In 1971, Franklin H. Frye was accused of stealing a $20 necklace from a woman on the street, and the court found him not guilty by reason of insanity. He was committed to Saint Elizabeths Hospital, where he has spent almost all of the past four decades, The Washington Times reports.

His lawyers have been trying to free him for many years. In 2005, his lawyer asserted in a motion that "Mr. Frye has recovered his sanity and no longer suffers from a mental illness as defined by law." It wasn't the first time he's sought release.

So how exactly did a man accused of a petty, nonviolent crime end up spending most of his life legally committed to a mental hospital? Digging into Frye's case, it seems to be an unfortunate combination of difficult circumstances, bad luck, and bureaucracy. Here's what we found.

The long and winding paper trail

The director of Saint Elizabeths first recommended Frye's unconditional release in 1973, a motion filed on Jan. 8 notes. At that time, the court instead granted Frye a conditional release, giving him permission to seek employment. Still, if all had gone well, this should have led to Frye transitioning into the community and out of the hospital on a permanent basis.

It's not entirely clear why that conditional release, as well as others in subsequent years, always ended up with Frye back at Saint Elizabeths full time. But the 2005 court order explains what went wrong with one such release, granted more than a decade ago:

On January 8, 2001, he was placed in the community in an Intensive Rehabilitative Residence. However, his mental condition deteriorated rapidly. He violated the home’s smoking regulations and concealed a knife in his room. Thus, he was returned to inpatient status on April 23, 2001.

In the document the judge acknowledged that Frye had been "intrusive and oppositional," known to distort reality and struggle with hospital rules. Yet, Frye worked five days a week in the Hospital's Work Adjustment Training Program and regularly went on trips to visit his family without incident.

The judge then ordered Frye's conditional release into outpatient treatment, concluding that he is medicated, "mentally stable," and "will not, in the reasonably foreseeable future, present a danger to himself or others because of mental illness."

It's unclear whether or exactly how that release went wrong, but it specifies that "if [the] defendant's mental condition deteriorates, or if he violates the conditions of this release he shall be returned to inpatient care at the Hospital."

In 2008, Frye's lawyer again petitioned the court for his unconditional release, saying he no longer suffered from a mental illness. The most recent motion, filed on Jan. 8, was submitted after five years passed with no response from the court to the 2008 filing.

Silvana Naguib, the public defender now representing Frye, argues in the Jan. 8 motion that there is no reason for her client to remain at Saint Elizabeths:

In the early years of Mr. Frye’s hospitalization, Mr. Frye would sometimes get in fights with other patients, often over money, food, clothing, and the other hotly-desired commodities of institutional life. However, in the last decade, as Mr. Frye has aged, these conflicts have all but vanished. Now, nearing 70, Mr. Frye displays no dangerous behavior of any kind.

We reached out to Naguib for comment but have not heard back.

Frye currently has permission to leave the hospital to visit his family and attend a now-shuttered day program, but he still lives at Saint Elizabeths.

The hospital

The D.C. Department of Mental Health, which oversees Saint Elizabeths, declined a request for comment about Frye from The Washington Times. A spokesperson said the hospital considers the release of each patient "not guilty by reason of insanity" at least once a year.

But its procedure for successful releases has been called into question.

After a review of Saint Elizabeths in 2005, the Department of Justice signed a settlement agreement with the D.C. government, compelling Saint Elizabeths to address several alleged deficiencies. In the DOJ's 2008 progress report on the settlement, it noted several problems with the hospital's psychiatric care, psychiatric diagnoses, and discharge planning.

The DOJ report went into some detail on what was going wrong with Saint Elizabeths' discharges:

Due to a lack of adequate assessment and documentation upon admission and throughout the treatment planning process, the hospital is not able to adequately determine if individuals are being appropriately discharged to settings commensurate with their needs. Additionally, the hospital currently lacks a mechanism for follow up with discharged individuals and/or their community case managers to determine if the discharge was successful and necessary community-based services and supports were implemented and utilized.

Still, Frye might be a particularly challenging case.

His diagnosis

While we don't know all the details of Frye's circumstances, a 2005 court order said he received "a diagnosis of Schizoaffective Disorder, Bipolar Type; Alcohol Abuse, in a controlled environment; and Borderline Intellectual Functioning."

Schizoaffective Disorder shares some symptoms with schizophrenia and some with mood disorders, and Borderline Intellectual Functioning designates those with IQs above the range for intellectual disability (once called mental retardation) but below the range for "normal."

Such a dual diagnosis can exacerbate the symptoms of both disorders and make proper care and treatment especially complicated and difficult. When people have "a psychiatric diagnosis in addition to their intellectual disability," Susan Hayes of The University of Sydney writes in the International Handbook of Applied Research in Intellectual Disabilities, "they may fall through the gap between intellectual disability services and mental health services."

One Missouri study found that having either "a psychotic disorder, a mood disorder, a substance abuse disorder, or mental retardation/borderline intellectual functioning" decreased the odds that someone committed after using the insanity defense would be unconditionally released.

Frye has a combination of all four.

His stay at Saint Elizabeths now has been longer than that of the Hospital's most famous resident, John Hinckley Jr., who was committed to Saint Elizabeths after his 1981 assassination attempt on Ronald Reagan and was recently granted a conditional release.