Jared Loughner, the accused shooter in the Tuscon, Arizona murders of 6 people and dozens of others wounded — including Congresswoman Gabrielle Giffords — apparently had some issues. What exactly those “issues” were, we may not know until he is properly examined by a mental health professional. But his YouTube videos, combined with descriptions of the last few months of his life, suggests something serious was going on.
I won’t play armchair psychologist here and make a diagnosis from afar. I think it’s a bit irresponsible when Kate Pickert and John Cloud writing over at TIME, suggest that among the 6 warning signs of mental illness, it includes things like smoking marijuana (sorry, this is not a sign of mental illness!), had five contacts with campus police (again, not a sign of mental illness), and he started scaring his friends (not included in any of the mental disorders symptom criteria I’m aware of).
The other signs of psychosis or schizophrenia — disorganized thoughts, paranoia — may indeed be signs of a mental illness. But we simply don’t know in Loughner’s case, because he was never seen by a mental health professional. They could also be signs of heavy drug or alcohol use… or something else altogether (like an undiagnosed brain tumor).
But I will point out that someone who repeatedly gets in trouble with others — teachers, school professionals, friends, and the law — because of erratic behavior suggests someone who is grappling with issues not well-understood by anyone. The problem is one we’ve seen before — nobody has the complete picture of the man. Everyone has these small interactions with him that suggest something is amiss, but how badly amiss? You can’t make a valid or reliable threat assessment if you only have 10% of the picture.
At some point, a mental health interview or intervention may have not only been warranted, but ultimately benefited Loughner, had one been ordered. But he hadn’t been ordered into treatment. It’s not clear if that was something strongly suggested. Given some of the reports of his alleged behavior at school, it seems like there may have been grounds to have him checked out by a mental health professional even without his consent (based on allegations he threatened others).
Many are pointing out that Loughner suffered at the hands of the broken Arizona state mental health system. That’s wrong, though. He would have had actually had to have interacted with that system in order for this argument to make sense. To date, we’ve had no evidence he ever came in contact with the public (or even private) mental health system.
Is it society’s responsibility to proactively seek to identify, single out, and treat — by force, if need be — anyone who might have a mental illness? I’d suggest no, that’s going too far. We live in a free society where treatment is not something forced upon us, with one notable exception — unless we present a clear and present danger to ourselves or others. Otherwise, I don’t want the government interfering so directly into my healthcare and life — “Sorry, mister, you’re not dealing with stress in a mentally healthy manner. Forced treatment for you!”
A Comprehensive Social Safety Net
Jared Loughner is not an example of our broken mental health system. What he may be an example of is our broken lack of communication amongst numerous parties who are all involved with the same individual in different ways — a comprehensive social safety net. Pima Community College apparently knew (or at least had strong suspicions) that this individual was of concern; so much so they apparently kicked him out. But that’s where their communication seems to have ended — “Thank goodness he’s not our problem anymore!”
What we need is a more systematic way to communicate amongst organizations and agencies to collaborate on individuals who may be at risk for something, like a mental health concern. This seems more likely to be a public social work function rather than a strictly mental health function, because it means someone should be coordinating with all of these different organizations and law enforcement to get a holistic and clear picture of the individual.
Schools are often the place where young people demonstrate erratic or concerning behavior when they’re experiencing troubles in their life. Most schools don’t have any policies in place in order to do anything more than deal with the student in the context of the school. In fact, due to privacy regulations, it may be difficult for them to share information about a student of concern with others.
This has to change so that colleges and universities start to understand that their students are a part of a larger community, a community that deserves to be treated with mutual respect and care. Colleges and universities must setup ways to communicate concerning information with other agencies within the community to ensure students like Loughner don’t slip through the cracks of society in the future.
And here’s a radical idea — let’s require an Emotions & Stress Regulation 101 course for all students at all schools. Let’s teach students to recognize their own emotional reactions and reactions to stress early on and give them the basic tools to help better deal with these things sooner. Let’s de-stigmatize mental health concerns even more, so that other students feel free to question when one student seems to be acting in an erratic and concerning fashion in and outside of the classroom.
