The Shooting and its Effects on Mental Health Treatment

[whopper]

I knew a few psychiatrists that were chicken and held everybody when it came to evaluating people in emergency psych. Columbine already over-filled psych emergency centers with kids who actually had the cajones to write something interesting and how they were really feeling in English class. Reminds me of the character Adrian Veidt from Watchmen. The kid was so talented that his teachers were spooked and creeped out by him. He had to intentionally do poorly in class to prevent them from believing he was cheating or having him psychiatrically evaluated.

I'm fine with people wanting something that can be implemented to prevent a future tragedy like what happened in Aurora, but I can't think of a system that wouldn't step on civil liberties or otherwise get killed by special interest groups, no pun intended.

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[kugel]

I'm fine with people wanting something that can be implemented to prevent a future tragedy like what happened in Aurora, but I can't think of a system that wouldn't step on civil liberties or otherwise get killed by special interest groups, no pun intended.

If there was a system for reporting "weirdos" and even "suggesting" psych evals based on that, I would publicly recommend that anyone being reported go to the eval, and then say NOTHING except, "I have never wanted to hurt myself or anyone else. May I go now, or are you holding me against my will?"
I would Not tolerate such a system of even suggesting psych evals for almost any form of non-conformity. That is the road taken by many police states, and Joseph McCarthy. Once we get people to focus on "the enemy next door," they stop thinking about the evil and control of the people in charge.

As for predicting violence,
I have not seen anyone mentioning the two most reliable risk factors for violence:
past violence, and alcohol.
If you want to address future risk, those are the two things to address - much more than psychosis or mood disorders.
If you want, you could make parole after a violent felony could be permanent. If you are convicted of one violent felony, you get the choice between parole for 10 years, or adding 50% to your sentence. After 2 felonies, it's 30 years parole, or 100% more prison time. After 3 felonies, your choice is parole for life, or 200% added to your sentence.

As for alcohol, one episode of violence involving alcohol, and you get an alcohol-detecting ankle monitor for 3 yrs, or 200% of your jail/prison sentence, whichever is less. After 2 episodes, it's 10 yrs, or 400% of sentence. After 3 episodes, it's an ankle-monitor for life or double your sentence. You get the idea, everyone is allowed to drink UNTIL you show you have lost that privilege. There is no "right" to alcohol consumption, and no reason that those who endanger the rest of us via alcohol should be permitted to repeat without serious efforts to curtail it. BTW, ankle monitors cost the state about $4/day.

I should check to see if I have stock in ankle monitors.

 

[Ceke2002]

Overall, any sort of screening process like that kind of reeks of police state and conformity, even if it's couched in "free treatment." You play dungeons and dragons? See a psychiatrist. Tattoos and piercings?! Into metal? Wow, you write hip hop lyrics about shootings. Etc. I can see just "weirdness," "creativity" etc being referred. Also creating a bigger schism than already exists between these factions/subcultures and mental health treatment.

I was recently given a basic psych eval during triage at the ER (I was there for a non psych related issue, just had to get a DVT ruled out), when old self injury scars were noticed on my legs. It was the standard 'how are you feeling right now, are you having any thoughts or desires of harming yourself' type deal. I didn't mind, I actually appreciated they were being thorough, & taking care of me.

Now had I turned up to the ER in my preferred mode of dress, which is Goth, and they'd gone 'I see you're wearing black clothes, a studded dog's collar & a large amount of eyeliner', are you have any thoughts of harming yourself. Um, yeah, not quite so happy there

 

[Ceke2002]

The downside of guns, IMO, is not the ownership in those with mental illness, it's that it leaves very little room for error or regret. If you've ever talked with someone post suicide attempt, very often they have regret or even a lifting of their mood. Not always, but in my experience a lot. Shooting oneself in the head doesn't leave much room or time to develop insight, or change your mind.

