s expressed plans are reasonable and address the most salient

aspects of his historical risk. He wishes to remain engaged with community service

providers, and would like to continue group therapy and individual therapy as needed. He

intends to remain adherent to his psychiatric medication, and will follow his treating

psychiatrist’s recommendation for transition of psychiatric care in the long term. He plans

to live in the Williamsburg/Hampton Roads area and has no interest in travelling,

particularly in light of the pandemic. His plans to publish his music and art appear

motivated by a desire to be seen as an artist and to receive feedback on his work, rather

than to seek fame or notoriety. While there exists the potential for negative outcomes from

publicly displaying his work, he has handled negative reactions well in the past, seeking

the support of his therapist when needed.

5) Relationship Instability. Since his commitment to DBH, Mr. Hinckley has engaged in

several romantic relationship which have ranged from short term, to an over twenty-year

relationship. While early in his hospital course it was remarked that his relationships were

significant for some dependency on his part, over the years his ability to navigate complex

aspects of social and romantic relationships has greatly improved. This was most recently

indicated by his own decision to dissolve a romantic relationship that he perceived could

impact his own well-being. Mr. Hinckley is not a social person and will likely always

struggle to establish and maintain social and intimate relationships. Nevertheless, the

progress he has made in opening up, establishing honesty, and using his available supports

to navigate difficult interpersonal situations indicate that his history of relationship

instability is not a salient risk factor with regard to future dangerousness.

6) Treatment response/Insight. Mr. Hinckley has greatly improved with respect to his insight

into his need for treatment. He utilizes his support network appropriately. While he has

expressed the desire to reduce or discontinue some services, this has been done in concert

with his treatment providers and are informed by his clinical needs. Mr. Hinckley has

exhibited independence in managing his finances, business, and the care of his family

members. He has demonstrated self-motivated commitment to ensuring his mental health

needs are met. Available evidence suggests that this will not change with the removal of

Court oversight.

In summary, it is the opinion of DBH that Mr. Hinckley no longer meets the criteria for

commitment to the Department of Behavioral Health under Title 24, Section 501(d)(1) of the D.C.

Code. The OFRB relies on the underlying rationale of Dr. Benesh’s risk assessment and the

Treatment Team/FOPD’s recommendation in opining that Mr. Hinckley is entitled to an

Unconditional Release from his commitment to DBH, as he has sufficiently recovered his sanity

and will not in the reasonable future be dangerous to himself or others due to mental illness.

Nevertheless, the OFRB supports a more gradual approach to a self-executing Unconditional

Release, in which Mr. Hinckley makes the changes that he and his treatment team deem to be

clinically appropriate, while continuing to remain under DBH/Court oversight, The rationale for

continued oversight is based on the fact that Mr. Hinckley’s freedoms in the past have been so

‘tightly controlled that there have been no opportunities to observe him making his own treatment

choices, driven by clinical needs as opposed to Court mandates. Furthermore, nomothetic risk

management principles support a more graduated approach to a complete removal of protective

conditions. In this vein, Mr. Hinckley and his treatment team anticipate the following changes to

his treatment in the short-term will be made (should this request be approved):

1) Discontinuation of music therapy

2) Reduction in frequency of individual therapy

3) Transition to Colonial Behavioral Health or other community service provider

4) Allow unrestricted display of his art and music

5) Allow unrestricted travel

During this transition period, DBH/FOPD proposes ongoing monitoring of Mr. Hinckley’s

psychiatric status by maintaining monthly remote communication with Mr. Hinckley, and

maintaining monthly remote communication with his Williamsburg treatment team. Monthly notes

will be documented in his medical chart and can be available to the Court/parties if requested.

DBH also proposes that in order to facilitate continued monitoring for subtle signs of

decompensation, we continue to have access to his phone, email, and computer/internet use. At

the end of the 6-12 month period, DBH/FOPD will submit a clinical update to the Court, after

which, providing his clinical status and risk picture remains unchanged, he may receive a full

Unconditional Release.

If you have any questions regarding this report, Dr. Shilpa Krishnan may be contacted at (202)

815-0991 or shilpa. krishnaniwac.ge .

Respectfully,

NKfekb haantAp

Shilpa Krishnan, Ph.D.