Sure, let’s find a way to fully fund the public mental health and social work systems. But this is a pipe dream for state governments that are facing bankruptcy and huge deficits, and state agencies that are forever underfunded. Because when it comes right down to it, society cares only so much for the poor and indigent who have mental health concerns. We only care when a Congressperson or a bunch of people get shot at, and then, within weeks, the nation’s attention turns elsewhere. When taxpayers are asked to pay even more into their taxes to fund such programs, they rebel, leaving us with the same broken system we started with.
Read the Dr. Pies article on the Tuscon shooting: The Arizona Shootings: A Recurrent American Tragedy
Read the transcript from yesterday’s PBS Newshour: In Loughner Case, Missed Signals and a Troubled Mental Past
22 comments
Thank you for a thoughtful, sensible article about a problem we all face. For those who love someone who is “troubled,” whether or not they have officially been diagnosed with anything, it’s not as easy as “just get them in to see someone” and the problem goes away. (Get them in to see *who*, a magician? And how do you persuade somebody to get help, who’s convinced he doesn’t need any?)
There’s a lot we still don’t know about this particular situation. However, we DO know that lack of information about mental illness, and the cuirrent social stigma about acknowledging possible mental illness – whether for oneself of one’s children – makes potential tragedies like this more likely.
The Mental Heath System had nothing to do with this man. His family and close relatives are responsible for not getting him to a professional to get help. It seems the whole family were very introverted from what neighbors say about them. They were always to themselves, never communicated with any of them. I knew I wanted help when my depression set in, I wasn’t feeling the joys I had been. I am a people person, I was very quiet and didn’t enjoy anything anymore. People like his family though, just don’t seem like people to ask for help, and it really is very sad….
I agree with the above article
that when the college professor said , that he talk with his parents and told them to get him mental help
but I think we Americans needs to intervene and for the college professor would have taken him to the college health clinic or the counseling office
for I now that the counseling offices at the college just DO NOT deal with college class scheduling but other counseling issues and metal health issues.
also, I think we need to do better with High School drop outs and college drop outs.
like build schools just for drop outs to get them off the streets.
i work in a High school and when kids tell me that this is their last day of school for they are droping out of HS i tell them I do not want to see them on the streets or in jail or getting into trouble and some of them listen and i try to talk to another teacher or staff member and ask if there is any thing else we can do to keep the student in school.
alot of the students are 17 or 18 years old and only have 3- 10 credits and it is too far to graduate from HS and so they drop out but I think the educational system in the US needs to do better to some how keep theses kids to stay in school for most young adults really do not grow up until about 30 years old or so.
Hope this helps.
We had a system which was working, in which someone could be involuntarily put into the mental health system if they were behaving irratically, dangerously, etc.. Now, mentally ill people can sign themselves out. This is really insanity. The military, school and others knew there was something wrong with him, but no one could do anything….until he acted upon his impulses.
More insanity. So this cycle of violence will continue in our society.
I mean, that’s the crux of the problem if a person won’t seek out mental health care on their own —
An individual’s freedom versus forcing them into mandatory treatment.
Most states only have one rule that can trump individual freedom, and that’s if a person is an imminent danger to themselves or others. In the past, we’ve probably erred too much on the side of locking people up for little reason for mental health care. Now, we bend over backwards NOT to lock someone up or involuntarily commit them into treatment.
I’m sure there’s a balance inbetween somewhere, but it’s a difficult one to find. Especially when you’re not doing it in hindsight, when all of the now-obvious signs are so blatant. When you’re doing it in real-time and the one they’re trying to lock up is you or a loved on, it may be harder to digest taking away someone’s freedom.
I applaud Dr. Grohol’s sensible call for “a comprehensive social safety net”, as well as for increased education on the nature and signs of emotional disturbances. To update John Donne’s famous statement, “No person is an island.” We are all part of the human community, and when one of us becomes a lost soul, we all suffer for it.
