Echols' mental stability during the years immediately prior to the murders and during his trial was the focus of his appellate legal team in their appeal attempts. In his efforts to win a new trial, Echols, 27 at the time of the appeal, claimed he was incompetent to stand trial because of a history of mental illness. The record on appeal spells out a long history of Echols' mental health problems, including a May 5, 1992, Arkansas Department of Youth Services referral for possible mental illness, a year to the day before the murders. Hospital records for his treatment in Little Rock 11 months before the killings show a history of self-mutilation and assertions to hospital staff that he gained power by drinking blood, that he had inside him the spirit of a woman who had killed her husband, and that he was having hallucinations. He also told mental health workers that he was "going to influence the world."