Deputy Director, Forensic Services Division

cc:

Clerk, Criminal Division

United States District Court for the District of Columbia

3rd and Constitution Avenue, N.W., Room 1225

Washington, DC 20001

Kacie Weston, Esq.

Assistant United States Attorney

Judiciary Center

555 4th Street, N.W., Room 10-451

Washington, D.C. 20530

Barry Levine, Esq.

Blank Rome LLP

1825 Eye Street, N.W.

Washington, D.C. 20006-5403

DBH »

PRPART MENT OF

kk ok OL NAVINEAL HEALTH

DOCUMENT UNDER SEAL

May 10, 2021

Our Reference: DBH/FOPD/SK John W. Hinckley, Jr. 123,173)

Your Reference: Criminal Case Number 81-306

The Honorable Paul L. Friedman

United States District Court for the District of Columbia

333 Constitution Avenue, NW, Room6012

Washington, D.C. 20001

Your Honor:

We wish to call your attention to Mr. John Hinckley, Jr., who was admitted to Saint Elizabeths

Hospital by Court order on June 22, 1982, pursuant to the provisions of Title 24, Section 501(e)

of the D.C. Code, after having been found Not Guilty by Reason of Insanity on four counts of

attempted murder, four counts of criminal! possession of a weapon, and four counts of possession

ofa prohibited weapon. Currently, Mr. Hinckley resides full time in Williamsburg, Virginia, after

this Court ordered him conditionally released for convalescent leave on July 27, 2016, and Saint

Elizabeths Hospital released him on September 10, 2016.

Reference is made to our August 21,2020, letter to the Court, in which we recommended that Mr.

Hinckley be granted a self-executing Unconditional Release. Specifically, while it was the opinion

of DBH that Mr. Hinckley no longer meets the criteria for commitment to the Department of

Behavioral Health under Title 24, Section 501(d)(1) of the D.C. Code, we recommended a period

of 6-12 months whereby DBH would retain limited oversight of Mr. Hinckley, while changes to

his treatment were made. These changes would be dictated by a collaborative decision-making

process hetween Mr. Hinckley and his treatment team. Subsequently, on October 29, 2020, Mr.

Hinckley received a modified consent order that allowed for the following!:

1) Mr. Hinckley may reside independently or with a roommate;

2) Case management will be provided by Mr. Jonathan Weiss, as often as clinically indicated;

3) Dr. Giorgi-Guarnieri will provide psychiatric treatment for Mr. Hinckley, but has the

discretion to transition him to an alternate community provider;

‘Only substantial changes are listed here.

4) Mr. Carl Beffa will continue to provide individual and group therapy to Mr. Hinckley, as

often as clinically indicated;

5) Mr. Hinckley may display, under his own name, without restriction, his artwork and music;

6) The Williamsburg treatment team and FOPD shall continue to identify alternative

treatment providers in the Williamsburg area in orderto facilitate Mr. Hinckley’s transition

to new providers when the current team members retire or leave the area;

7) A status hearing will be set for (7) months from the issuance of this order, at which the

government shall inform the Court of their position with respect to any DBH

recommendations and whether they intend to seek an independent evaluation of Mr.

Hinckley. It was further ordered that a status update be submitted prior to the Court date,

in which DBH would inform the Court of their position regarding his unconditional release

from commitment.

Review of Clinical and Risk Management Factors

We refer the reader to our letter to the Court dated August 21, 2020, for a summary of Mr.

Hinckley's relevant history. Furthermore, monthly status updates have been submitted to the Court

regarding Mr. Hinckley’s progress since November 2020. The following is a summary of clinical

(current) risk factors and risk management (future) risk factors:

Treatment or Supervision Response (current and future)

Following the removal of substantive conditions of his consent order, with collaboration from his

Williamsburg treatment team, Mr. Hinckley has discontinued music therapy and individual

therapy. Mr. Hinckley and his therapist, Mr. Beffa, reasoned that there would not be any

incremental benefit if he were to continue individual therapy, and they discussed that the option to

resume therapy exists if the need arises (i.e., a stressful situation such as the death of a loved one),

He remains involved in group therapy and is described as an “active participant providing help to

others, as well as accepting help from others,”

Mr. Hinckley is in compliance with his consent order, which is consistent with his supervision

response since he received his first conditional release order in December 2003. With regard to his

future plans for treatment, Mr. Hinckley is committed to continuing his participation in group

therapy and as mentioned previously, is open to resuming individual therapy should the need arise.