–Ronald Pies MD
Never has the nation received a learning tool as valuable as Jared Loughner, he must have been sent from the heavens as an opportunity to understand and better our lives. It is puzzling why a young man with a loving middle class family and fine education should go on a murderous rampage. Only Jared can provide that answer. We need Jared to speak to the nation and explain his reasons for destroying his own future and the lives of others. In exchange for his honesty he should be set free.
I agree with you a 100% that schools and colleges should take a proactive stance on recognizing mental issues among students and faculty. I have been trying to get a teaching job at a local community college for years and I seem to fail on one question they ask me in the interview. “How do you control disorderly students?” This question should not be initially asked to prospective instructors but rather a policy should be in place to deal with a disorderly student that disrupts a class. I can’t carry a gun to class and if I feel threatened by a student then who will help. Thanks for your insight. Carrie
When it comes to psychosis, I do think that forced treatment is appropriate. Here’s why: When my husband became psychotic, he honestly didn’t know he was ill. He thought he was fine — everybody else was overreacting.
The last thing he wanted to do was sign himself into the hospital. The only reason he did was because I begged him to do it. (And many people don’t have someone whose pleas will convince them to do something they 100% don’t want to do.)
Despite how hard he resisted treatment, however, after the fact, he was intensely grateful that he’d agreed to go to the hospital.
My husband didn’t WANT to be psychotic. He didn’t know he WAS psychotic.
Giving people who don’t know they’re sick the “freedom” to stay sick–and get even sicker–is cruel.
So should people be forced to get treatment for stress? No. But a severe, debilitating mental illness like psychosis? Absolutely.
An excellent article, Dr. Grohol, far better than 90% I’ve read in newspapers or blogs over the past several days. Particularly the suggestion that all college (and perhaps high school) students be taught about dealing with friends or schoolmates who may be suffering. I would also suggest something that I haven’t heard or read the slightest hint about since Saturday. That is, what do other countries do about this problem? Both advanced countries in the first world and developing countries such as China, India, Brazil and Indonesia. Do they have anything to teach us? What is their thinking, let alone their practice, on these issues? These are human problems that affect everyone in the world, not just us here in the United States. And there are many places (believe it or not) that have rates of violent crime far in excess of ours (including violent death). Has any American expert ever investigated foreign treatmen of this issue? If they have, I haven’t seen any mention of it over the past several days, and I read a very sizeable number of newspapers and periodicals. Take care!
I definitely agree with those who are in favour of increased control of the students whose behaviour is unacceptable in a class. I know that so many teachers today have to experience difficult situations every day and that’s why more and more measures should be taken at all levels in order to prevent attacks like this one.
One of the reasons given for not intervening in this or similar cases is that people are fearful of being sued. While this may be a convenient excuse for apathy (which is a whole ‘nother issue) I’d like to throw out a suggestion.
I believe there are good samaritan laws in most states which serve to protect from liability those who intervene, in good faith, to help victims of accidents. How difficult would it be to amend the existing good samaritan laws to include those who would try to get help for people like Mr. Loughner?
Lets encourage the well-intentioned, but faint-hearted among us to reach out to those in need without fear, real or imagined, of ambulance chasers.
I would expect this kind of response from a psychologist.Psychiatry is never the problem.THE SYSTEM IS NOT ONLY BROKEN IN OHIO,IT WAS DESTROYED BY 30% BUDGET CUTS BY OUR GOVERNOR.I am Bipolar type II and after 30 years I have enough insight in to my own illness to know when to seek help.I have never had to be involuntarily committed.In Ohio mental illness is the only medical disorder that you can only be treated in the county that you live in.All 88 counties are fighting over funding.The average wait in the county that I live in is 4 months to even see a doctor,let alone to receive the medication that people need.The crisis line here is not staffed with mental health professionals but with people with canned answers that they get from a computer.The problem is not the psychiatrist but the politicians that will not fund the community based mental health system.I have tried many times to get medication adjustments long before the need for hospitalization.The system is not into prevention.All it cares about is covering their behinds in the sad event that some one in this broken system who does not have the ability to understand that they are sick and goes out and kills some one.The sad fact is this is not a new problem and in a month society will go back into denial just as they did with Hinckley and the man that killed John Lennon
The true answer to this problem may be speculative by many. However, the realization of the existance of a true problem cannot be denied. Personally, I stand with those who believe that everything has a root cause. Regretfully, it is the root cause that gets caught up in the shuffle when something happens. I read Dr. Pie’s comment: “No man is an Island”…My mind traveled to the time Fred Warring, a very accomplished composer put those lyrics to music many years ago. Anyway, our country has laid a very profound foundation for hatred, disrespect, and insensitivity in too many ways. Such infestations can only lead to the proliferation of violence. I dare not even try to
say what pushed this young many to seek comfort. Whether or not the behavior stemmed from a participation in strange practices or not, I do not know. One thing I do know, ours is a land of violence, and mass scale violence had its inception form the inhabitants, not aliens. With that in mind, there is a great for each individual to do an individual soul search, be honest, change all behavior that does not communicate love, and make this place a better place.
