Monday, May 07, 2007

Cho Never Received Outpatient Treatment

Shockingly, Cho never received the mandatory treatment he was court-ordered to have in December of 2005 (Hat Tip: Bugs):

Seung Hui Cho never received the treatment ordered by a judge who declared him dangerously mentally ill less than two years before his rampage at Virginia Tech, law enforcement officials said, exposing flaws in Virginia's labyrinthine mental health system, including confusion about the law, spotty enforcement and inadequate funding....

When a court gives a mandatory order that someone get outpatient treatment, that order is to the individual, not an agency," said Christopher Flynn, director of the Cook Counseling Center. The one responsible for ensuring that the mentally ill person receives help in these sorts of cases, he said, is the mentally ill person. "I've never seen someone delivered to me with an order that says, 'This person has been discharged; he's now your responsibility.' That doesn't happen."

Yes, it's always best to let a mentally ill person decide whether or not they need to attend court-ordered treatment. Maybe the next step should be to let criminals decide whether or not they want to go to jail or not.


Anonymous Anonymous said...

The reaction Virginia's mental health authorities may go on record as the largest collective shrug in American history. I understand the sound of bucks being passed could be heard as far away as Australia.

6:37 PM, May 07, 2007  
Blogger DADvocate said...

I love how they always include these two words - "inadequate funding...."

In my community mental health center experience, the "collective shrug" was common. Cho just brought it to light.

9:46 PM, May 07, 2007  
Blogger tomcal said...

Well, this will certainly make my life easier -- do whatever I want, let a court decide if I was mistaken, and suffer what the court recommends, as long as I agree with the recommendation. :)

10:28 PM, May 07, 2007  
Anonymous Anonymous said...

I understand the point, but I don't see how it is realistic for some of these agencies to track everyone down who doesn't want treatment. I work in community mental health, and I end up spending considerable time calling to check up on people or sending service letters to people on my caseload who don't come in. This crowds out time in the day for people actually engaged in treatment who want more frequent appointments.

11:31 PM, May 07, 2007  
Anonymous Anonymous said...

He should have had a parole officer who would jail him if he missed appointments.


11:41 PM, May 07, 2007  
Blogger tomcal said...


My ongoing stalker situation has convinced me that regardless of how things should work, the ultimate burden falls upon the victim, or upon concerned members of the public, to make sure the probation officer does his job.

Unfortunate, but a fact of life these days.

2:01 AM, May 08, 2007  
Blogger tomcal said...

I should say to help the probation officer do his job. I have found that most of them are genuinely concerned, but simply overloaded.

2:03 AM, May 08, 2007  
Blogger KG2V said...

Unless you've actually dealt with it, you have NO idea how hard it is to get someone committed. My B-I-L (RIP) was, what was called at that time, Manic-depressive - aka Bi-polar disorder, with a history of being institutionalized.

One summer, we had a small problem - he took a job as a life guard, and at the same time, his MD went on a 3 week vacation. Between the sunshine and the activity, my B-I-L started drinking a lot more water. Guess what THAT did to his Lithium levels? Yep - his drugs slipped out of control, and he stopped taking them. By the time a MD would see him, it was too late.

During the next 6 months or so, he was arrested for impersonating a police officer (he jumpped in to help with an arrest in the subway - the police let him go instead of taking him to the hospital for an eval), he chased a student down the hall with a hammer in college screaming "I'm going to kill you" (I went to the same college and was able to stop him). He attacked my F-I-L with a knife (Police brought him in for eval - could only get ONE MD to sign for commitment - the other said 'not enough risk' - hello...)

Finally, towards the end of the 6 months, as he started to come down from the manic phase, we were able to talk him into a voluntary commitment. Within a couple of weeks of meds, he was doing MUCH better, but there is an issue - the 6 months tends to mess up certain mental paths - took him years of treatment to get most of the way back to normal. The docs all said "if we could have treated him in the first few weeks, everything would have been much easier"

My B-I-L always thanked me for standing by him and trying to get him help, and was always angry that it is so hard to get care for a person who needs help, but is refusing it, due to being insane.

