A Kailua man acquitted by reason of insanity for the slayings of his mother and aunt in 2004 was back in court yesterday for threatening and intimidating fellow patients and staff at Hawaii State Hospital.

A judge granted the state health director permission to force Micah White to take antipsychotic medication after White, 26, agreed with hospital staff reports that his behavior poses a danger to himself and others and is the result of him refusing his medication.

In February, White followed another male patient around until the other patient threatened to "dig (White’s) eye out," according to a report from the hospital staff psychiatrist. That month White also spat on a staff member’s shoe and yelled, "You are infected with a disease," and, "Get out of my face."

The following month White yelled at a female patient, "Get away from me, you psycho," and instigated a fight with a male patient in the hospital’s gym.

In April, White stared at another patient and said, "I’m gonna cut your head off."

In May, White blocked the door to the gym. When members of the hospital’s response team searched him, they found four sharp rocks and broken glass hidden in his socks and in a bandanna wrapped around his right knee.

He has also locked himself in his room on more than one occasion by tying the door handle with a T-shirt or a sheet. He has pulled the fire alarm.

The report says White began refusing to take his medication a few days in January and, as the months progressed, refused more frequently. During that time his behavior deteriorated, he became more isolated and he refused to talk to staff. The frequency of his disruptive, intimidating and threatening behaviors also increased, according to the report.

White stabbed his mother and aunt multiple times on April 5, 2004, before setting them on fire. The fire spread and burned down the family’s Kainui Drive home.

His aunt, Sharon White, 58, suffered stab wounds in her chest, hands and arms and burns over 50 percent of her body. She died April 14.

His mother, Kerry White, 48, suffered stab wounds in her neck and chest and fractures to her ribs and left arm in the attack. She also suffered burns over 80 percent of her body. She died April 29.

Micah White told his court-appointed mental health examiners that he thought his mother and aunt were vampires who were going to kill him. His family said White exhibited bizarre behavior before the killings and had a preoccupation with vampires.

A state judge found Micah White not guilty in 2006 of murdering his mother and aunt by reason of insanity and placed him in the custody of the health director at the Hawaii State Hospital.