The man accused of wounding Rep. Gabrielle Giffords in a deadly shooting rampage is still delusional but can be restored to competency after another eight months of treatment, a psychologist said at a federal courthouse in Tucson, Ariz.
Dr. Christina Pietz testified Wednesday at a hearing on the mental status of 23-year-old Jared Lee Loughner. She has been treating Loughner at a prison facility in Springfield, Mo.
Pietz said Loughner, who is being forcibly medicated, remains on suicide watch but is no longer having auditory hallucinations. She said she has no reason to think he won't keep getting better.
Pietz added Loughner "understands that he has murdered people" and "talks about how remorseful he is."
Loughner sat expressionless as he listened quietly to Pietz's testimony. He looked thin and pale and was wearing a white T-shirt and khakis. He was sporting a short haircut and sideburns. Two federal marshals stood behind him.
Experts have concluded Loughner suffers from schizophrenia. Though many of his records have been sealed as confidential, some documents out there describe him as pacing his room for days until his feet bled and spitting at his attorneys, NPR's Ted Robbins tells All Things Considered host Melissa Block.
"His own defense team filed papers in advance of today's hearing and they show that the prison staff has noted he's stayed in bed for 18 and a half hours on one day," Robbins says. "During one week, he was depressed much of the time, or appeared depressed, [and] had poor hygiene."
Loughner's court appearance Wednesday was his first since an angry outburst got him kicked out of a May 25 competency hearing. But this time, Loughner was under the effects of psychotropic drugs, which he has been forced to take the past 60 days.
U.S. District Judge Larry Burns will decide whether to grant prosecutors' request to extend his stay at the Missouri prison facility by another eight months. He has been at the facility for the past four months after Burns found him mentally unfit for trial at the May hearing in Tucson.
Loughner interrupted that hearing with a loud rant. According to court transcripts, he said: "Thank you for the free kill. She died in front of me. Your cheesiness."
Loughner did not have to be in the courtroom Wednesday, but Robbins says he reportedly wanted to attend so he could see his parents, who live in Tucson.
Loughner has pleaded not guilty to 49 charges stemming from the Jan. 8 shooting that killed six and injured 13, including Giffords.
If Burns decides to extend Loughner's stay in Missouri, the judge likely will also discuss whether to hold another hearing to determine if Loughner should continue to be forcibly medicated in a bid to make him mentally fit for trial.
Prison officials have forcibly medicated Loughner after concluding at an administrative hearing that he posed a danger at the prison.
Loughner's lawyers have been seeking to have the judge, rather than the prison, decide whether Loughner should be medicated.
Loughner was first forcibly medicated between June 21 and July 1, but an appeals court temporarily halted the medications after defense lawyers objected.
The forced medication resumed July 19 after prison officials concluded Loughner's psychological condition was deteriorating, noting he had been pacing in circles near his cell door, screaming and crying for hours at a time.
The legal battle revolves around case law. "One standard says a defendant has a right to a full hearing before being medicated against his will, and Loughner has never had that hearing," Robbins says. "The other case says that if a defendant is a danger to himself or others, he can be medicated for safety reasons."
Loughner's medications include the sedative lorazepam, the antidepressant Wellbutrin and Risperidone, a drug used for people with schizophrenia, bipolar disorder and severe behavior problems.
Pietz said Loughner has made progress in making more eye contact with people, improving his personal hygiene and pacing less often.
But defense attorneys said none of the changes confront Loughner's delusions and noted he remains on suicide watch.
Loughner's defense team is lead by Judy Clarke, who defended the Unabomber, Ted Kaczynski, and the Oklahoma City bomber, Timothy McVeigh. She and the rest of the team just want to save Loughner's life, Robbins says.
"He cannot be tried for the 49 counts against him unless he's competent to stand trial. So if they can prevent that, he'll remain hospitalized — maybe forever," he says. "If he can be successfully treated, he could stand trial, be found guilty and receive the death penalty."
Material from The Associated Press was used in this report.