Unfortunately we lost him a few years back to heart disease

8:06 AM, May 08, 2007  
Anonymous Anonymous said...

Tomcal wrote: "My ongoing stalker situation . . ."

Yikes! I did not know about that. I had two or three people just slamming me here every time I breathed and putting rude posts about my children on my blog, and the rude posts about my children was unnerving enough. I can't imagine dealing with a legit stalker.

I agree that your safety is on a basic level your responsibility. But I certainly hope you get help from the stalkers P.O. Maybe some home baked cookies would let them know how much you appreciate their cooperation in your safety.

Hang in there.


10:26 AM, May 08, 2007  
Blogger tomcal said...

My secretary at the office has a real live stalker who followed her for three years. His approaches became more and more bold, including vandalism of her car (actually her company car, so it was really my car) and leaving her notes such as the following:

"Soon I will die, soon die will I;
Soon *** will die;
Soon will die *** and I..."

It cost $8,000 worth of private investigators and attorney bills to gather enough evidence to convince the DA's office to bring bring charges against him, but we got a felony conviction last August.

For that, he spent 6 months in jail and got out on probation in February. She now has a 500 yard perimeter restraining order and a 500 yard criminal stay-away order, and he has probed the perimeter 3 times that we know of.

As soon as we get hard evidence of him violating the perimeter he will go to State prison for 3 years. We wanted to put a tracking anklet on him but California does not have a program to use those for stay-away order enforcement. So the burden is on the victim, her friends, her family, and her employer to be constantly vigilant.

An interesting fact is that the two of them were never involved in any way. He always loved her from afar. I wasn't sure I believed that myself until he admitted it in court. He said that she just reminded him of a former girlfriend who died of some sudden illness 10 years ago, and he was sure that god but *** on the earth to replace her.

The death of the girlfriend is now being re-investigated but the police are very tight lipped about what is going on on that front.

The sad part is that the victim would never have had the resouces or courage to even get the conviction if I hadn't decided personally to go after this dirtbag; but he pissed me off by vandalizing the car.

11:54 AM, May 08, 2007  
Blogger Helen said...


You might tell your secretary to go to the library or purchase the book "The Psychology of Stalking" by J. Reid Meloy. It has a section, I believe, on what to do if you are stalked that may offer her some insight:

12:08 PM, May 08, 2007  
Anonymous Anonymous said...

"Shockingly, Cho never received the mandatory treatment he was court-ordered to have in December of 2005"

Oh, I am shocked, shocked, to learn than Cho ignored a court order. I'm beginning to think he wasn't a gentleman.

... Seriously, what other response can one make?

12:57 PM, May 08, 2007  
Anonymous Anonymous said...

With respect, I'm not sure I buy the "overloaded worker" excuse in this case. It sounds like all the officials and organizations in Cho's case had enough resources, but no one felt they had the responsibility or the authority to monitor him. Each time he vacated a patch of jurisdictional turf, he became somebody else's problem.

After the Governor finishes twiddling with the gun laws, he needs to untangle this little hairball of bureaucracy so it can actually get things done instead of endlessly referring people from place to place.

1:42 PM, May 08, 2007  
Blogger Helen said...


I agree, the overloaded worker is not a reason to do a bad job. There are always ways to deal with too much work given. I simply refused to take on more than I could do competently and/or worked privately or in a manner that I could always make sure that each person in my caseload was given the time and attention they needed. Time and competence are the most important variables when working with the mentally ill, especially those who have referred because it was court-ordered. Many of us get referred cases that take 20 or more hours and we get paid for less than 10. It goes with the territory.

2:26 PM, May 08, 2007  
Blogger Dewave said...

