THE PSYCHIATRIST WHO treated James Holmes before he attacked a Colorado movie theatre said she did not have enough evidence to have him detained even though he confessed his homicidal thoughts

Dr. Lynne Fenton was so concerned about him though that she violated his health care privacy to call his mother.

Fenton yesterday testified that Holmes SAID he was having homicidal thoughts as often as three or four times a day, but never let on that he was building a weapons arsenal and planning a mass killing.

If he revealed his intent, “I likely would have put him on a mental health hold and contacted the police,” Fenton said.

But her concerns remained, even after he abruptly walked out of her office in 11 June, 2012, about a month before he sprayed bullets into the audience at a Batman movie, killing 12 people and wounding 70 more.

Fenton called Holmes’ mother, but was told that her patient had been shy and socially awkward for many years, diminishing the apparent risk that he would be a danger to himself or others.

“I thought it was much less likely this was a sudden, new psychotic break,” Fenton said.

The scene outside the cinema shooting in 2012. AP / Press Association Images AP / Press Association Images / Press Association Images

Freed from patient-client privilege by Holmes’ insanity plea, Fenton testimony in Holmes’ death penalty trial marked her first public statements about him.

Among other things, she described his behaviour as anxious, hostile, bizarre and so worrisome that she took it upon herself to alert campus police but didn’t find the evidence needed to hold someone against his will.

Defence lawyers say Holmes, who has pleaded not guilty by reason of insanity, is schizophrenic and was in the grips of a psychotic episode as he carried out the attack on. If the jury agrees, he’ll be committed indefinitely to a mental hospital.

The state must prove he was legally sane at the time, which is the conclusion of two court-appointed psychiatrists who examined Holmes months and years after the attack. A guilty verdict could bring the death penalty or life in prison without parole.

Fenton’s testimony helped explain how she handled Holmes and his thoughts of killing people. But it’s unclear how it will play with jurors trying to assess his mental state at the time of the shooting.

Under cross-examination by Tamara Brady for the defence, Fenton acknowledged she had written in her notes that Holmes “may be shifting insidiously into a frank psychotic disorder such as schizophrenia.”

The trial is ongoing in a Colorado courtroom. AP AP

Fenton’s session notes said his demand to know her “philosophy” might indicate “psychotic level thinking.” When Brady pressed her on that, she confirmed Holmes was at the age when schizophrenics sometimes experience their first psychotic break.

Fenton and Holmes had five therapy sessions between mid-March and June 11, 2012, when he dropped out of the graduate neuroscience program at the University of Colorado. He had come in with what a social worker described as the worst obsessive-compulsive disorder symptoms she had ever seen.

Holmes received medicine but deflected efforts to probe his thinking, Fenton said.

At times, he showed flashes of anger, she said.

When Holmes couldn’t get a prescription filled because Fenton miswrote his name on the prescription, he sent her an email with an emoticon that he said signified him punching her.

When she asked him about it, he responded: “Violence, is that what you wanted to hear?”

Holmes could face life in a mental institution or the death penalty. AP / TheDenverPost AP / TheDenverPost / TheDenverPost

Fenton said Holmes may have been worried that she was trying to lock him up. Brady asked whether Fenton pressed him on that point, and she said she did, but “he wouldn’t answer.”

Two years after the attack, Holmes told a court-ordered examiner that he kept secret his elaborate schemes and to-do lists. He waited until just before the assault to mail his journal to Fenton.

“I kind of regret that she didn’t lock me up so that everything could have been avoided,” Holmes told the examiner.

Fenton, who also faces a civil suit accusing her of not doing enough to stop the attack, faced a few more questions from the jury before leaving the witness stand. A prosecutor asked if she could be released from her subpoena, but the judge agreed with a defence objection, saying she may be summoned again.

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