His Williamsburg treatment team is committed to continuing to provide case management, group

therapy, and psychiatry support to Mr. Hinckley. There are no plans to transition him to other

providers at this time. However, Mr. Weiss has represented that should a member of the treatment

team retire or move from the area, there would be an overlap of care whereby the remaining

Williamsburg treatment team members will continue with Mr. Hinckley, while a third member

from Colonial Behavioral Health or other qualified provider assumes their role. For example,

should Dr. Giorgi-Guarnieri retire or move from the area (there are no imminent plans for this),

Mr. Hinckley’s psychiatric care will be transferred to a psychiatrist at Colonial Behavioral Health,

while Mr. Beffa and Mr. Weiss will continue to provide therapeutic servicesand case management.

This gradual transfer of care would continue until sucha time that Mr. Hinckley is fully connected

with Colonial Behavioral Health.

Should the Court grant an Unconditional Release, and should there be any emergent mental health

issues, Mr. Hinkley’s treatment team would pursue the usual pathway of seeking emergency

hospitalization in the Commonwealth of Virginia. For the record, Mr. Hinckley’s mental illness

has been stable for over 30 years and it is highly unlikely that he would experience a sudden, acute

episode of severe mental illness.

Symptoms of Major Mental Disorder

Mr. Hinckley remains connected to his Williamsburg treatment team and continues to receive

psychiatric care from Dr. Giorgio- Guarnieri. Over the course of the past six months, Mr. Hinckley

has maintained his psychiatric and behavioral stability with no psychotic, mood, or anxiety

symptoms reported or exhibited. He is medication adherent and no changes have been made to his

psychiatric medications.

Insight

Mr. Hinckley continues to evidence good insight into his mental illness and need for treatment. He

has actively sought outadvice and guidance from his treatment team before makingany of his own

decisions, even when he has been afforded the ability to make some of his own choices under the

current Consent Order. He has expressed through therapy, remorse for his past actions and is

keenly aware of his risk factors for violence, and what is needed to mitigate those risks (i.c.,

continuing to participate in mental health treatment).

Violent Ideation or Intent

Mr. Hinckley has not made any threatening statements and not engaged in any behaviors indicative

of harm to himself or others. He has not displayed any disruptive or problematic behaviors. He

does not have access to firearms or other weapons, nor has there been any data to suggest he is

interested in procuring a firearm.

Instability

Mr. Hinckley does not demonstrate any cognitive, affective, or behavioral instability.

Professional Services and Plans

One significant change that has occurred with Mr. Hinckley in the past few months, is that he has

closed down the booth he has maintained at an antique mall in Williamsburg, VA, which he has

had for more than three years. In January 2021 he closed down his booth due to financial reasons;

the antique mall was not doing well overall in light of the pandemic-related restrictions. In

hindsight, Mr. Hinckley stated that this was “one of the best decisions he has ever made,” because

it freed him from monthly financial liabilities that would have been difficult to maintain. He

receives SSI and, by all accounts, manages his finances well. He is considering renting a table at

the Newport News Flea market in the future.

Regarding the public display of his art/music, under his own name, Mr. Hinckley has sent songs

that he has written/produced to two local radio stations but they have not aired. He has also posted

some music on the website “YouTube,” and he has received positive feedback. There have not

been references to his notoriety aside from one comment, “Reagan would be proud.” He has not

responded to any comments. Regarding the feedback he has received, Jonathan Weiss commented,

“It has not all been glowing, and he has handled those responses thoughtfully and maturely.” With

increased focus on his mother’s wellbeing, there has been less music production since end of

February 2021.Mr. Hinckley’s long-term plan is to compose jingles or write songs for others, and

he is not particularly interested in performing before live audiences.

Regarding his art, Mr. Hinckley has sold about 15 11x14 paintings for less than $100. There has

not been any mention of his notoriety in the sales. At present, he has taken a hiatus on creating

new paintings, so he can focus on his music production and on caring for his mother.

