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Wednesday, January 12, 2011

Missed Chance To Intervene In Tucson

Jared Loughner could have been involuntarily admitted for evaluation under Arizona's progressive mental health laws long before he allegedly showed up at a Tucson grocery store parking lot with a semi-automatic pistol, mental health professionals say.

Whether or not Loughner is mentally ill is unclear. But what is known is that friends, relatives and teachers watched as Loughner's behavior apparently became increasingly erratic, including outbursts in class, isolation and bizarre Internet postings suggestive of someone in the least disturbed and at times incoherent.

Arizona allows for family, friends or even acquaintances to petition a local court for a mental evaluation, said Suzanne Hodges, chief compliant officer at the Community Partnership of Southern Arizona, the group that provides mental health treatment for Pima County, where the shooting occurred. The court would have then sent someone to interview Loughner and determine if he needed treatment — even if he was not an imminent danger to himself or others, as most other state require.

Being in such treatment would have prevented him from purchasing a handgun, according to Arizona's gun laws.

"[The mental health law] is very flexible," Hodges said. "It's ahead of some other states — the fact that you don't have to be imminently dangerous to yourself or others."

But that's not what happened.

Signs Of Increasingly Erratic Behavior


Instead, Loughner left in his wake a series of increasingly odd outbursts over the course of almost two years.

On the Web, writings attributed to Loughner appear nonsensical and even paranoid. Frequently using an "if/then" construction, he writes about how he believes the government is controlling a secret currency, is controlling his mind and even that the government was controlling the words that make up language.


YouTube
A screengrab of one of Jared Loughner's postings on YouTube.
In postings apparently from Loughner, he writes: "I teach a mentally capable 8 year old for 20 consecutive minutes to replace an alphabet letter with a new letter and pronunciation. Thus the mentally capable 8 year old writes and pronounces the new letter and pronunciation that replaces and alphabet letter in 20 consecutive minutes."

Later, he continues, "The government is implying mind control and brainwash on the people by controlling grammar…what's government if words don't have meaning."

Dr. Alan J. Lipman, director of the Center for the Study of Violence, has not treated Loughner. But he has spent many years working in psychiatric wards. Lipman said he would have been suspicious of a problem had he been at the school and seen these writings. He said discussion of language can reflect a mind that is struggling to make sense of its own thoughts but that no longer has the logical reasoning in place to do so.


"The bonds that ordinarily keep language together come apart," Lipman said. "So they make up new words, with opaque, twisted, nonsensical meanings. This is not an effort at creativity, but [is instead] because they are having delusional ideas that need to be expressed in new ways."

'He Was A Very Strange Kind Of Person'

Lipman said there is no way to know from reading postings what could be happening in Loughner's mind. But such writings could have been enough for someone who knew Loughner to bring it to a court's attention.

That, and the behavior that some of Loughner's friends say they witnessed. Several of Loughner's friends told Mother Jones magazine that he seemed to become more irrational by the end of high school. At Pima Community College, campus police were called five times to the classroom because of his outbursts, which scared his teachers and classmates.

One former friend and classmate at the community college, Don Coorough, told NPR that during one class, while all the other students remained seated, Loughner jumped out of his seat to read a poem, aggressively grabbing his crotch while talking about mundane everyday chores.

"He was a very strange kind of person," Coorough said. "He was very much a loner."

Ben McGahee, who taught Loughner at the college, told NPR: "He would come out with these senseless outbursts. It's like, he would say, 'How can you deny math instead of accepting it?' "

After Loughner wrote "Mayhem Fest!!!" across one of his quizzes, McGahee decided to alert the dean.

"When I saw that on the quiz, I became very concerned for the safety of our students in the classroom and for the school as well," McGahee said.

Mayhem Fest is the name of a music festival that tours the country each summer.

Officials at Pima Community College said they told Loughner and his parents that he could only return to the college if he sought a mental evaluation. He did not try to return and the matter was dropped.

Missed Opportunities For Intervention


Neither officials, students nor his parents sought to have a court-appointed counselor interview Loughner. Such a failure to intervene, Lipman said, is a common scenario among friends and relatives who are unaware of available local resources, and colleges dealing with thousands of students, some of whom, like Loughner, are only enrolled in one or two classes and bow out quickly.

"There was no one single individual to point the finger at," Lipman said, "but it is true that when he was engaging in these bizarre behaviors at the community college, there may have been an opportunity to guide him to treatment. This lack of information about mental disorders and when to intervene and how to intervene is a very serious problem."

Multiple studies over the past three decades have shown that people who have a possible mental disorder are only slightly more likely to commit acts of violence than other people. Studies also show that a possible mental disorder may not necessarily be the cause of a violent outburst, but rather is often a contributing factor. The person, for example, may seek notoriety or a sense of belonging to a greater cause.

Robert Bernstein, executive director at Bazelon Center for Mental Health Law, said he is concerned that the public may misread what happened at the grocery store and call for more detention of people who are mentally unstable or seemingly erratic. But he agrees that getting people into treatment when needed can help them cope with stressors and help prevent a violent act if a person is headed in that direction.

Substantial cuts to community health programs across the country and in Arizona, though, may make that difficult. There are fewer resources to offer counseling — or to make friends, family or teachers aware that a treatment program is available for someone they are concerned about.

"Many people who find themselves under pressure don't get services," Bernstein said. "What has happened around the country is that for decades, mental health has been underfunded, and instead of funding services early on and averting crisis, we as a nation have invested money in emergency room care and jails and prisons."

In fact, the vast majority of people with mental illness are not in community treatment centers. According to the Justice Department, 24 percent of the nation's jail inmates and 16 percent of prison inmates have a mental disorder, a number that has increased threefold over the past 30 years. According to the numbers, the largest single mental health provider in the country is the Los Angles County jail.

(source:npr.org)

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