Tuesday, January 11, 2011

Neo-NeoCon: "So, why did no one report Loughner to the Arizona mental health system?"

In my mind, the bigger question is, "would it have done any good?" Time and time again, I have seen the mental health system fail for those who are ill and the families that need them. Psychiatrists hand people meds and don't monitor their patients and psychologists don't take the time to really assess the patient and take the time to do the grueling work it takes to get someone who is psychotic/and/or personality-disordered back to reality. It is hard time-consuming work.

I have gotten a number of calls and emails from the media about this case and many others. Mainly, these reporters want some quick answer about why these killings happen with a simple explanation or game plan to tell their readers or viewers how to stop it. In my experience, there isn't one. The solution is rather, a complex set of variables that must be assessed and then intervened upon. This takes tremendous time, energy and work, none of which our quick-fix society wants to engage in.

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22 Comments:

Blogger AST said...

Just what I would have said. The problem is that if they had called the cops and courts nothing would have been done, because he hadn't done anything yet.

If you think somebody's dangerous and you turn him in and he gets released who do you think he'll come looking for? I think that's what goes on in the minds of the people who are now talking about him.

1:49 PM, January 11, 2011  
Blogger Larry Sheldon said...

The bigger question is indeed, would it have done any good.

Early extractions from what passes for news suggests that it was indeed reported

and did no good.

It could do no good. The ACLU requires it.

5:00 PM, January 11, 2011  
Blogger I R A Darth Aggie said...

The problem is that if they had called the cops and courts nothing would have been done, because he hadn't done anything yet.

He phoned in death threats to various people in the Tucson area: people connected with the Pima Community College, local bloggers and others. Simply arresting him for a single felony beef puts him in the NICS system as a do not sell firearms to this person. He would have also been required to turn over any firearms he possessed until final adjudication.

That should have slowed him down, and the window of opportunity might have slammed shut on him.

6:50 PM, January 11, 2011  
Blogger Cham said...

As you can see from IRA Darth Aggie's post we already have plenty of laws that protect the public, it's just a matter of enforcing them or not ignoring them because they create work.

7:57 PM, January 11, 2011  
Blogger fred said...

Get a few facts on this. Arizona in his area had cut mental health support by 50%. Reports on his problems had been issued by everyone that had contact with him. The system is falling apart and elsewhere, there are possible remedies, places to check on such things. Arizona of course has budget problems far worse than in most places.

8:12 PM, January 11, 2011  
Blogger Grey Swan said...

One thing that must be kept in mind is that life is imperfect. There is no way to prevent every tragedy. Furthermore, creating permanent policy in response to what appears to be a rather unique occurrence is a very dangerous idea indeed.

The rest is here...

8:31 PM, January 11, 2011  
Blogger DADvocate said...

"would it have done any good?"

Very doubtful. I've never come across the mental health entity that would do anything if a problem was reported directly to them. Mental health agencies aren't law enforcement. They can't go out and pick up people, investigate, etc.

There are reports law enforcement, the sheriff in particular, was notified and did nothing. Too often, law enforcement sees their job and catching the bad guy after he's done something beyond threats.

Interesting how the journalists wanted the simple, easy answers. That fits their level of understanding.

Fred - they could have increased the funding 500# and it wouldn't have stopped this incident. Throwing money at every thing isn't the answer to our problems.

8:40 PM, January 11, 2011  
Blogger MeTooThenMail said...

As I wrote below - convincing LE or the court of imminent danger to oneself or others is not always easy, nor does it provide for permanent relief.

And yes, Dr. Helen is correct. Each case, each set of circumstances often requires distinct resources and remedies.

In this specific case, there are confirmed reports that Mr. Loughner did make threats against a person or persons. What if he was arraigned?

One could speculate that his illness would be manifest and detected, he may have been held, treated for a period of time, and eventually released.

This may have prevented him from acquiring a firearm.

It may be that the failure here was in fact a failure of LE to fully investigate and prosecute the confirmed threats.

Or not.

If estimates of schizophrenia are 1% (3M people) are correct, there is no way to fully assess the immediate and continuous danger these persons have to themselves or others.

More to the point, virtually all violent crime is committed by non-schizophrenics. Sociopathy (amongst other Axis II diagnoses) substance abuse and dependency, alcoholism, are far more common traits in violent crime - and there is little or no progress on these fronts.

9:52 PM, January 11, 2011  
Blogger TMink said...

