It Seems Like Déjà Vu, All Over Again:

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Columbine, Aurora, Sandy Hook Elementary, and Now,

The Washington Navy Yard

 

 

A person has a mental problem.  He calls authorities to report hearing voices.  No action is taken, despite his pleading for help.  He continues to hear voices.  The person then purchases a gun and ammunition.  He goes on to shoot dozens of individuals.

This happened in Columbine.  It happened again in Aurora.  It happened again in Connecticut at Sandy Hook Elementary.  And it happened once again at the Washington Navy Yard.

This time, in the Washington Navy Yard case, the perpetrator contacted authorities in Newport, Rhode Island, advising them that he was hearing microwave signals in his hotel room.  He continued to hear these signals/voices, even when his room was changed.  He called the police again.  The police suspected something was wrong.  Knowing that this man worked for the Navy, police authorities contacted the local Navy command and reported the weird circumstances.  Unfortunately, nothing was done.

It was a similar story in Aurora.  The perpetrator sought out a psychiatrist.  He presented a bizarre picture, clearly threatening others.  The psychiatrist had ample information to then bring the case to a university committee, the first step for an involuntary hospitalization.  But the university committee took no action.  The examining psychiatrist had enough information to hospitalize her patient, but the university had a backup system to protect individuals in such cases.  That backup system, the special university committee, did not act.  The psychiatrist could still have hospitalized the individual, but chose not to.  That individual then chose to shoot hundreds of shots in a movie theater, killing many.

Our society has set up all kinds of protections for the patients.  We are rightfully concerned with hospitalizing individuals against their will, with taking away their freedoms.  But with all these cases, protecting the rights of the patients resulted in taking the rights away from the general public.  We kept the offenders on the streets, free to pursue their demons, resulting in the deaths of dozens of individuals.

After all these nearly identical cases where maintaining the freedom of someone clearly insane was the preferred option rather than protecting the public through involuntary hospitalization, I have come to the conclusion that it has become time to show a preference for the common good and public, rather than for the sole patient/offender.

In Los Angeles County, when the Psychiatric Emergency Team is called in regard to an adolescent case, the PET team must take an individual to a hospital, even if the person has calmed and experienced a “recovery” upon the arrival of the team.  At the hospital, there are various options, but often the person is held for 72 hours.  In those 72 hours, medication may be tried, therapy initiated, and other methods attempted.  At the end of the 72 hours, a hearing may be held.  Is the patient stable?  Does he still represent threats to himself, threats to others?  Holding someone for up to 14 days involuntary hospitalization may follow.

However, these individuals responsible for mass murders are not even admitted for the first 72 hours.  There is no attempt at treatment.  All this has occurred with clear signals of mental illness and true threats to society at large.

Watching the videos of the Navy Yard perpetrator wandering the halls with a weapon drawn is haunting.  What is particularly haunting is the notion that authorities had reasons to suspect that this man was insane.  Authorities in Newport knew that there was something “fishy” about this guy.  They reported these facts to the Navy.  The Navy took no action.  Despite his irrational behavior, he still held on to his security clearance.  He still had an ID card giving him access to every military base in the country.

Like many other perpetrators of mass murder, like the one in Connecticut, the Washington Navy Yard perpetrator was killed.  Rather than having his rights temporarily taken away through an involuntary hospitalization, he is dead.  So who benefits when the authorities ignore the signs of mental illness?

It is time to reconsider all of the “safeguards” against involuntary hospitalizations.  Rather than making hospitalization so difficult, ease up the standards so that those in crisis may be treated.  When authorities find evidence of totally irrational behavior, let them hospitalize.  When someone reveals that they have plans to harm others, let them hospitalize.

We have seen a breakdown in our mental health system.  Individuals who present as troubled and of potential danger go untreated.  They often later go on toward mass murder.

This is not only in regard to mass murderers.  A woman from Connecticut drove with her one year old child in the back seat from her home to the streets of Washington where she tried to mow down a secret service officer as she rammed the gates on the White House perimeter.  A chase ensued and she was shot dead.  Post-mortem reports indicate that she had an obsession against the President, that she was insane and deteriorating.  Again, preventive involuntary hospitalization could have prevented this needless loss of life.

I think we have to revise the way we treat those in mental decline and open up hospital beds to care for them.  If we hospitalize someone who does not really need it, we release them in 48 or 72 hours.  No harm, no foul.  But, if we see potential danger, we can treat someone.  We can continue to hold an individual who threatens others.  We can medicate them.  We can keep them locked up.

Being weary of taking action has resulted in unnecessary harm against the public.  Aurora, Sandy Hook Elementary School, and now the Washington Navy Yard.  We need to dramatically change the way we respond to mental illness.

There are no guarantees, but maybe with changes to the way we treat mental illness and threats to others, we can prevent the next incident.

 

Robert J. Rome, Ph.D., is a licensed psychologist in clinical practice in Encino, California.  He can be reached at RJRome@aol.com

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