Central Ohio Psychiatric Hospital was a pivotal institutional setting in Billy Milligan’s legal and psychiatric history: he was sent there from prison for evaluation and treatment, later returned to a specialized ward within the institution, and was ultimately ordered back to Athens Mental Health Center. Its place in the narrative is defined by a recurring tension. Clinical opinions about Milligan’s condition informed legal decisions, while the question of where and how he could be treated remained contested even after the court had resolved the charges. The book also notes that he had spent three months at the hospital when he was fifteen, making it a setting he encountered at both an earlier and a later stage of his life.

Transfer and competency evaluation

On October 24, Judge Jay Flowers ordered that Milligan be transferred immediately from prison to Central Ohio Psychiatric Hospital. The order also directed Southwest Community Mental Health Center to examine him and report on whether he was competent to stand trial. Dr. George Harding Jr. was permitted to attend at his discretion. The order thus connected the hospital to a specific legal question: whether Milligan, at that point, could understand the proceedings and assist his attorney. It did not itself decide whether he was criminally responsible when the charged acts took place.

A report submitted on November 15 described Milligan as competent to stand trial and capable of assisting in his defense. The report reflected the assessment of Dr. Stella Karolin and Dorothy Turner, who had last seen him, but it also stressed the fragility of his condition. His then-present fused state, the report warned, might at any time disintegrate into the dissociated personalities previously observed. The finding therefore did not present competence as a settled or durable recovery; it described a capacity that clinicians believed was present but vulnerable to change.

The distinction became visible on December 4, when Milligan was moved from the Columbus Ohio Psychiatric Hospital to court. Looking in a mirror, he noticed that his mustache had been shaved, an act he did not remember. The episode brought another period of lost time into the immediate lead-up to trial. He understood himself as partially fused, not as the core Billy and not as a completely fused person, and believed that Arthur and Ragen had remained apart. He nevertheless continued to answer to Billy’s name and was considered sufficiently able to proceed. The hospital period thus sits between a formal finding of present competence and Milligan’s own account of continuing discontinuity in memory and identity.

Trial outcome and transfer to Athens

The trial separated two questions that the hospital evaluation could not settle by itself. Judge Flowers dismissed the first rape count, citing the absence of corroborating evidence and of a similar modus operandi. On the remaining counts, the court considered stipulated medical evidence that Milligan had been mentally ill at the time of the offenses, unable to distinguish right from wrong, and unable to refrain from the acts. The judge found him not guilty by reason of insanity on counts two through ten. This decision concerned his mental state at the time of the offenses, rather than simply his ability to participate in court in December.

After the verdict, Judge Metcalf committed Milligan to Athens Mental Health Center in the custody of Dr. David Caul. The move ended Central Ohio Psychiatric Hospital’s immediate role as his pretrial setting, but not the larger dispute over the relationship between psychiatric care, public safety, and confinement. Milligan was taken away before Judy Stevenson and Gary Schweickart returned to say goodbye. The narrative records the hurried departure and the distress it caused, details that mark the transition from a court process to a new period of treatment rather than a simple release from institutional control.

A prior stay and a later treatment ward

Central Ohio Psychiatric Hospital also had an earlier place in Milligan’s history: he had spent three months there at age fifteen. Years later, a proposed move from Dayton Forensic Center to the Central Ohio Regional Forensic Unit offered a possible route out of one maximum-security institution, though not a return to Athens. The unit was part of Central Ohio Psychiatric Hospital, and Dr. Judyth Box, who had testified for Milligan at a previous hearing, had recently become its clinical director. Milligan initially resisted transfer to another maximum-security hospital, saying he wanted to return to Athens and Dr. Caul; he eventually agreed after the possibility of treatment with Dr. Box was raised.

As part of the treatment plan, Dr. Box placed Milligan on a new ward with three other patients she had tentatively diagnosed as having multiple personalities. She believed that people requiring specialized treatment might benefit from being together. The arrangement became a public controversy. Two weeks before an election, State Representative Don Gilmore accused the Columbus hospital of giving Milligan preferential treatment, including allowing him to choose the patients who would live on the ward. Hospital administrators denied that he was receiving such treatment, but Gilmore continued to press his allegations. The dispute showed how a clinical arrangement could be reframed as a question of privilege and institutional fairness, independently of whether the ward was therapeutically appropriate.

Competing assessments and the decision to return

At a later hearing, Dr. Mijo Zakman, the clinical director of Central Ohio Psychiatric Hospital, testified that he and two other psychiatrists had examined Milligan for about two hours and had seen no personalities. Zakman described him as not mentally ill and as having an antisocial personality. The testimony threatened to change the terms of the case: if Milligan were found not mentally ill, he might be discharged from the hospital and taken into custody by the Ohio Adult Parole Authority as a parole violator. A disagreement over diagnosis therefore carried consequences beyond clinical language, potentially changing both his institutional placement and his legal status.

Dr. Jay Davis offered a sharply different assessment. He described Milligan as fragmented and said that the personality present was not Billy. Davis also argued that maximum-security facilities obstructed treatment for people with multiple personalities and that treatment at the Columbus facility was likely to be unproductive. Dr. Harry Eisel’s testing of several of the more aggressive personalities—including Philip, Kevin, and Ragen—did not find them significantly dangerous. The hearing also included a social worker’s claim that Milligan had threatened him and his family; under questioning, the worker acknowledged that patients often threatened him and that those threats had not led to anything. Dr. Caul, for his part, said he would accept Milligan for treatment and abide by restrictions the court imposed.

On April 8, 1982, Judge Jay Flowers ordered the Department of Mental Health to transfer Milligan back to Athens Mental Health Center. The order allowed him to paint and do woodworking, while requiring close supervision away from the ward and court notification before he could leave the hospital grounds. On April 15, after two and a half years in three Ohio maximum-security hospitals, Milligan returned to Athens. Central Ohio Psychiatric Hospital was therefore both a place of attempted specialized treatment and part of the custodial system from which the court eventually directed his transfer. The outcome did not establish a final clinical resolution: the narrative reports that, by then, communication among the personalities had been absent for a long time, lost time remained substantial, and the Teacher had not returned.