REDWOOD CITY -- Attorneys dueled Tuesday over the key witness in a competency hearing to decide whether once-prominent child psychiatrist William Ayres will be tried again on molestation charges.
John McIlnay, the Napa State Hospital forensic psychologist who concluded this summer that Ayres was faking symptoms of dementia, overruled two psychologists and a psychiatrist at Napa who had found Ayres suffered from the disease. He defended his report on Ayres, 80, on the final day of testimony in the hearing, which also produced a startling revelation about Ayres' allegedly "grooming" a fellow patient at Napa.
Deputy district attorney Melissa McKowan portrayed John McIlnay as a specially trained expert who caught patterns others didn't. McIlnay observed discrepancies between Ayres' performance on tests that gauge mental function. He also noted differences in his behavior in front of doctors and with nursing staff and other patients in his ward.
Defense attorney Josh Bentley painted McIlnay as an inexperienced clinician whose malingering diagnosis runs counter to the assessments of a dozen psychologists and psychiatrists who have evaluated Ayres. A 2009 trial over charges that Ayres molested five young male patients ended in a hung jury.
McIlnay began his investigation into Ayres in May at the request of the hospital's admissions unit, which had found the former San Mateo psychiatrist uncooperative upon his arrival last October, raising suspicions about possible malingering. He determined Ayres was exaggerating some, if not all, of his symptoms of dementia.
McIlnay said his review showed the men who treated Ayres, psychologist Thomas Knoblauch and psychiatrist Dr. Scott Sutherland, had decided early on that their patient could not be restored to competency and made little effort to engage him in activities designed to restore him to competency. Sutherland's testimony on Friday that he had made "an alliance" with Ayres also made McIlnay uneasy.
"The impression was, 'Case closed -- we're just helping this guy to stay comfortable until he can go somewhere else,' " McIlnay recalled.
When McIlnay confronted Ayres with his findings in June as he was wrapping up his investigation, Ayres' response was lucid, bolstering McIlnay's confidence in his assessment.
"This is a major shift on behalf of the organization," McIlnay recalled Ayres saying. To the psychologist, the patient's remark demonstrated an understanding of Napa's evaluation process and Ayres' standing in it.
Ayres' attorney for the competency hearing, Josh Bentley, pointed out that McIlnay was assigned Ayres' case just one month after joining the forensic unit.
Bentley cited a list of 12 clinicians, both inside and outside Napa, who have found Ayres suffers from dementia, an incurable disease that gets worse with time.
'Grooming' a victim
McIlnay testified that his doubts about Ayres' symptoms, and the patient's lack of cooperation, made it impossible for him to render an opinion as to whether Ayres has dementia.
The nursing supervisor who oversaw Ayres' unit was among five other people who testified Tuesday. The supervisor, Sybil James, told the court that on more than one occasion Ayres had to be removed from the company of another inmate out of concerns he might be "grooming" him, a term used for the process by which sexual offenders prepare a potential victim for abuse.
James said she and other staffers noticed Ayres spending time alone with the man, who is developmentally disabled. The man had previously been involved in an undescribed incident with another man that resulted in the filing of a police report. The developmentally disabled man was eventually moved to a different unit of the hospital for his safety.
San Mateo County Superior Court Judge John Grandsaert permitted James' testimony on the alleged grooming only for consideration of what to do with Ayres once Grandsaert rules on the former psychiatrist's competence. Bentley dismissed James' testimony outside court, saying Ayres did nothing wrong and the hospital took no action against him.
McKowan and Bentley will deliver their closing statements at 10 a.m. Wednesday.
Contact Aaron Kinney at 650-348-4357.