Case against psychiatrist took years to assemble

As seen in the San Francisco Chronicle

There were warnings for almost two decades that Dr. William Ayres, the retired child psychiatrist from San Mateo accused of molesting five former patients, might have been abusing boys sent to him for counseling.

But some of the alleged victims couldn't be found or wouldn't cooperate, and Ayres continued to receive scores of referrals from San Mateo County's juvenile justice system for years, according to police reports, court records, other documents and interviews.

When a criminal case against him was finally filed earlier this month, it was partly the result of years of digging and prodding by a 52-year-old freelance writer from New York City who had never met Ayres, but became the most dogged advocate for many of his alleged victims.

Ayres, now 75, was treating boys sent to him by juvenile court judges as late as 2003, 16 years after the first complaint about him was filed with county officials. From 1987 to 2002, government agencies received at least four complaints involving allegations that Ayres was molesting male patients, according to records and police officials. Authorities alerted juvenile court judges after the fourth complaint was filed, police said.

"He continued to be a primary care provider for years," said Jeff Lugerner, who was a licensed clinical social worker when he brought a complaint to authorities in 1987 after one of Ayres' former patients told him the psychiatrist had fondled him at age 15. "That's what I'm really floored by."

Authorities said there were plenty of impediments to building a case. Not the least was the difficulty of verifying accusations brought by once-vulnerable or troubled youths against a former president of the American Academy of Child and Adolescent Psychiatry praised by county officials in 2002 for his "tireless effort to improve the lives of children."

"We took quite extraordinary measures in this case because there was so much out there, but nothing we could substantiate for a long time," said San Mateo Police Chief Susan Manheimer, whose agency has investigated Ayres several times since 1987.

"By the time it became apparent to us it was real -- there's smoke here, and now it's fire -- once we determined that, we took very aggressive steps," said Manheimer, who became chief in 2000.

Ayres was charged this month with masturbating five boys in his private, soundproof office from 1988 to 1996 under the guise of giving them medical exams. The psychiatrist, who is married and has adult children, has declined to comment about his case other than to say, "These are all very complex situations."

He acknowledged under oath in 2004 as part of a lawsuit filed against him that he sometimes conducted physical exams of patients, but he denied ever masturbating them, according to a transcript of his deposition. He has not entered a plea on the current charges.

At least thirty-seven men have accused Ayres of molesting them as boys dating to at least 1969, but most of the cases fell outside the statute of limitations and couldn't be charged, prosecutors said.

The first known complaint against Ayres was filed with the county social services agency in 1987, six months before the psychiatrist allegedly fondled the first of the boys he is now charged with molesting, records show. San Mateo police determined the report was unfounded, and the case was never formally referred to prosecutors.

The original police file, including a copy of a $1,000 check that Ayres allegedly sent to the boy's mother in 1985 because of an "accounting error" after the youth refused to go to more sessions, is missing, according to a 2005 police report.

The case probably wouldn't have been prosecuted without a corroborating witness or other evidence, said Deputy District Attorney Melissa McKowan, who is handling the current charges against Ayres.

"You have a prominent psychiatrist saying, 'I didn't do it,' and a troubled youth who's seeing a psychiatrist," McKowan said. "You have to be able to prove a case beyond a reasonable doubt. ... It doesn't mean I don't believe that boy today."

Two other complaints were received in 1994, including one from a former patient who told the state Medical Board that Ayres had molested him in 1966, San Mateo police Capt. Mike Callagy said. Board investigators could not find that man, however. The other accuser -- a Folsom State Prison inmate who told a nurse that Ayres had molested him as a boy during court-ordered sessions -- refused to cooperate with police, according to records and police officials.

Ayres, in his civil deposition in 2004, said the county's juvenile justice system, its court-appointed attorney program, pediatricians and social workers all referred patients to him for decades. He estimated that he had seen about 2,000 patients in 40 years of practice in the county.

Police and later the district attorney's office were under no legal obligation to report the allegations to people who were sending boys to Ayres for counseling, said San Mateo County District Attorney Jim Fox.

"Obviously, you want to minimize the harm; you don't want people to be put in a position that we believe is dangerous," Fox said. "If we had known about it and there were still referrals, we would probably have taken action, but obviously hindsight is 20/20."

In September 2002, a complaint to San Mateo police from a man who said Ayres had molested him starting in 1976 resulted in a criminal investigation. County referrals to the psychiatrist continued, however, and payments from juvenile courts were not cut off until December 2003, after police alerted court officials and social services.

Juvenile Court Supervising Judge Marta Diaz, who records show referred a patient to Ayres as recently as January 2003, declined to comment about the psychiatrist or the juvenile court referral system, citing judicial guidelines against discussing pending cases.

Police considered the case reported by the man in 2002 a solid one, but their investigation ended abruptly when the U.S. Supreme Court struck down a state law in June 2003 that had retroactively extended the statute of limitations for filing child-molestation charges. The alleged victim then sued Ayres in December 2003; the psychiatrist agreed to a confidential settlement about a year and a half later.

Criminal charges against Ayres might never have been brought if not for a chance contact that the 2002 accuser made with a New York freelance writer and victims rights advocate, Victoria Balfour.

A mutual friend had suggested that the man call Balfour about tips for finding writing work. Among Balfour's credits was a 1999 piece in Vogue magazine about eating disorders, in which she wrote of having been molested as a child. During their conversation, the former patient mentioned that Ayres had abused him.

Over the next four months, Balfour urged him repeatedly to call police, she said in an interview. The man finally did so, but after the Supreme Court ruling that killed his criminal case, investigators' interest in Ayres flagged, Balfour said.

On her own, she pursued leads from the civil case, placed postings online and took other steps, compiling a list of 15 possible victims by 2005. She pushed authorities to prosecute the psychiatrist.

"It was like treading water," Balfour said. "I felt like the police didn't know how many victims there were."

One alleged victim sent an e-mail to Balfour in the fall of 2005, in which he wrote, "I'm not strong enough to pursue anything. It makes me very depressed. The (San Mateo) police, courts, city officials will never tell the truth. It will make them look bad. No way will they do that for me."

Two weeks later, the man was killed in a motorcycle crash. Balfour called it the catalyst for her. She sent Callagy, the San Mateo police captain, an e-mail saying, "I think the time has come to figure out a way to find new victims."

Callagy responded later that day, saying he was prepared to take a "real long shot" to obtain a search warrant for Ayres' patient records and seek victims whose accusations would fall within the statute of limitations, e-mails show.

"I am willing to do everything I can to make sure justice prevails," Callagy wrote.

Callagy asked Balfour for the names, phone numbers and dates of alleged molestation victims she had compiled to "show a sustained pattern of cases," e-mails show.

"I know the amount of work that you put (into) this has been unbelievable," Callagy wrote to Balfour a few days later. "I am personally going to write the search warrant."

Police served the warrant on Ayres' home and a storage locker in March 2006, seizing records for more than 800 former patients, authorities said.

After trying to track down those former patients, police came up with three alleged victims, a process Callagy called "a little like looking for a needle in a haystack." After charges were filed, more than a dozen additional accusers came forward, and prosecutors have added two of them to the criminal complaint against Ayres.

Callagy said police worked the case "pretty steadily" for years, but he acknowledged that Balfour's efforts really helped.

"What is most important is that these victims came forward," Callagy said. "I don't know if the victims would have come forward without her encouragement."