Nearly a year ago, a tragic story unfolded as Danielle and Ken Lambert handed their two children — a 5 year old daughter and a 4 year old son — over to Danielle’s twin sister, Marcelle Thibault, to drive them to a sleepover. They never made it there alive, as Thibault crossed the median of a busy interstate highway in her car, stopped it in the wrong direction, undressed herself and the two children, and then ran them into the oncoming traffic, to all three of their deaths.
Now the Lamberts want justice and to prevent this bizarre incident from happening to another family. But given the complete and utter random bizarreness of the incident, it’s a tragedy unlikely to unfold in anyone else’s home anytime soon. The article in today’s Boston Globe lays out the story:
“If she got the help she needed, this wouldn’t have happened,” Danielle Lambert said. “My sister was a good person. She was my best friend. I know she wouldn’t have done that intentionally.” […]
The Lamberts, in the interview, said McLean doctors should not have discharged Thibault after six days; Thibault, they said, was still delusional and believed God had sent her to the hospital to help other patients. Danielle Lambert and another sister, Stacey Coady, also said McLean staff never told the family at a meeting before Thibault’s discharge that she was at risk to kill herself or someone else.
The case comes down to the fact that two things stand out. One, she was treated for nearly a week, 4 months prior to the event, at McLean Hospital, a prestigious psychiatric hospital outside of Boston. There she was diagnosed with bipolar disorder, placed on appropriate medication, and was recommended to continue treatment on an outpatient basis. She was likely not considered a danger to herself or others at the time by the mental health professionals who treated her, so that’s likely why nobody was told she was. No offense, but someone who has delusions and believes they are put on Earth to “help other patients” is not exactly someone who screams out, “I’m suicidal or homicidal.” They are just as likely to be seen as harmless (since there’s absolutely zero research or data to show someone who is delusional is at greater risk to harm others).
The second concern happened the same night Thibault went to pick up the children. She stopped in the very same median a few hours earlier, and got out of her car. A Good Samaritan stopped to see if she needed assistance, and she started throwing punches at him. State Police arrived at the scene and talked to Thibault and made the determination that although her behavior was erratic, it didn’t arise to a serious enough level to consider taking her into custody for a psychiatric evaluation.
Now in 20/20 hindsight, everyone sees that the tragedy may have prevented had the police taken her into custody instead of letting her go on her way. But these are judgment calls made in the moment with little evidence to go on outside of the way the person is behaving. If we start second-guessing every such call, we prevent police from carrying out their daily jobs. And in America, police are right to err on allowing someone their Constitutional rights to freedom and her personal liberty. After all, it’s not against the law to act “weird” or even “erratic.” We may think these are signs of something more dark and sinister, but in 99.9% of the cases, they are not.
So do we therefore make new laws and demands on institutions and the government to protect us in these 0.01% of cases? I hope not.
We Can’t Legislate Bizarre Behavior
We also cannot (or generally should not) force people into outpatient treatment — or any kind of treatment — if they are not an immediate danger to themselves or others. McLean’s clinicians apparently didn’t think she was and that’s why she was released. And indeed, while followup care should dictate a certain measure of ensuring people are adhering to their treatment regimen, in a free society, such as ours, we cannot demand that they do so.
6 comments
This was a tragedy for everyone of course, but the family thinks that they should have been told at discharge that she was at risk of harming herself or others? Presumably their response at the time would have been: why are you discharging her then, doctor?
And what about the family’s judgment? If she was impaired enough to wander on the highway earlier THE SAME DAY, it seems there might have been other not-so-subtle warning signs that perhaps she shouldn’t have been put in charge of young children at that point in time.
Often the system is to blame, but as you say we can’t ALWAYS blame the system and let the individual (or family) off the hook.
Indeed, nobody wants to make a bad situation worse, but there is sufficient blame in this tragedy to go around. Suffice to say that while there very well have been warning signs, there were not warning signs of imminent self-harm or homicide. Suggesting that someone who is delusional should automatically be detained against their will is likely to result in dozens of new lawsuits filed by people who claim otherwise (and result in negligible increased future safety of society).
We specifically find the recommendations of their new nonprofit troubling and invasive:
http://www.keepsoundminds.org/Mental_Health_Discharge.html
http://www.keepsoundminds.org/Law_Enforcement_Changes.html
Matters currently left to a professional’s judgment would now be mandated by law, and if you’ve ever been admitted to a psychiatric hospital, you would now be in a database forever flagged as possible risk to others.
Well-intentioned, but ludicrously dangerous and short-sighted.
Speaking as the mother of an adult with mental health issues, the invasion of privacy frightens me. I know enough not to leave a child with my daughter. In the Boston Globe article it was mentioned that the family was worried because this woman had discontinued her meds and refused therapy. Yet they allowed her to take their children alone? They were naive in thinking she was the same person she had been before her illness. Not evil, just not the same person. Sorry for such a tragic loss.
Reading between the lines, one has to assume that the family thinks the hospital had some knowledge, (perhaps being told by the patient herself) of active homicidal/suicidal ideation at the time of discharge. At least, that’s the only way I can come up with a valid case for the facility bearing any responsibility for notifying the patient’s family. Even in that instance, the tragic events were so far removed timewise, that I’m not certain the hospital would have legal responsibility. Its not as though they discharged her while she was issuing threats, and then she killed someone a few days later.
The other part of this is that her own family knew that she was mentally unstable. By definition, that means that she will be stable at times, and then slip into instability. Children are a stressor for anyone and caring for them, sometimes even for a short time, can certainly tend to compound instability. People have such blinders sometimes when it comes to the members of their own family. They take risks with their children in caregiving situations that they would never take if that caregiver was an adult unrelated to them by blood or marriage.
Four months is a long time in terms of mental health, and much can change in a patient’s life and functioning in that time. I’m not saying that the hospital didn’t discharge her prematurely, or that she wasn’t homicidal or suicidal when they let her go. She may well have been. But this incident is too far removed from the time of discharge to blame the facility, and the family left the children with her unsupervised. Tragic for everyone concerned. My thoughts and prayers go out to them.
Terrible indeed to have this loss of life, a bigger shame will be the loss of confidence in the mental health care that Mclean is famous for as they certainly have saved a tremendous amount of lives with their ground breaking treatment over the years. I believe the bigger issue is the families of patients need to be educated and to identify the warning signs from patients who may be heading into a downward spiral. The police need to be educated on how to deal with situations where a woman or man call and make claims of abuse against another party which contradicts the truth. The people with bipolar disorder, or other mental health issues could be posturing for a better divorce settlement, or a need to be seen as the victim are known to make false statements and know how to mask themselves as a perennial victim thereby leaving the other partner disproving frivolous charges.
Mclean Hospital In Belmont Mass,has refused to
let a young Autistic Man return to their day school , because he has reported abuse towards
himself and others, the case Is still under Investigation, what does this tell you about Mcleans ! ?