As noted previously, Mr. Hinckley intends to remain adherent to his psychiatric medication,

remain in group therapy, and is open to resuming individual therapy should he experience

additional stressors. His Williamsburg treatment team will continue to work with him for the

foreseeable future.

Living Situation

There have been several obstacles to Mr. Hinckley finding housing related to his financial

eligibility. However, on May 4, 2021, he did sign a lease for a one-bedroom apartment, for which

he is very excited. Mr. Hinckley has been residing with his mother since his release to the

community, and undoubtedly it will be an adjustment to living alone. That said, given the nature

of his current caregiver role with his mother, which requires patience and can be taxing both

physically and emotionally, in some ways adjusting to singular living may involve less stress.

Personal Support

Mr. Hinckley’s social interactions are limited to group therapy and a few acquaintances in the

community. He is not romantically involved. His socialization has been further limited due to the

pandemic and in light of his mother’s health needs. As noted in our August 2020 letter to the Court,

Mr. Hinckley is not a social person and will likely always struggle to establish and maintain social

and intimate relationships. Nevertheless, the progress he has made in opening up, establishing

honesty, and using his available supports to navigate difficult interpersonal situations indicate that

his history of relationship instability is nota salient risk factor with regard to future dangerousness.

Stress or Coping

Mr. Hinckley’s ability to manage stress has been one of the most relevant risk management factors

that has been discussed, as his support network is so limited and due to his notoriety and likelihood

of high-profile exposure. One of the goals of observing him with reduced court-mandated

oversight was to note how he responded to potential stressors.

In the past year, Mr. Hinckley’s mother has experienced a medical set-back, and currently is bed-

ridden. Mr. Hinckley has been responsible for her activities of daily living, toiletry and

nourishment. Recently, he started receiving help from his brother in assuming responsibility for

hercare. Although Mrs. Hinckley has long-term care insurance and is eligible for in-home nursing,

Mr. Hinckley and his brother prefer to care for her, citing concerns over the increased risk for

Covid-19 exposure, and their mother’s expressed wishes. Mr. Hinckley has been “calm and

collected,” in light of his mother’s decompensation, and he is able to discuss “more comfortably”

about the eventual passing of his mother in that he feels “emotionally prepared,” as much as one

can be in a similar situation.

On October 29, 2020, tabloid online publisher TMZ obtained store security video of someone

holding a rifle that was for sale. TMZ contacted Attorney Barry Levine, US District Court Judge

Friedman Chambers, USAO, and Saint Elizabeths Hospital asking them to confirm the man in the

video was Mr. Hinckley. All parties who viewed the photos and video acknowledged it did not

look like him. Mr. Hinckley felt “annoyed” but was relieved and grateful that those involved in his

case believed him. In mid-April 2021, two local newspaper articles discussed the motion Attomey

Levine filed with the Court about requesting an UCR. Mr. Hinckley did not have any significant

reaction to the media coverage, and it was “described as a fairly favorable write up.” Mr. Hinckley

has not been in contact with the media or engaged in political/social activist movements. He

continues to express the wish of living a quiet life in the Williamsburg area. One notable

discrepancy from this sentiment is his desire to be recognized as an artist under his own name.

According to his DBH treatment team, Mr. Hinckley’s wish in this regard is less about wanting

public notoriety/fame, and more about being recognized as having successfully recovered from

mental illness.

Summary of Risk Assessment Findings2

In response to FOPD’s request, Dr. Samantha Benesh evaluated Mr. Hinckley for the purposes of

assessing his risk for violence in the context of Unconditional Release from his commitment to

DBH. In her report, she noted that Mr. Hinckley plans to continue to reside in the Williamsburg

area, maintain his business at the local antique mall, attend group therapy and take his current

psychiatric medications, He does not plan to travel, particularly in light of the pandemic. He would

like to discontinue music therapy, and either reduce or discontinue individual therapy, at the

recommendation of his therapist, Mr. Beffa. He also expressed the desire to continue with group

therapy, stating that he finds the feedback he receives to be helpful. Dr. Benesh noted that Mr.