On the one hand, I'm uncomfortable with the thought of some judge being able to declare you 'mentally ill' and you get forcibly 'hauled off to the loony bin' as it were.

But at the same time, it would be a prudent move to check for mental illness as well as criminal past in background checks for firearm sales.

4:56 PM, May 08, 2007  
Blogger tomcal said...

Another interesting thing about this dirtbag's behaviour. At one time my secretary moved to get away from him and he hired a PI to find her under the pretext that they had lived together, she owed him rent, and he wanted to serve her with a small claims action.

After finding her, and unfortunately after he gave her whereabouts to the stalker, the PI became suspicious, and to make a long story short, he asked us to subpoena him for the civil portion of the situation. The best way to get these guys off the street is to get a civil restraining order, the violation of which is a criminal offence.

Anyway, not a week after he was out of jail, he showed up at the PI's office ranting about the fact that his Felony conviction was the PI's fault for talking, and my fault for financing the gathering of evidence for the DA's office. Had it not been for us, in Mr. Stalker's opinion, there would have been no problem.

Unfortunately, although we tried, his behaviour did not technically cross the line that would have created a probation violation, as he has no restrictions against approaching the PI or me.

So we are just siting here waiting for him to come back, my secretary had to move again; and we're hoping that he makes his next move sooner rather than later. It's very difficult to be on alert 24/7.


Thanks for the recommendation, I ordered a copy.

5:01 PM, May 08, 2007  
Anonymous Anonymous said...

H: That wasn't a swipe at mental health professionals. I'm sure it's sometimes is a thankless job, and maybe that was a factor in how the folks in Virginia's system dealt with Cho. But I think it's possible one or more of them would have acted differently if they a) believed that they were responsible for what happened to Cho and b) were confident that they had the authority to do something about him. The current system doesn't seem designed to give its workers that kind of power. (Not "power" - I mean potency or effectiveness. The ability to get things done.)

6:54 PM, May 08, 2007  
Anonymous Anonymous said...

dewave: "On the one hand, I'm uncomfortable with the thought of some judge being able to declare you 'mentally ill' and you get forcibly 'hauled off to the loony bin' as it were." Very much agree.

Thank you also to kg2v for telling his story.

I was the relative needing help. My spouse was (is, still some) a control type who didn't actively discouraged me from getting help. There are personal social status emotions, concerns about effects on work status, et cetera.

Like your chemical imbalance example, my case included a chemical imbalance contribution due to two pregnancies close together. Add to this a car accident PTSD, marriage communication conflicts, et cetera, and it took becoming temporarily manic for my spouse to realize *I NEEDED HELP*. I needed rest from long-term physical exhaustion: kids care, full time job, spouse absent on extended travel, poor sleep patterns due to nighttime feedings, general worries (some to OC extremes that I did not understand how to let go of), et cetera.

Finally, he took me to the hospital. (I have some memory of trying to call the police myself.) I volunteering admitted, for about a week, and took a month unpaid time off from work. That was a few years ago. It took a few years to get caught up on rest, adjust my emotional issues (and my spouse's issues), one more brief hospitalization when nerves got to me again, gradually weaned myself off the medication as I matured my behavior control and our marriage relationship improved, et cetera.

I'm grateful my spouse stuck with me (although sometimes he's still controlling, understandable though due to my history). People can get better, and they are not always able to ask for help in an easy way. It takes time, and a balance of the personal support of friends/family and some professional help.

I am uncomfortable with the government being able to too
declare you 'mentally ill' and have you forcibly 'hauled off to the loony bin'. Members of the public have to make individual personal judgments about those around them: to reach out to help a person (like Baldwin and Britney) versus find a means to protect yourself (like from a stalker or a parent-child situation).

9:17 AM, May 09, 2007  
Anonymous Anonymous said...

Typo: Remove the "didn't" from the early sentence.

Change "who didn't actively discouraged me from getting help." to "who [DID] actively discourage me from getting help. "

9:18 AM, May 09, 2007  
Anonymous Anonymous said...