By no means is my comment meant to imply that folk should not be accountable for their behavior. The laws of the land should be obeyed, and upheld by the strongest measure. However, there is a great need for each individual to do an individual soul search, be honest, change all behavior that does not communicate love, and make this place a better place. The power is present to be received.
I totally agree with the idea that we need to communicate better. I would suggest that this not only be applied to Colleges and Universities but all schools, elementary, middle and high school. These are where some of these issues begin and could be addressed before they get to this point. Mental health screenings should be part of any well child or routine appointment with doctors. Counselors in scholls should be able to do a quick mental status exam without a barrage of complainst. any person who comes into contact with somene they feel might benefit from a mental health appointment needs to have the avenue available to make that happen. In order to make this hapen we need to address the stigma that still permeates a mental health issue. It is a disturbance, disorder, disease… not the plague!
Warren, explaining why you did something is not an excuse and escape from doing a crime. Let him go???? If anything he needs to be removed from society so he doesn’t hurt or kill more people. Many people explain why they have committed a crime but that doesn’t get them off the hook, thank god.
Sorry, that was to Morris Wise, not Warren… got the name wrong.
The reason why the mental health system is to blame, is because they have done away with involuntary commitment. Psychotics , such as Jared, do not know they are psychotic. It is impossible to get someone treatment if they don’t want it. I have been there, with a bipolar psychotic loved one. Jared, should have been made to be evaluated after he was forced to leave his college. We need to fix the mental health laws.
Dr. Grohol’s “radical idea” of requiring Emotions & Stress Regulation 101 course for all students at all schools is a positive step for helping college students many of whom are in a mental health crisis. I was one of them 40 years ago with undiagnosed Bipolar Disorder and too afraid of stigma to reach out for help. I wasn’t diagnosed until I was 42 and by then had lost a marriage and a career because of my erratic behavior.
The reality is that half of all people with a mental health diagnosis first experience it by age 14, but will not receive treatment until age 24. Less than one-third of teens who need mental health care receive help. While we have science-based methods to successfully engage and serve persons with even the most severe mental illnesses, access to those services continues to be a challenge for multiple reasons, including resource limitations and the continuing social stigma associated with behavioral health conditions.
Yes, I agree Dr Grohol we should teach students to recognize their own emotional reactions and reactions to stress early on and give them the basic tools to help better deal with these things sooner. Let’s de-stigmatize mental health concerns even more, so that other students feel free to question when one student seems to be acting in an erratic and concerning fashion in and outside of the classroom.
According to a 2009 survey by the American College Health Association, 46% of college students said they felt “things were hopeless†at least once in the previous 12 months, and nearly a third had been so depressed that it was difficult to function, Then there is this: Of 133 student suicides reported in the American College Counseling Association’s survey of 320 institutions last year, fewer than 20 had sought help on campus.
It took the suicides of my brother and sister to convince me to put a face and a name on mental illness by telling my story that there is no shame with having a disease of the mind. Get help now, if not for yourself, then get help for someone showing signs of a mental disorder.
This is a clear cut case of MOBBING based on the NY Times archived school records:
http://memoryholeblog.com/2014/12/04/missing-pieces-in-2011-tucson-shooting/
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