A high-stakes legal challenge to the credibility of mental health fitness assessments in St. Vincent and the Grenadines is set for a ruling Monday at the Serious Offences Court, after three clinicians publicly admitted they lack specialized psychiatric training to evaluate defendants’ competence to stand trial. The case, brought forward by pro bono defense attorney Grant Connell, calls into question long-standing systemic gaps that have potentially put mentally ill defendants at risk of improper conviction and sentencing.
Connell is representing 32-year-old Kesroy Williams, a Belair resident with a documented schizophrenia diagnosis who faces a second illegal firearms charge in 18 months. Williams was first arrested and jailed in December 2024 after pleading guilty to unlawful possession of a .38 pistol and three rounds of matching ammunition. At the time, he told arresting officers he kept two weapons, “one for a wedding and one for a funeral,” and requested that officers return his gun after he completed his sentence. A Mental Health Rehabilitation Centre (MHC) located in Glen deemed him fit to enter a plea, a finding that went unchallenged — until Connell observed Williams’ second hearing last month.
Williams was arrested again in February this year on charges that he possessed an unlicensed modified .32 caliber firearm and three matching rounds at his home. When Connell arrived at court in March for what was expected to be a routine sentencing hearing, he said alarm bells went off as the unusual facts of the case were read aloud. In addition to Williams’ history of bizarre statements to police, he noted that Williams had approached passing police officers to voluntarily hand over his weapon, only to be ignored before being arrested later. Connell told reporters after Thursday’s preliminary hearing that the situation struck him as immediately off: “Which person tells you they have a firearm, one for a funeral, one for a wedding, gives it to police and asks for it back after their sentence? That is not the behavior of a legally competent person.”
Suspicious of the MHC’s competency ruling that deemed Williams fit for trial, Connell requested Chief Magistrate Colin John summon the three clinicians who signed off on Williams’ latest assessment to testify under oath about their qualifications and assessment process. When the trio — Dr. Alisa Alvis, Dr. Micheal Stowe, and Dr. Franklyn Joseph — appeared in court Thursday, their testimony exposed systemic under-resourcing that shocks legal and public health advocates.
Alvis, who heads the country’s Mental Health Services and was called on to sign off on Williams’ report, confirmed she holds a PhD in psychology but is not a licensed clinical physician authorized to prescribe medication, and is not formally specialized in psychiatric assessment for court proceedings. Stowe, a general practitioner, told the court he is still completing a master’s degree in psychiatry, and only completed a two-week psychiatric rotation as part of his basic GP training. Joseph, also a general practitioner, completed only a two-month psychiatric rotation during his own GP training. Most strikingly, Alvis told the court that St. Vincent and the Grenadines currently has no practicing licensed psychiatrists on staff at any public mental health facility.
Beyond the lack of specialized training, the clinicians admitted they lack basic diagnostic tools required to complete comprehensive competency assessments. The team told the court they do not have access to standardized IQ testing, and cannot complete many of the lab and cognitive tests required to fully evaluate a defendant’s mental capacity. They also acknowledged they could not rule out additional undiagnosed conditions that could impact Williams’ competency.
Connell’s questioning further probed the red flags around Williams’ ongoing treatment. Williams takes daily risperidone, a powerful antipsychotic medication commonly prescribed to manage schizophrenia symptoms. A well-documented side effect of the drug is 24-hour cognitive impairment, including problems with memory, concentration, and critical thinking. Connell pressed the team: how can a person constantly living with these side effects be expected to follow court proceedings, respond to cross-examination, and assist in their own defense?
Even more troubling, Connell told the court he discovered that competency reports written by the two different GPs, 40 days apart for separate defendants, are identical word-for-word. He slammed the current assessment process as perfunctory and fundamentally flawed: “All they do is ask a handful of basic questions — do you hear voices? Do you know who the prime minister is? If you’re dressed properly and don’t have an outburst in the office, you’re labeled fit to plead. That’s absolute nonsense. They even admitted that Williams could have an episode mid-trial and strip off his clothes running out of court, but still called him competent.”
In an interview after Thursday’s hearing, Connell said this systemic failure has gone on for years, putting countless mentally ill defendants at risk. He noted he is not criticizing the individual clinicians, who are working with severely limited resources, but is calling for urgent systemic reform. “You can’t gamble with people’s lives like this. When you lock a mentally ill person who isn’t competent to stand trial in prison, they face abuse from other inmates, improper medication dosing, even death. I already know of one young man who died in prison from a medication overdose because no qualified specialist was overseeing his care,” he revealed.
Connell is calling on parliament to prioritize urgent legislation to fix the broken system, and push for the government to recruit at least three full-time qualified psychiatrists to oversee MHC’s court assessment services. “Even if you are a prisoner or living with mental illness, you are still a human being who deserves dignity and due process. This isn’t a political issue — this is a human rights issue that demands urgent action,” he said.
Following Thursday’s testimony, Chief Magistrate Colin John announced he would issue his formal ruling on the challenge to the competency report on Monday. Prosecutor Inspector of Police Renrick Cato said the prosecution will consult with the Director of Public Prosecutions to map out the next steps once the ruling is issued.