Adding to the evidence that Thibault exhibited no previously threatening or deadly behaviors, she was out of treatment for four months and in constant contact with her own twin sister. If one’s own twin sister couldn’t detect anything was seriously wrong with her, what makes anyone think a clinician spending an hour (or even a few hours over the course of six days) with a stranger can do better?
We can’t legislate against irrational, in-the-moment behavior. We can’t prevent people acting in a bizarre manner when they had no previous indication they might be capable of such a tragic and extreme act. And we can’t hold mental health professionals, institutions or the police to some impossible, ideal standard of being able to look into a crystal ball and see inside a person’s mind what their true intents are.
Nonprofit Group Started from Tragedy
Outside of the likely lawsuit the Lamberts seem prepared to file, they are attempting to do some good with their grief:
The Lamberts have started a nonprofit group, Keep Sound Minds – www.keepsoundminds.org – and want to change how police officers respond to individuals exhibiting serious mental illness. The organization, which is holding a fund-raiser March 28 at the Sheraton Boston Hotel, also wants to change how psychiatric hospitals discharge patients, including requirements to discuss risks of suicide and homicide with family members and to make sure patients get outpatient treatment.
Great. Except that I’ll point out that mental health professionals have no special expertise in assessing violence, suicidal or homicidal risk in patients, because we have no reliable indicators for predicting such behavior (the most reliable indicator is a simple one anyone can use — past violent, suicidal or homicidal behavior).
Show Me Your Mental Illness ID
One other idea mentioned in the article is a horrible one, opening a can of privacy worms that would likely result in no better outcomes — and take away the mental health privacy rights of tens of millions of Americans:
Thibault’s husband, Michael, an EMC Corp. employee who met his wife at Bellingham High School, said it might be a good idea for police to have access to a database of individuals who had been committed to psychiatric hospitals, despite the inherent privacy concerns.
Yeah, no thanks, I’ll pass on that. Mental illness ,without the presence of a co-existing substance abuse problem, is no greater risk factor for violence than in the general population (as I’ve noted previously here and here and here). So although we think more information would be more helpful in questionable situations, it actually would just feed the prejudice and stigmatization that already exists about people who have been diagnosed at one time with a mental disorder.
I sympathize with the feeling of the need to “do something” after a tragedy like this. Words can’t express the depths of their despair, I’m sure. But sometimes the best thing you can do is honor the children’s memory and help educate others about the lack of a comprehensive mental health system in this country that may have helped someone like Thibault receiving ongoing, continuous followup.
Read the full article: Finding words at last for an unspeakable loss – The Boston Globe
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 ! ?