Hinckley could develop further in the area of socialization, but has made some improvements in

this regard.

Dr. Benesh re-scored Mr. Hinckley on the Violence Risk Appraisal Guide, Revised (VRAG-R),

on which she adjusted his risk score based on the past two years during which he has demonstrated

offense-free time in the community. With this adjustment, she assessed Mr. Hinckley to fall with

the lowest category of risk, (i.e., 6-16%). On a structured professional judgement tool of risk

factors, the HCR-20V3, she assessed him to be at low range of risk for Future Violence, Serious

Physical Harm, and Imminent Violence. Historical risk factors she noted as present included

* Please see Risk Assessment report by Samantha Benesh, Ph. D, ABPP, dated July 2, 2020.

5

Violence (high relevance), Relationship Instability, Employment Problems, Major Mental

Disorders (high relevance), Personality Disorder, and Treatment Response. She did not note the

presence of any current clinical risk factors. She noted that future risk management concems

included issues related to his living situation and personal support, neither of which were rated as

highly relevant.

Dr. Benesh noted that, in assessing Mr. Hinckley’s suitability for Unconditional Release, she

specifically evaluated the impact of the removal of the 30 conditions detailed in his November

2018 Consent Order, on his violence risk. In reviewing these conditions3, Dr. Benesh’s overall

opinion was that, in light of Mr. Hinckley’s successful community integration andclinical stability,

that he no longer requires the level of care currently provided by his treatment team and required

by his Court order. In the short term, changes to his treatment that he will likely implement (in the

absence of a Court order requiring it), will include 1) discontinuing music therapy; 2) decreasing

individual therapy; and 3) transitioning his psychiatric medication to a primary care physician in

the near future. Dr. Benesh opined that Mr. Hinckley’s risk of danger to self or others would not

increase as a result of removal of Court oversight, and her risk assessment was in support of his

Unconditional Release.

DBH Recommendation

On May 5, 2021, the Outpatient Forensic Review Board (OFRB), chaired by the undersigned,

convened to discuss Mr. Hinckley’s progress since he was granted his most recent conditional

release, and in anticipation of the status hearing set in his case for June 3, 2021. The purpose of

the OFRB meeting was to ascertain whether there were any adverse events that occurredasa result

of the removal of substantial conditions to his conditional release, and to make any further

recommendations in Mr. Hinckley’s case. Within this discussion, the fact that Mr. Hinckley has

not been transitioned to his new providers was noted as a concern, inasmuch that sucha transition

could contribute to increased risk for psychiatric decompensation. However, it was also discussed

that Mr. Hinckley has transitioned to new providers before (i.e., when he transitioned from

inpatient to outpatient status), and thatthe gradual plan fortransition put forth by his Williamsburg

treatment team will serve to cushion against any abrupt change. In this way, although it was

suggested that an additional period of observation may be helpful, it was also noted that such an

additional period would be arbitrary in light of Mr. Hinckley’s stable, long-term psychiatric status.

While any number of events could contribute to increased stress for Mr. Hinckley (i.e., the death

of his mother, the retirementof one ofhis core treatmentteam members, negative media exposure),

he has shown time and time again, the ability to work with his treatment providers to manage these

stressors without any evidence of psychiatric deterioration or aggressive behavior. Within this

framework, the OFRB accepted the Williamsburg treatment teams’ expressed transition plan as a

reasonable one.

In summary, consistent with our August 2020 letter to the Court, it is the opinion of DBH that Mr,

Hinckley no longer meets the criteria for commitment to the Department of Behavioral Health

under Title 24, Section 501(d)(1) of the D.C. Code. The OFRB relies on the underlying rationale

of Dr. Benesh’s risk assessment and the Treatment Team/FOPD’s recommendation in opining that

Mr. Hinckley is entitled to an Unconditional Release from his commitment to DBH, as he has

* Pages 24-32 of the Risk Assessment

sufficiently recovered his sanity and will not in the reasonable future be dangerous to himself or

others due to mental illness. In making this determination, the OFRB considered Mr. Hinckley’s

risk factors individually, as well as the interaction of these risk factors, Over the past six months,

Mr. Hinckley has maintained his psychiatric and behavioral stability while stil! choosing those

therapeutic services that are helpful to the maintenance of his psychiatric well-being. In this way,

Mr. Hinckley has shown intrinsic motivation and investment in his current level of support and

psychiatric care, The additional extrinsic factor of DBH/Court oversight does not add incremental

value to the maintenance of Mr. Hinckley’s psychiatric status.

