Their findings weren't the final word on whether David Tarloff can stand trial; at least one other evaluation is planned, and ultimately a judge will rule on the issue. But the results were enough to spur a mistrial in the midst of jury selection, frustrating prosecutors and the slain therapist's family, who had expected opening statements as soon as Monday.
Tarloff's lawyers, however, saw the doctors' report as a sign of the depth of his mental problems. They have planned an insanity defense if he is tried.
"It's clear already that he's psychotic and should be found unfit and go to (a state mental institution) to get the care that he needs," lawyer Bryan Konoski said.
Tarloff's mental state has been an issue since his arrest in the February 2008 attack. It killed Kathryn Faughey and seriously wounded Dr. Kent Shinbach, a psychiatrist, in their Manhattan office.
Tarloff told police he went there to rob Shinbach - who'd treated him 17 years earlier - for money to get Tarloff's mother out of a nursing home and take her to Hawaii. Faughey confronted Tarloff, who told police he feared she would kill him.
Prone to delusions that he's the Messiah and God and the devil speak to him, the 42-year-old Tarloff has been in and out of mental hospitals for almost two decades, his lawyer and psychiatrists have said.
He was deemed mentally incompetent for trial for about a year after his arrest, until doctors said last year that his condition had improved. Being competent for trial means being able to understand court proceedings and help in one's defense. It doesn't foreclose an insanity defense, which entails proving that a person was so mentally ill when committing a crime that he or she didn't know it was wrong.
Tarloff muttered prayers and blew kisses during jury selection last week, and then refused to leave a courthouse holding cell or respond to questions after a lunch break Friday, his lawyers said. His behavior spurred Manhattan state Supreme Court Justice Edward McLaughlin to order a psychiatric exam for him.
After being taken back to Bellevue Hospital on Friday, Tarloff stripped naked and ran around a psychiatric ward, Konoski said. He later told Konoski he'd been rattled because of "issues he was having with God," the attorney said.
Tarloff is medicated, but the drugs are apparently overmatched by the stress of the impending trial, Konoski said.
Two court-system psychiatrists told McLaughlin on Monday that Tarloff wasn't mentally competent, but prosecutors called for another evaluation by a psychologist of their choice. They bristled when Tarloff's lawyers objected.
"Sorry that on a murder (charge), we want to have someone speak to the defendant, who was fit five days ago when we started picking a jury," Manhattan Assistant District Attorney Evan Krutoy retorted.
If the psychologist also finds Tarloff unfit for trial, that will end the discussion, McLaughlin said. Tarloff would then be sent to a state hospital until doctors again find he had improved enough to stand trial - if they ever do. Some defendants have been consistently found incompetent for as long as a quarter-century.
If the prosecutors' psychologist says Tarloff is mentally fit, however, his lawyers could then ask for yet another exam by their chosen doctor. That would likely eventually lead to a hearing on the various findings, with the judge ultimately ruling on the issue.
In the meantime, McLaughlin declared a mistrial, meaning that jury selection would have to start over if the trial goes forward. Twelve jurors and one of about a half-dozen alternates had already been picked.
Faughey's family braced for more uncertainty in a case that has had plenty of it. Her six siblings were "questioning the validity" of Tarloff's recent behavior, said one brother, Owen Faughey.
"We're all just very upset," he said. "After two-and-a-half-plus years, we thought we were going to have this resolved."
If Tarloff is tried and convicted, he could face up to life in prison; New York's prison system has some psychiatric units. If acquitted because of insanity, he could be held indefinitely in a mental institution if hearings determined he should be committed. He would then need approval from a judge and psychiatrists to be released.