Court allows involuntary medication of murder suspect

A district judge on Thursday issued an order allowing the Montana State Hospital to hold a woman accused of murder for another six months while she's treated for mental health issues, and to allow hospital staff to medicate her involuntarily if she continues to refuse treatment. 

Pamela Jean Courtnage, 44, has been at the Montana State Hospital since she pleaded not guilty to deliberate homicide in June. Following Judge Elizabeth Best's order at the end of the hearing, the state hospital staff will hold Courtnage at the facility until sometime in March, and, in an effort to bring her out of her deeply-entrenched auditory and visual hallucinations, be allowed to medicate her through injections if she continues to refuse prescribed medications.

Thursday's hearing was also the first time the victim was referred to on the record as Courtnage's 69-year-old mother. According to her obituary, Katherine Elaine Courtnage, who died on May 26 in Great Falls, was the mother of three daughters, including Courtnage. 

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Police believe Courtnage killed her mother as she was helping with repairs around Courtnage's home. In arguments at Monday's hearing, chief criminal deputy attorney Susan Weber said the details of the alleged murder were, in her opinion, "one of the most brutal murders I've ever seen."

Courtnage appeared Thursday through video from the Montana State Hospital, where she was accompanied by staff psychologist Dr. Virginia Hill. Courtnage has previously been committed to the facility twice, and in the current commitment been diagnosed with schizoaffective and bi-polar disorders, Hill said.

"At this time, I do not believe Ms. Courtnage is fit to stand trial," Hill said. 

Hill said Courtnage suffers from delusions that have been a part of her daily life for the last three to five years. At the mention of her reported delusions, Courtnage interjected, simply saying "Not delusions." Hill said because of her mental health issues, Courtnage is unable to reconcile her need for medication. 

"She has denied having a disease," Hill said, adding that Courtnage has told hospital staff she takes medications to make them happy. To this sentiment, Courtnage picked up some papers in front of her and flipped through them, creating noise in the microphone and briefly disrupting the hearing. 

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Hill said Courtnage, who has reportedly taken steps toward suicide in the past, is considered a danger to herself and others until she is more heavily medicated for at least a six-month period at the facility. Hill did say, however, that she believes Courtnage is treatable and gave her a "greater than 50 percent chance" at successful treatment, meaning a qualified fitness to defend herself at her murder trial. 

According to court documents, Katherine Courtnage had not returned her husband's calls on the night of May 26, so he went to their daughter's home looking for her the next morning. After finding his wife's body, he called police. 

Officers who found Katherine on the back porch noted she had apparently died from blunt force trauma. A blood trail led officers up the back stairs inside the house into a bedroom, where there were signs of an altercation. Blood was on the bed, the nightstand and throughout the room, court documents state. 

Courtnage was arrested later in Missoula County, driving her mother's truck. For leaving Great Falls with the truck, Courtnage was also charged with theft. 

Courtnage's public defender asked Best to dismiss the case and have her civilly committed to the state hospital for fear the potential side effects of the prescribed medication could actually make her conditions worse ahead of trial.

Best said it would not be appropriate to dismiss the charges at this time, but emphasized in her order that the involuntary medication is to be a last resort, and that the medication should be done in the "least invasive, dangerous, life-threatening and de-humanizing" methods possible. Hill said, if required, the procedure, an injection of drugs to which she is already prescribed, would be done in careful and outright planning, not by surprise.

"If we have to go there, we have to do it carefully to keep everyone safe," Hill said, referring to the potential risk of the hospital staff as well.

Best ordered Courtnage be committed to the facility for another six months, and requested another update in 90 days.