If you have any questionsregarding this letter, or should testimony on behalfof DBH in this matter

be required, Dr. Shilpa Krishnan may be contacted at (202) 815-0991 or shilpa.krishnan@dc.goy.

Respectfully,

Shilpa Krishnan, Ph.D.

Deputy Director, Forensic Services Division

cc.

Clerk, Criminal Division

United States District Court for the District of Columbia

3rd and Constitution Avenue, N.W., Room 1225

Washington, DC 20001

Kacie Weston, Esq.

Assistant United States Attorney

Judiciary Center

555 4th Street, N.W., Room 10-45 |

Washington, D.C. 20530

Barry Levine, Esq.

Blank Rome LLP

1825 Eye Street, N. W.

Washington, D.C. 20006-5403

MITCHELL H. HUGONNET, PH.D.

CLINICAL, FORENSIC & NEUROPSYCHOLOGY

4405 EAST-WEST HIGHWAY

SUITE 312

BETHESDA, MD 20814-4585

EMAIL: FORENSIC.CONSULTATION@GMAIL.COM

MOBILE: 202.246.4846

LICENSED IN DC, MD, VA

September 2. 2021

United States Attorney for the District of Columbia

Judiciary Center Building

555 4" Street, N.W.

Washington, DC 20530

Re: United States v. Jolin W. Hinckley, Jr., Case No. 1981- CR- 306 (PLF)

Introduction:

John W. Hinckley. Jr. shot President Ronald Reagan and others in a thwarted assassination attempt

outside the Washington Hilton Hotel. on Marchi 30. 1981. The bullets struck the President, Press

Secretary James Brady. Secret Service Agent Tumothy McCarthy. and Metropolitan Police Officer (MPD)

Thomas Delahanty. Mr. Hinckley was adjudicated Not Guilty by Reason of Insanity (NGBRD, by jury

trial, on June 21, 1982, The jury verdict found Mr. Hinckley NGBRI with respect to four counts of

attempted murder, four counts of criminal possession of a weapon, and four counts of possession of a

prohibited weapon. The next day, on June 22, 1982. Mr. Hinckley began a 34-year forensic inpatient

conunitment to the John Howard Pavilion (HP), Saint Elizabeths Hospital's (SEH) forensic inpatient

services division. On July 27, 2016. the Court granted Mr. Hinckley convalescent leave from JHP. Mr.

Hinckley was discharged from inpatient care at St. Elizabeths JHP on September 10, 2016. Mr. Hinckley

remains on convalescent leave; Mr. Hinckley is requesting an unconditional release from the Court. Judge

Paul L. Friedman has scheduled a hearing on this matter in U.S. District Court on September 27, 2021.

I was again retained by the Office of the U.S. Attorney to independently review John W. Hinckley’s

mental condition and risk of dangerousness, in response to Mr. Hinckley’s motion through counsel for

unconditional release from convalescent leave. The interested reader may wish to review my original

forensic report dated October 22. 2018. U.S. District Court Judge Paul L. Friedman signed the order

approving the government’s motion to retain this psychologist on May 6, 2021:

ORDERED that Dr. Mitchell Hugonnet, may conduct such examination of John

W. Hinckley, as he deems appropriate. in order to determine Mr. Hinckley’s

present mental condition and risk of dangerousness. if any. if unconditionally

released from his commitment.

Mr. Hinckley’s social history, and extensive 39 year legal and mental health history are well documented

in the voluninous material I reviewed and referenced in my original 2018 report. In preparation for this

2021 update report, I reviewed additional material listed below. Please refer to these reports and records

for this information.

United States v. John W. Hinckley, Jr.

The DBH Outpatient Forensic Review Board (OFRB). chaired by Shilpa Krishnan, Ph.D. Deputy

Director, Forensic Services Divisi

This text is long and has been trimmed here. Open the source document for the complete record.