TUCSON, AZ -- Jared Lee Loughner has threatened to hang himself, apparently remorseful for the Jan. 8 rampage in which he allegedly killed six and wounded 13, including Rep. Gabrielle Giffords, his psychologist said at a new competency hearing for the mass-shooting suspect on Thursday.
"I do not believe he is competent to stand trial today," Loughner's primary treating psychologist, Christina Pietz, said.
"If we take him off medication, he will deteriorate and possibly die," she added. "I think he needs to be on medication for the rest of his life."
Prosecutors want eight more months to treat Loughner for schizophrenia at the Federal Medical Center in Springfield, Mo, where he has been held since U.S. District Judge Larry Burns declared him incompetent in late May. Loughner's attorney, Judy Clarke, argues that more than two months of forced daily medication of a "four-drug cocktail" has only exacerbated the suspect's precarious mental state.
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Clarke cross-examined Pietz for more than two hours Wednesday.
Pietz said Loughner wrote a suicide note and admitted that he'd been thinking about hanging himself.
"His is constantly thinking about the event," Pietz said, referring to the Jan. 8 rally for Rep. Giffords where Loughner allegedly opened fire.
Before being medicated, Loughner suffered from "disorganized thinking and prominent delusions," Pietz said, adding that he likely still suffers from delusions.
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She also said Loughner laughs and smiles at times, but often appears depressed.
Loughner is "guilty and remorseful" about the event, which is the primary cause of his depression, Pietz said.
Because of his depression, he "lacks motivation to defend himself," Pietz said.
In his first public appearance since his May outburst, Loughner sat calmly and watched the proceedings carefully, with two guards in suits standing behind him.
Clean-shaven and wearing his hair short, the 23-year-old defendant was clad in a white T-shirt and tan pants.
Loughner appeared thin, with the psychologist explaining that the patient's appetite has been poor over the last several weeks. She added that he has shown improvement in eye-contract, delusions, expressing himself, sleeping and not pacing so much.
Pietz said the unmedicated Loughner would often look up, laughing and sometimes speaking to someone who wasn't there.
Though Loughner is less paranoid about his defense team after about 60 days of forced medication, "if he remains how he is today, he will not be competent to stand trial," Pietz said.
She said Loughner has seen a security video of the Jan. 8 shooting, but he thinks that it is a re-enactment, or that it has been edited by his attorneys and law enforcement.
Doctors in Missouri began administering psychotropic drugs to Loughner in July after he allegedly became a danger to himself, but Clarke has rigorously fought the forced medication regime.
Initially, a panel of 9th Circuit judges in San Francisco ordered the government to stop the medication, but they changed course after Loughner's condition reportedly deteriorated. The court has yet to rule on the merits of the issue after hearing oral arguments earlier this month.
Prosecutors maintain that Loughner can be restored to competency within eight months. Loughner's primary treating psychologist, Dr. Christina Pietz, reported that "while the defendant presently remains incompetent to stand trial, it is likely that he will be competent in the near future," as "historically most defendants reach competency within eight months of their commitment," according to recent court filings.