Jared Loughner, Colleges, And the Mentally Ill

Should schools be compelled to give troubled students mental health support? It's a chilling and complex question that comes to light as as a patchwork portrait of Tucson shooter Jared Loughner emerges.

We know that Loughner's behavior so bothered his classmates and professors at Pima Community College that the school asked him to leave, ordering him to undergo a psychological evaluation. His strange conduct also led to several run-ins with Pima campus police, and prompted one student to vent in an e-mail to a friend that Loughner "scared the living crap" out of her.

So there were warning signs. But according to Columbia University assistant clinical psychiatry professor David Leibow, a school cannot legally force a student into treatment unless he or she poses a threat. Leibow said that, in theory, the campus police who interacted with Loughner could have transported him to an emergency room, where he could have undergone relevant examinations. But even in that case, he could have been discharged. He could have opted to cease any treatment, as people routinely do, or he could have refused treatment altogether.

The only people who would have truly been in the position to help Loughner, Leibow said, were his parents. (Loughner's parents were allegedly notified of their son's situation at the college, the Times reports.)

In any case, as his classmate Steven Cates told the Times, getting kicked out of Pima "was probably a major blow" to the 22-year-old Loughner. "He was really into school. He really loved the acquisition of knowledge. He was all about that," Cates said. "It would make sense that losing that outlet would be a negative thing for him psychologically."

Students like Loughner put colleges in an extremely difficult situation. Take the case of Community College of Baltimore County student Charles Whittington. Last October, Whittington, an Iraq veteran, wrote a paper for an English course the on narcotic quality of war. "Killing is a drug to me and has been ever since the first time I have killed someone," he wrote. "At first, it was weird and felt wrong, but by the time of the third and fourth killing it feels so natural. It feels like I could do this for the rest of my life and it makes me happy."

After the essay was published in the school's newspaper, Whittington was barred from the school pending a psychological evaluation. Whittington obtained one, but the school said he did not submit proper documentation. He ultimately decided not to return to the college. A source close to Whittington told the Sun that he "seemed unusually depressed," though he was being treated with counseling and medication.

A Community College of Baltimore County spokesperson said that the school was exercising increased caution in a post-Virginia Tech world. The 2007 massacre, which left 32 dead, tipped the scales between caution and compassion on campus toward the former.

"It's a tough predicament and there is no one answer that can solve this problem," Leibow said. "The real fortunate thing here, I think, is that every school now and every student health service since Virginia Tech and Columbine is aware of the need to assess dangerousness."

Correction appended: An earlier draft of this article quoted David Leibow as saying it was unfortunate that schools had to assess dangerousness as a result of Virginia Tech and Columbine. He actually said that was a fortunate outcome.

 

Follow Leah Finnegan on Twitter: www.twitter.com/leahfinnegan

Comments

[Kamododragoon]

12:00 AM on 01/18/2011

The problem with this is that it has the affects of being abused and mental health people abusing the system by mistakenly taking people rights away without due process or a hearing.

[Janet Granofsky]

05:00 PM on 01/16/2011

More on my getting kicked out of CCBC-Essex, which hapend 17 years before and across town from "CJ" Whittington's experience (and across country from Jared Loughner's with PCC. (See my start post on HP- Jan 11 on this page) : I consulted with 2 female job-and-academic counselors on campus several months before, but was not elegible for "displaced homemakers" program...
See MJG 94-3483 in the US District Court for Maryland: Janet Granofsky v. Essex Community College, Baltimore County Police Department, Franklin Square Hospital, and Spring Grove Hospital Center. It's probably in storage in Philadelphia, but if enough people are interested, it could be retrieved. I won't have any more web access until Tuesday, and I can't afford court fees anyway. Happy MLK Day.

[rainydayz]

04:01 AM on 01/16/2011

Having mental health care may be feasable at the university level, but I can't imagine it being viable at the community college level. Today's community colleges barely have the staff to handle academic issues due to the giant increase in enrollment and decrease in funding let alone complicated psych issues. Also, they don't tend to have medical clinics either.

As for the young man in Tucson, unless he specifically stated that he was going to kill someone or himself there was no way for someone to make him "get" help. Making him get treatment for his mental health issues is as impossible as making a victim of a car accident go to the hospital. If they're adults and competent, they don't go if they don't want to. In a way the college did try to make him access treatment by removing him from the school until he made contact with mental health and received an eval.

The case of the veteran sounds more like a culture clash. My husband is a VietNam vet who has talked about combat, a topic that usually ends in tears for both of us. The one thing that he has said is that this abnormal situation becomes normal. Should he see a VA counselor, definately, for help with combat related issues, but to kick him out seems to be a huge overreaction. He will learn though to never be that open again.

[Bright Creature]

04:35 PM on 01/13/2011

I don't think that should be a school function. That should be a government function. If the US government can force schools to give mental health services then the government should just perform those services themselves so every person, not just students, can enjoy mental health. If that's socialist then so be it.

[CptFreakout]

09:13 PM on 01/12/2011

It sounds like a candidate for the law of unintended consequences , if someone disagrees with your lifestyle or philosophy or just has an issue with you or you just inadvertently make someone nervous over something they misheard or something makes them uncomfortable (the great American past time) you get a psyche evaluation , like that wont smeg off people in a very bad way .
This idea of schools getting involved like that is a bad idea .

[Janet Granofsky]

02:50 PM on 01/11/2011

The Community College of Baltimore County- Essex (then called Essex Community College) did unjust about exactly the same thing(s) to me that they did to Charles Whittington, but THEY didn't submit the proper documentation to a judge before sending Baltimore County Police to my apartment to trick and pressure me to the Franklin Square Hospital ER, which dumped me to Spring Grove (state mental) Hospital, where my scary letters to ECC counselors, a teacher and administrator appeared again. I was involuntarily "withdrawn" from ECC before and while being misdiagnosed, released after 10 days in Spring Grove, and officially banned another week after that.

