Tuesday, August 7, 2012

What If They Had Treated Him When He First Showed Signs of Mental Illness?

Loughner has, under intensive treatment, recovered his sanity enough to stand trial, so he pleaded guilty.  From August 7, 2012 Wall Street Journal:

Mr. Loughner's plea spares him the death penalty and came soon after a federal judge found that months of forcibly medicating him to treat his schizophrenia had made the 23-year-old competent to understand the gravity of the charges and assist in his defense.
Under the plea, he will be sentenced to life in federal prison without the possibility of parole.
What if, when he was first expelled for college for his frightening statements, and in light of his history of behavior that had brought him to the attention of the police, he had been committed and treated?  Six people wouldn't be dead.  Dozens of others would not be still recovering both physically and emotionally from what happened.

And, it appears, Holmes' psychiatrist was sufficiently worried about his mental health to break doctor/patient confidentiality and contact police weeks before the killings in Aurora:  From August 6, 2012 ABC Nightline:

The psychiatrist who treated suspected movie-theater shooter James Holmes made contact with a University of Colorado police officer to express concerns about her patient's behavior several weeks before Holmes' alleged rampage, sources told ABC News.
The sources did not know what the officer approached by Dr. Lynne Fenton did with the information she passed along. They said, however, that the officer was recently interviewed, with an attorney present, by the Aurora Police Department as a part of the ongoing investigation of the shooting.
Fenton would have had to have serious concerns to break confidentiality with her patient to reach out to the police officer or others, the sources said. Under Colorado law, a psychiatrist can legally breach a pledge of confidentiality with a patient if he or she becomes aware of a serious and imminent threat that their patient might cause harm to others. Psychiatrists can also breach confidentiality if a court has ordered them to do so.
I'm guessing that this was a Tarasoff notification--one of those situations where a psychiatrist is required to break confidentiality in the interests of safety for others.

9 comments:

dearieme said...

"still recovering": if recovering.

Michael K said...

At least she had the good sense to ask for help. Of course, it wasn't there.

Anon Y. Mous said...

So, if she broke confidentiality and disclosed info to the cops, it would have had to have been about a specific threat that he had made about harming someone. Which would have necessitated an investigation by the cops. Which you would think would involve interviewing Holmes himself at a minimum. Of course, the questions would almost certainly have made it clear to him that his psychiatrist had spilled his secrets.

If all that is true, you have to wonder what effect that had on his state of mind and whether it pushes him towards his monstrous actions.

John Cunningham said...

It seems to me that we need psycho control more than gun control. Back in 1954, with a far smaller US population, we had a million people in mental hospitals. I think we need at least 2 million to be confined currently.

Clayton said...

John: about 550,000 were hospitalized in 1954, but a large fraction were syphilitic insane (don't have those anymore to speak of) and senile elderly (who are now largely in nursing homes, paid for by Medicare). But the current numbers are too low.

Mr. Mous: Yes, there is danger of breaking good relationship between doctor and patient, but Tarasoff warning requirements are so clear that it must have been a clear threat to others that caused the psychiatrist to make the call. And it's pretty clear that the psychiatrist was right to be concerned, don't you think?

asdf said...

Clayton, I don't think you have ever addressed directly the obvious concern -- that of Stalinism if we ever undo deinstitutionalization.

Recently, we have seen a whole pseudo-science created just to allow University professors to claim that those who disagree with them, even on simple points like the optimum level of taxation, are clearly suffering from a brain disorder. So the concern is quite real.

How do we in fact handle this?

karrde said...

Remember the item that may have been lost in the mail-room at the University?

I wonder how much that relates to whatever triggered the warning.

I also wonder how this will affect counselors, Police, and University authorities dealing with similar cases in the future...

Clayton said...

asdf: About half the states required a jury trial for an involuntary commitment. If a jury is sufficient protection against abuse of power in a criminal case (or a civil suit), it seems sufficient in this situation as well.

Windy Wilson said...

A law that wasn't followed -- besides the law against murder, that is.
Well, after this revelation, I'm certainly more open to the suggestion of Senator Chuck Tumor and others that more and more complicated laws would have prevented the tragedy in Aurora. [/sarcasm]
You know, tragedy isn't such a bad word to use here, because Greek tragedies were the result of a fatal flaw in a human, usually hubris, or overweeing pride and a belief in one's power. Hubris certainly describes the belief that Leftists have in the power of more, more complicated, and more intrusive laws to bring their vision of perfection to the world.

As for ASDF's concern:
As a lawyer, I am aware of the cost of defending bogus lawsuits, particularly the expense of bringing the case to the point of a judge saying "this case has no merit", which is generally AFTER hiring a lawyer, filing an answer, propounding discovery, responding to discovery, a couple of depositions, and THEN a motion for Summary Judgment. If someone does not have money, one can always get a public defender, but a public defender gives marginal attention to your case, as shown by those cases that proved inadequate representation, and those were only the murder cases.

And abuse of process is not always an easy thing to show on a case by case basis. Like a "vexatious litigant", often abuse of process shows up after a case or two.

Perhaps a cheaper course of action would be to change one's name to Andrei Sakharov, the famous Soviet dissident confined to a mental hospital for "sluggish schizophrenia", aka opposition to Communism.