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Repercussions from VA Tech Tradgedy

This one from Dr. Elmes...

Given the horrors of VA Tech, should the state of VA reduce the requirement for mandatory commitment of "mental patients" to psychiatric hospitals by changing the criteria from "Imminent danger to self and others" to "Danger to self and others"?

Apparently, VA is one of a dozen or so states that has "Imminent danger" as a criterion. What are issues/costs/benefits of broadening the criteria for commitment?

Comments (7)

nm:

This notion of therapists having legal standing brings up a good point; to what extent will commitments be made based on 'liability concerns' rather than real concerns for the well being of a family member or society? Is it likely that poorer, less 'sophisticated' clients might be more often seen as a danger than those who come from the same class/group as those doing the committing?

ww:

To play devil's advocate even further. What if you were a single parent, recently divorced, and had 2 or more kids to take care of. Imagine that the psychological stresses of your situation resulted in a major depressive episode. Though you feel that your kids are the only thing making life worth living, your therapist believes they may be in danger of neglect and as a result the therapist wants to commit you to a psychiatric facility and put your kids in state custody as your have no family members to take care of them. You are strongly against this idea, but the therapist has the legal standing to commit you.

Another consequence of broadening the law is that those those who are committed will only be those people who have the wherewithal to seek counseling. How are those who seek counseling likely to be different from those who don't?

Sarah Otey:

I agree with Amy and Katie. A lot of people's jobs are based on evaluating situations like this and considering what could have been done and what could have prevented the situation. Thus, obviously the media is biased in that direction. Watching the news and/or reading the newspaper, the public gets the sense that this situation could have easily been prevented if only someone had done something. So I think a lot of the information that I have heard in interpersonal conversations has been flavored by the media's impact.

To play devil's advocate...another argument is that a lot of people that are forced into psychological therapy do not improve. Numerous studies have demonstrated that criminals learn to be smarter and more careful in prison rather than being reformed. I have read a couple of studies that demonstrate the dangers of institutionalizing individuals whose psychological conditions barely merit institutionalization. Psychopathology can develop, in some cases, via exposure to psychopathology.

I realize that this does not address the ultimate question of whether or not gun laws should be sold to individuals that pose "danger to themselves or others." In this case, the perpetrator purchased guns legally. However, the legality of his act was clearly not an issue. Someone who commits mass murder will find a way to purchase guns, legally or illegally. In my opinion, the public and the media should stop wasting so much energy focusing on legislation and should spend more money and energy focusing on treatment for individuals who do pose a threat to themselves or others, so that their behavior does not escalate to create a similar problem.

Katie Kingsbury:

I agree with Amy here. It may indeed be true that we need to "lower the bar" in VA, but we also have to consider the impact this has on the American definition of personal freedom. The issue is not simply seeking to pinpoint and treat mental problems sooner, but also whether we are willing to to push the boundaries concerning an issue that has always been a basic virtue for America: individual freedoms.
Also, like Amy said, it's easy to say that this man presented all the signs of a killer, now that the murders have already happened, than it is to say that all such individuals who exhibit the same early symptoms as this man are on the path toward committing the same crimes.
Overall, I agree that the VA bar should be lowered from "imminent danger" to "danger," and from there we should trust family, friends, and mental hospital staff to make the best judgment calls that they can. But the reason this has not happened already, and possibly may not happen at all, is because of the implications that such a measure might have on our national emphasis on personal freedom.

Amy Roberson:

I agree with both of you to an extent, but I think the issue is a little more complicated with that. The purpose of the law should be to protect all citizens, including someone who is mentally ill. After seeing what the Virginia Tech shooter was capable of, it is easy to look back and say that he should have been committed. But hindsight is 20/20 (pardon the cliche). It is hard to determine who is a danger to self and others before they have actually done anything dangerous. Is it better to err on the side of committing too many people just to be safe?

Just a thought...

Kelly Will:

I agree that lowering the bar for institutionalization is a smart idea. It can't hurt a person to get help for psychological problems even if they are more minor than they seemed at first. The only issue becomes cost. As it is there isn't enough money for high quality care and flooding the system with more people won't help that. It's similar to the dilemma with the prison system. The prisons are overflowing and as a result people are just being placed in prison instead of receiving any help for the problems that put them there in the first place.

Instead of treating the current problem a more preventative approach is necessary. First, children need to be taught early on that "mental" problems are a common part of being human. Instead of stigmatizing them, children need to understand that almost everyone at one point or another suffers from some psychological dilemma. Second, the VA Tech shooter could have had some intervention far earlier in his life. High quality child care and training for parents and teacher that centers on helping children develop a sense of self, a sense of purpose in life, and a sense of belonging to society can head off a lot of drift that seemed apparent in the shooter's life. I'm not saying that he never had a caring adult or a bad childhood, but more attention paid to the developmental needs of children in all strata of society could prevent teenagers who feel disocnnected and develop violent thoughts as a result.

Meghan Joss:

A few things:
While I know that it would probably cost the state more money to "lower the bar" for institutionalization, I do think it may be smart. More importantly, however, I think private institutions (ie W&L, a family, corporation) should consider institutionalization even sooner. Perhaps it comes from the stigma associated with mental hospitals, but it seems like we're too reluctanct to get individuals the help they are crying out for until it is too late.

This, however, is assuming mental health workers are effective. In the case of Tech, it sounds like the gunman was "getting help" from a psychologist of some sort...

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