This is very true, at least it was definitely the case with me. I won't go into detail, just in case we have some other psych patients lurking around here who may be triggered, but I made a very serious suicide attempt back in 91. At the time I was absolutely determined to die, the attempt was planned down to the last detail I could think of, but the very moment I came to, and realised it hadn't worked, OMG I can't even begin to describe how relieved and happy I was. In an instant I went from desperately wanting to end my life, to 'I can't believe how happy am to be alive'. Had I access to a gun, I seriously doubt I would be typing this post right now.

Having said that, we have very strict gun control laws in Australia & a friend still managed to get hold of one and commit suicide with it (Julia Morris, I've mentioned her on here before, you can Google for the full story). I've also had other friends, some closer than others, who have committed suicide & yet they were surrounded by some of the best treatment & support networks anyone could hope for. My point is, when someone is that determined to die, at some point there's not a lot you can do about it, they will find a way. That doesn't mean though, that we need to provide them with easy access to a way that almost guarantees they will be successful.

I know not being part of the US, or its culture, I probably shouldn't be commenting on the 2nd amendement, or gun control in the Unites States in general, but I believe this image sums up my feelings on the subject quite nicely - there comes a point when, constitutional protection or not, some people just should not be allowed access to a fire arm, period.

[Image edited out]

 

[kugel]

there comes a point when, constitutional protection or not, some people just should not be allowed access to a fire arm, period.

I have to admit, I haven't seen any gun rights activists arguing that felons or those with serious mental illness should have guns. (Might have been interesting to see someone publicly state Ronald Reagan must have guns removed from his house at the time he was diagnosed with dementia.)

HOWEVER, if it is a "right," then shouldn't everyone have that right?
I mean, doesn't everyone in the U.S. (mentally ill or not) have the right to free assembly, freedom of religion, freedom from unreasonable search and seizure, right to own property, etc., etc. (unless that right is removed by a court with appropriate hearing and evidence)?
Are any of these other rights removed simply by the presence of an illness?
(And don't try the argument that epileptics are prevented from driving in most states. That is a privilege - which explains why you have to show ability and responsibility by getting a license.)

IF it is a privilege that you can lose, then we need to try to draw the line somewhere. And that line will inherently move back and forth as conditions and society change. And perhaps you need to show the ability for safe use - just like driving.

 

[Hernandez]

I have to admit, I haven't seen any gun rights activists arguing that felons or those with serious mental illness should have guns. (Might have been interesting to see someone publicly state Ronald Reagan must have guns removed from his house at the time he was diagnosed with dementia.)

There are many who make the argument that NON-violent felons should have their 2nd amendment rights returned after they've completed their punishment/reperations. And there is a means for them to do so in most states and on the federal level.....but it's not easy, and but the federal department isn't fundedm which effectively negates that.

I agree violent felons shouldnt have their rights restored, just as they aren't allowed to vote. I'm not sure where I stand on non-violent felons, especially if you want to confound the discussion and talk about felony creep.

 

[Ceke2002]

I have to admit, I haven't seen any gun rights activists arguing that felons or those with serious mental illness should have guns. (Might have been interesting to see someone publicly state Ronald Reagan must have guns removed from his house at the time he was diagnosed with dementia.)

HOWEVER, if it is a "right," then shouldn't everyone have that right?
I mean, doesn't everyone in the U.S. (mentally ill or not) have the right to free assembly, freedom of religion, freedom from unreasonable search and seizure, right to own property, etc., etc. (unless that right is removed by a court with appropriate hearing and evidence)?
Are any of these other rights removed simply by the presence of an illness?
(And don't try the argument that epileptics are prevented from driving in most states. That is a privilege - which explains why you have to show ability and responsibility by getting a license.)

IF it is a privilege that you can lose, then we need to try to draw the line somewhere. And that line will inherently move back and forth as conditions and society change. And perhaps you need to show the ability for safe use - just like driving.

I agree with the bolded part, not sure how it is in the US, but in Australia people with a diagnosis of epilepsy have to be seizure free for 2 years, before they can apply for a driver's licence. Why not apply those same principals to gun ownership in the US, you have an illness that has the capacity to affect your judgement, then you need to prove that you're well enough/stable enough to take on the responsibility of being a gun owner.

