If anything seemed obvious during a recent attempt to arraign multiple-slaying defendant Isaac L. Zamora, it was that he was not assisting in his defense.

“You’re fired,” he told his attorney during one of several courtroom outbursts at the Oct. 30 hearing. “You don’t speak for me.”

Finally, Skagit County Superior Court Judge Michael Rickert ordered Zamora removed from the courtroom.

“There is certainly a reason at this time to question Mr. Zamora’s competency,” Rickert said as he directed that the defendant be taken to Western State Hospital for a mental health evaluation.

The law requires that a defendant be competent to assist in his own defense. Psychologists at Western State will determine if Zamora’s mental state would make it impossible for him to cooperate with his attorney.

A second Skagit County murder defendant’s mental health is also being evaluated at the hospital. Ben Price has already been ruled competent to stand trial by the hospital despite his claims of hallucinations in which he sees the devil.

He is now undergoing an evaluation to see if he is eligible to plead not guilty by reason of insanity. Price is accused of killing his ex-girlfriend in 2006. His attorney, Public Defender Keith Tyne, has already indicated the likelihood of an insanity plea.

The insanity defense has yet to be mentioned in court in the case of Zamora, whose mother Denise Zamora has publicly said her son suffers from serious mental illness.

Competency and insanity are not the same thing. Competency is a person’s ability to understand court proceedings and assist his attorney. Sanity is a legal finding by a judge or jury. It is a person’s mental capacity at the time of the crime — whether or not he knew right from wrong or the gravity of what he was doing.

If a person is found not guilty by reason of insanity, he or she can be turned over to a mental health hospital until the maximum prison time of the crime committed or until he or she is “no longer a danger,” said Murray Hart, a psychologist and manager of the forensic evaluations at Western State Hospital.

Mental health professionals will report their findings on Zamora to the court before the defendant’s next arraignment hearing. That was initially set for Thursday, Nov. 13. But it was postponed.

If a person is found incompetent, his or her competency can be restored through medication and classes, Hart said. If he or she is uncooperative, the trial judge can order forced medication to make that person competent. Restoring competency can take months, Hart said.

“The state has an overriding interest to make people competent and bring criminals to justice,” Hart said.

Zamora has openly said in court that he wouldn’t cooperate with evaluations. Hart said the hospital has ways to deal with uncooperative patients.

“It’s really hard to force people to take a pill,” Hart said. But some drugs can be injected, he said.

Hart said that if someone is found not guilty by reason of insanity, working them back into the community on a conditional release is a very slow process filled with medication, therapy and monitoring for years.

“I can assure you the hospital, for liability reasons, is incredibly conservative,” Hart said. “We take our public trust very seriously … we have to be very careful.”

Murderers have gone back into the community, he said.

For criminals to be released, they must respond to therapy, take medications, participate in programs and “convince us that they are aware of the limitations of their illness,” he said.

Many can’t do that and never leave the hospital, he said. Some sink into a depression over the “realization of what’s been done,” he said.

“That can be a very, very difficult thing for some people,” he said.

However, it is rare for a jury to find someone not guilty by reason of insanity, Hart said.

Tyne said Skagit County averages about one successful insanity case per year, and those cases aren’t always major.

In June, 25-year-old Jessica Blindauer was found not guilty by reason of insanity to charges of eluding a police officer, reckless driving and resisting arrest.

Blindauer was not committed to a hospital but ordered to regular mental health treatment, according to Skagit County Superior Court documents.

Tommy Thompson was acquitted by reason of insanity from a first-degree rape charge in 1998. He was released from Western State Hospital six years later and moved to Georgia, according to court documents.

John Junker, a criminal procedure expert at the University of Washington School of Law, said the insanity plea is meant to take into account the best outcome for the defendant and the public.

“Usually in cases like this one (Zamora’s), the crime is so awful that from a nontechnical point of view you have to say there is something weird about that guy,” he said.

The question is if the judicial system or psychological and medical intervention is more fitting.

“It’s the way in which this state honors the notion that insane people are not capable of committing crimes and honors the notion that insane people may well be dangerous,” Junker said.

* Tahlia Ganser can be reached at 360-416-2148 or at .