Most schizophrenics are less likely than a healthy person to committ assault.

Dude is just nuts. This is sad and scarry, but we live in a world that is at least at times dangerous. God bless all the people involved.

Trey

9:21 AM, January 12, 2011  
Blogger Larry J said...

One could speculate that his illness would be manifest and detected, he may have been held, treated for a period of time, and eventually released.

This may have prevented him from acquiring a firearm.


It might've prevented him from acquiring a firearm legally but nothing would've stopped him from getting one illegally. There are a lot of people with criminal records who have no trouble obtaining firearms. As in the case of illegal drugs, if you want to get a gun, there's always someone willing to sell you one or you can steal one.

Whenever something terrible happens, the knee-jerk reaction is to pass new laws. However, the law as a whole only works for people who tend to obey the law. Passing new laws doesn't decrease crime, in fact, just the opposite happens most of the time.

9:34 AM, January 12, 2011  
Blogger Cham said...

If anything, Mr. Loughner looks extremely happy if I am reading his mug shot correctly. He didn't fit in to society, he didn't get along with his parents, he had trouble taking direction from authority, he didn't maintain friendships. Though, he desperately craved attention. He's now getting that much-sought attention from the media and the judicial system. Mr. Loughner is on the win-win program. Am I not the only one that recognizes this?

9:37 AM, January 12, 2011  
Blogger MeTooThenMail said...

Larry J

Yes, Mr. Loughner may also have tried and successfully obtained a firearm illegally.

We can only speculate as to the probability of his success given his mental state, but now we are traveling far afield.

I make no claim as to the need for increased "gun laws" only that had LE responded differently, the events of last Saturday may not have happened as they did.

9:40 AM, January 12, 2011  
Blogger Cham said...

Now that we are learning more about Mr. Loughner maybe he wasn't nuts. Reports of his parents routinely buying multiple cases of beer which tells me they might have been alcoholics, being constantly hassled by both parents and being chased by his father the morning of the killings. Maybe Mr. Loughner decided he wouldn't be able to satisfy anyone so he just gave up and checked out of the expected path of a young American white male.

12:55 PM, January 12, 2011  
Blogger Helen said...

Cham,

"Am I not the only one that recognizes this?"

No, it's pretty evident. I wrote about this phenomenon in my book on school killers. They do it to get noticed, in part, and also to be surrounded by many important people (lawyers, doctors, law enforcement, media etc) who fulfill the narcissistic need they have for attention, of whatever kind. The media frenzy makes it worse and probably encourages the next killer into feeling like his moment in the sun will come next. Loughner even has the entire country fighting about politics. He has to be loving it.

1:28 PM, January 12, 2011  
Blogger dr.alistair said...

how does the average person assess whether someone is deranged enough to get a gun, or is just a little odd?

if we start encouraging people to turn peole in because they feel they might be a danger, we set a moster in motion.

yesterday i walked my 6 month old malmute/bernese cross the two miles to starbucks and left him outside while i say and talked with friends for half an hour.

it was about 30 degrees outside and the dog settled down to wait for me to resume our walk as we do most days.

while i was sitting there one of the servers told me that someone had made a complaint that the dog was shivering and had been abandoned and that she was going to call animal control.

as i was leaving the animal control van appeared and i had to tell them to mind thier own business as my freaking snow dog (husky and bernese mountain dog....!!!!) was fine sitting for a while waiting for his master and that they should think before hassling someone acting in a law-abiding fashion.

do we want these same people able to notify the authorities if they suspect that someone might be in need of meds or incarceration?

2:43 PM, January 12, 2011  
Blogger Allison said...

--How does the average person assess whether someone is deranged enough to get a gun, or is just a little odd?

Actually, the average person would know very well how to tell. Every instinct in their brain, honed over several million years would tell them.

It's the educated person, the PC person, the person who does not allow themselves to act on their brain's split second judgment system (which is what has kept their gene line alive this long) that has trouble telling.

There is nothing that stops people from calling the police on suspicious behavior right now. Some people are more than willing to do that, but most would feel embarrassed, or squeamish, or second guess themselves for calling and saying "something is not right with this person, and they scare me."

"A little odd" isn't someone who isn't in reality, using words for his own meaning, experiencing time in their own way. "A little odd" doesn't explain someone whose eyes can't focus on you ever, or whose eyes can't stay still as they dart back and forth, and who says things that have nothing whatsoever to do with what is going on around them.