Missed a word. Sorry, I should preview and proofread better:

I am uncomfortable with the government being able to Too Easily
declare you 'mentally ill' and have you forcibly 'hauled off to the loony bin'.

BTW, similarly, if the government does make such a declaration, there needs to be a means to later have said declaration removed or amended, once a person has healed.

9:22 AM, May 09, 2007  
Anonymous Anonymous said...

As an example of the latter: Hinckley shot Ronald Reagan. It's been a LOT of years since that episode. What is his status? Should we allow him to be a person/citizen again, to again participate in society in some way? Or is he forever locked up and ostracized?

9:24 AM, May 09, 2007  
Blogger tomcal said...

From Wikipedia:

"Shortly after his trial, Hinckley wrote that the shooting was 'the greatest love offering [generously offered to Jodie Foster] in the history of the world,' and was upset that Foster did not reciprocate his love...

"...On December 30, 2005, a federal judge ruled that Hinckley would be allowed visits, supervised by his parents, to their home outside of Washington, D.C. The judge ruled that Mr. Hinckley could have up to three visits of three nights and then four visits of four nights, each depending on the successful completion of the last. All of the experts testifying at Mr. Hinckley's 2005 conditional release hearing, including the government experts, agreed that his depression and psychotic disorder are in full remission and that he should have some expanded conditions of release."

11:10 AM, May 09, 2007  
Blogger tomcal said...

I believe that statistically, when stalkers do kill, more often than not the victim(s) end up being someone entirely different from the original objects of their desire.

11:13 AM, May 09, 2007  
Anonymous Anonymous said...

anon@9:17 - Sounds like you've been through hell. Hope life's better now.

11:35 AM, May 09, 2007  
Anonymous Anonymous said...

anon 9:17: Thanks for telling your story. We've been kicking around the issue of involuntary treatment, trying to find the trade-off between protection of the public and the rights of the individual. I will admit that a legal regime where the government can have anyone locked up just on some other person's say-so, regardless of their credentials, is scary. But what happened at VT was darn scary too. There don't appear to be any easy answers to that.

However, it does seem to me that there is an easy answer for people like Cho who are ordered to treatment: make them post a bond. Heck, we can make jaywalkers post a bond if there is doubt about their showing up for their court appearance. Why should raving narcisstic psychotics merit more consideration than jaywalkers? Appoint the assigned therapist as an officer of the court, for the purposes of the case. If the patient doesn't show or is blatantly uncooperative, all the therapist has to do is make one phone call. Dog Chapman takes it from there. Problem solved.

3:59 PM, May 09, 2007  
Anonymous Anonymous said...

Definitely not "anybody" - just as you said, people determined by a court to be violent and a risk to others (maybe themselves, too).

The only other people I can think of offhand would be those picked up for petty crime, found to be mentally ill, and who have no family or others who can care for them and serve as advocates. I guess that includes a lot of the homeless, so maybe I'm opening a can of worms...

Anyway, most other people would have to be specifically excluded from mandatory treatment. If they're not violent, not suicidal, and have responsible relatives or others who are able to take care of them, then the government has no right to treat them - ever.

That's a high-level view. I'm sure the details would be massively complicated and fraught with uncertainty, as Helen might attest.

5:28 PM, May 09, 2007  
Blogger Matthew James said...

Hi Helen

Impressive. Like your stance and your writing style. I wonder if you'd been interested in looking at my blog and passing some (constructive) criticism. It is (A Light In The Darkness). Your professional opinion would be welcomed.

11:21 PM, May 10, 2007  
Anonymous Anonymous said...

If cowardly and dishonorable men sometimes shoot unarmed men with army pistols or guns, the evil must be prevented by the penitentiary and gallows, and not by a general deprivation of a constitutional privilege. - Arkansas Supreme Court, 1878.

- Baron Waste

6:07 PM, May 14, 2007  
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