How much do guns in the wrong hands of people actually infringe on other's rights in the US? (serious question, as well as a point) People have the right to free assembly, until someone with a gun comes along and starts shooting, people have the right to be protected against unreasonable search and seizure, until someone points a gun at your head and demands all your money. I know the examples I've given are more likely to be criminal activities as opposed to a person who is maintaining responsible gun ownership, but from my understanding at least, most of the guns that people use to disrupt the rights of others are, or at least can be, legally acquired. For me it's a case of 'the rights of the many out weigh the rights of the few', if gun ownership is infringing on the rights of others, then I think it should be re-examined, and significantly tightened up, if necessary.

And yes, yes I am a Democratic Socialist

 

[aphenomenon]

If there was a system for reporting "weirdos" and even "suggesting" psych evals based on that, I would publicly recommend that anyone being reported go to the eval, and then say NOTHING except, "I have never wanted to hurt myself or anyone else. May I go now, or are you holding me against my will?"
I would Not tolerate such a system of even suggesting psych evals for almost any form of non-conformity. That is the road taken by many police states, and Joseph McCarthy. Once we get people to focus on "the enemy next door," they stop thinking about the evil and control of the people in charge.

Exactly! Similar to what I was (trying to) say above. Thanks.

 

[whopper]

Why not apply those same principals to gun ownership in the US

The legal difference is that owning guns is a constitutional right in the U.S., driving is not. Any legislative branch can make any law they want concerning driving and no one could argue it's not constitutional. Anyone making any law to further control gun ownership will, by definition, automatically have a constitutional level suit on their hands, and it could be struck down by the Supreme Court, not to mention that there's a powerful gun-lobby in the U.S.

I'm not trying to get political, but I actually agree with some of the arguments brought up by the gun-lobby. Several proposed laws, if enacted, only hurt lawful gun owners while leaving the ones illegally owning them scott-free. E.g. a hyper-tax put on a newly purchased gun-yeah well the people that buy them illegally now don't have a tax on them, but the guy wanting to lawfully and responsibly own one has to now be taxed. On the other hand, several laws that have passed IMHO make perfectly good sense such as requiring locks on guns or a waiting period.

 

[billypilgrim37]

The legal difference is that owning guns is a constitutional right in the U.S.

As of 2008. People act like this has been settled since 1789. Until 4 years ago the Supreme Court had never established that the second amendment protected an individual's right to possess a firearm for lawful non-militia purposes.

 

[Iwillheal]

The shooting in the Sikh temple now...I wonder if the media paying so much attention to these cases does make it more likely that the next person will use such an extreme method to deal with whatever is bothering them.

 

[PikminOC]

So according to news outlets, the alleged batman perp made a call to the hospital to talk to lynne fenton 9 minutes before he did the crime....and she says she never received the call..

And lynne fenton said she met him once (june 11?) and their dr pt relationship ended that day. I hope she has that documented somewhere.

 

[whopper]

Dr. Keith Ablow gave a response alleging possible malpractice by Dr. Fenton.

http://www.foxnews.com/health/2012/07/31/what-did-james-holmes-psychiatrist-know-and-when/

Therefore, the Holmes case has the potential to become not only one of the most tragic criminal cases in America, but one of the most tragic cases of malpractice — ever.

His comments are, however, true, in fact I'd even go as far as to say it's the statement of someone who knows the field, but also someone who used his knowledge to report something not inaccurate but with a twist for hysteria. There's a reason why Fox News has all those "whoosh" sound effects and it's not like C-Span.

A more balanced response, from Paul Applebaum basically just bottom lines this as no one except for the people directly working on this case knows what happened, and there's no real information we psychiatrists can say on it given that we don't know so many things about this case. It's a shame because when these types of events happen, people want answer, they come to us, and we really don't have much to give them. When events like these happen, it's a great opportunity to teach people more about the system and how to improve upon it, but we have such little we can offer in explaning the reasons why these things happen because they only became known after several months of investigation.

 

[PikminOC]

Why was the defense striking down every question by the prosecution as violating dr patient confidentiality? I thought if you were subpoenad you could violate it.