Deranged people aren't just making normal rational decisions but mistaken about the probable outcomes. A psychotic in a mental hospital once got mad at me because she claimed I'd made the soda machine go away. I'd stolen it, she said. She was agitated about it. The medic tried to tell her "you're on the wrong floor; this is floor 2, not floor 3". A sane person looking for the soda machine would have been confused a bit and then wondered where they were, sooner or later realizing they were mistaken about being on floor 3. She saw me standing where the soda machine should be and thought I'd stolen it from her. Nothing in her brain told her that 100 lb girl can't steal or hide a soda machine.

10:47 PM, January 12, 2011  
Blogger ZZ said...

I have to go out on a limb here and dispute whether we even need, or should want, a "mental health SYSTEM" per se.

I think that any system that is organized enough and thorough enough to guarantee prevention of these freakishly rare mass murders would also snare and/or label and ostracize many, many people who are just odd but harmless. If there is a bright dividing line that predicts who will exhibit violent behavior and who will not, if there is some formula by which the two can be separated with more than 99% accuracy, then there are just not enough people in our society willing to be trained in this algorithm of evaluation and to spend their lives doing it.

In short, it would require tens of thousands of professionals that are just as smart and dedicated as Dr. Helen. People like her are just not that common.

10:52 PM, January 12, 2011  
Blogger Cham said...

Ah, you psychologists with your degrees, your clipboards and your fancy 8 syllable words, for some reason you think you are qualified to pigeonhole people in categories: very disturbed, somewhat disturbed, a danger to themselves and others, psychotic, schizophrenic mentally challenged, whatever. I'm not buying at all. You lost me when you created the category, antisocial, and decided those that fit into that box are bad people.

You know what you can do with your clipboards. You can tell everyone that Mr. Loughner was disturbed, I'm not buying.

8:19 AM, January 13, 2011  
Blogger dr.alistair said...

allison, i get what you are saying, but we live in a p.c. society where bureaucrats and liability issues are more important that a person`s risk to others.

in my example with my dog, the woman was clearly projecting a number of issues onto a dog sitting waiting for his master to return, and was setting a series of actions in motion without care or concern for the outcome or the effects on other people.

animal control actually found me and the dog walking home and harrassed me and only stopped when i told the guy he had no authority over me or my dog, and that if he wanted to persist i would have him charged with said.

and the woman who started it all?

probably some borderline personality type with specific hostilities to do with dogs, the perception of abandonment, delusions, hysteria etc....

maybe i should alert the authorities?

2:12 PM, January 13, 2011  
Blogger Micha Elyi said...

A psychotic in a mental hospital once got mad at me because she claimed I'd made the soda machine go away. ... Nothing in her brain told her that 100 lb girl can't steal or hide a soda machine.-Allison

Consider another point of view. A lot in her brain (i.e. experience) told her that in a mental hospital a 100 lb girl who's not herself a patient can often direct some large men on staff to do such things as move a soda machine. Quite a lot that goes on in a hospital seems arbitrary and capricious to the hospitalized. You may wish to find another example to support your claim that "Deranged people aren't just making normal rational decisions but mistaken about the probable outcomes."

6:00 PM, January 14, 2011  
Blogger DRJ said...

Dr. Helen points out that these cases present complex problems that require complex solutions. That leads me to believe it's even more important for the family to take responsibility. Who else will care enough to put the person's long-term interests first?

11:10 PM, January 16, 2011  
Blogger Chris said...

Three comments. (I work in Mental Health, at the sharp end).

1. The model US code for mental health requires a very high standard of danger for commital. It also gives the detained patient the right to refuse treatment. The Australian and NZ codes state "serious" danger to self and others OR inability to care for self. This lower standard allows one to detain people who are decompensating before they go off the cliff.

2. In my view, if you detain, you detain a person with an illness you can treat. And you do so. Aggressively. This requires community treatment orders, and the staff to do these things. A simple cure is to allow familes to sue health insurers if these things are not provided for... under duty of care.

3. Finally, psychiatrists are not jailers. We want to get people better and we take risks. This backfires at times -- we have people assault and suicide. We can't prevent every tragedy. But we can minimise these things -- either by funding assertive community treatment (which is expensive) or reopening the psychiatric hospitals (which is also expensive). What you can't do is mandate something -- and then not fund it.

My sympathies to all the families involved, but the legislature in Arizona needs to have a good look at these things before the gun laws.

4:56 AM, January 20, 2011  

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