You might say I "bombarded" Senator Barbara Mikulski's offices with phone calls, voicemail messages and faxes over several years, but I haven't gained any entry into HER head, as far as I know.

There were more issues involved in my story than in Charles Whittington's, Jared Loughner's, Seung Hui Cho's, or Tim McVeigh's, even BEFORE I attempted suicide and got evicted, spent another week in another psych ward, and landed in a horrible Baltimore County (and CAN and Franklin Square) homeless shelter.

I don't think CCBC has published any of my letters, and I doubt I should allow them to. I may still have some rights left, since I haven't killed ANYBODY. But everyone has ignored me, or worse, especially NPR, and I may never get a book deal, or even a job or apartment again. (I don't want a GUN.)

Google me.

[Janet Granofsky]

02:48 PM on 01/11/2011

"A school cannot legally force a student into treatment unless he or she poses a threat." But a certain school can illegally get rid of certain student(s) if they use caution, fake compassion, and maybe a little conspiracy.

The Community College of Baltimore County- Essex (then called Essex Community College) did unjust about exactly the same thing(s) to me that they did to Charles Whittington, but in a slightly different order and with a greater degree of involvment. THEY didn't submit the proper documentation to a judge before sending Baltimore County Police to my apartment to trick and pressure me to the Franklin Square Hospital ER, which dumped me to Spring Grove (state mental) Hospital, where my scary letters to ECC counselors, a teacher and administrator appeared again. I was involuntarily "withdrawn" from ECC before and while being misdiagnosed, released after 10 days in Spring Grove, and officially banned another week after that.

Losing that scholastic outlet was definitely a negative thing for me psychologically, socially, and careerly, altho I RESUMED my acquisition of knowledge and applied it as well as I could in my own behalf. But I also have not returned to school.

I tried to post this comment earlier today with my own website url. Google me, you'll find more.

[Sarah Perry]

12:23 PM on 01/11/2011

Should schools be blamed, should his parents be blamed? We live in a punitive society. We want to
blame someone and punish them as harshly as possible, or blame something and make new laws. Did
the US Army have Loughner undergo a psychological evaluation?

[healthanalyst]

02:26 AM on 01/12/2011

I think it was more his admission to smoking dope hundreds of times. That will keep you out. Once or twice, kids will be kids. That amount, a bit much.

[Janet Granofsky]

11:39 AM on 01/11/2011

"A school cannot legally force a student into treatment unless he or she poses a threat." But a certain school can illegally get rid of certain student(s) if they use caution, fake compassion, and maybe a little conspiracy.

The Community College of Baltimore County- Essex (then called Essex Community College) did unjust about exactly the same thing(s) to me that they did to Charles Whittington, but in a slightly different order and with a greater degree of involvment. THEY didn't submit the proper documentation to a judge before sending Baltimore County Police to my apartment to trick and pressure me to the Franklin Square Hospital ER, which dumped me to Spring Grove (state mental) Hospital, where my scary letters to ECC counselors, teachers and administrators appeared again. I was "withdrawn" from ECC before and while being misdiagnosed, released after 10 days in Spring Grove, and officially banned another week after that.

Losing that scholastic outlet was definitely a negative thing for me psychologically, socially, and careerly, altho I RESUMED my acquisition of knowledge and applied it as well as I could in my own behalf. But I also have not returned to school.

See http://janetgranofsky.angelfire.com. Or Google me.

[Turukano]

09:07 AM on 01/11/2011

We need to be careful about increasing the power of local government to declare someone mentally ill. It can be abused.

[healthanalyst]

02:27 AM on 01/12/2011

In a lot of states, you can do a 72 hour commitment. Should have been done in this case. They do an eval, usually have a judge involved besides the police / person complaining.

[Bellanova]

08:10 AM on 01/11/2011

College mental health services are overwhelmed by the deluge of emotionally sick students and not equipped to deal with them. The most troubled kids are treated as a potential liability by the school and in a unhelpful manner -- i.e., the school is interested in making sure that the student won't hurt anyone, but not so much in finding appropriate psychiatric and psychological help (see the overwhelmed mental health services, with long lines of potential clients and not always well prepared or compassionate staff).

To say that Jared's parents were in the best position to help him is true, but only to a point: as an adult, Jared can do as he pleases and his parents cannot compel him to seek help even if they believe he desperately needs it (and it seems that like so many parents, his too were the last ones to realize that their kid had problems).

Even if he were forcefully hospitalized for mental health eval as someone posing danger to self or others, he would have been released after the eval, and more likely holding a greater grudge against the oppressive society (his paranoia).

The worst thing was suspending him from school, I think, without making an effort to reach out to him and his parents afterwards to make sure he'd receive help and an opportunity to be reinstated when he got better. This abruptly severed contact with the source of social support and meaning was likely the last straw for him.

[healthanalyst]

02:29 AM on 01/12/2011

Also would community colleges have the health resources that some colleges / universities do? Which is a big deal. A lot of bipolar individuals go full blown in college. Due to stress, that its usually something that happened in early 20s in males, whatever. And you have the whole deal of keeping them on their meds.

[lastpost]

06:29 AM on 01/11/2011

“It would make sense that losing that outlet would be a negative thing for him psychologically."
Remove a source of external reference points.

“At first, it was weird and felt wrong, but by the time of the third and fourth killing it feels so natural”
Almost as if I was able to custom-engineer my own reality paradigm?

“It's a tough predicament and there is no one answer that can solve this problem,"
Hummmm.

[healthanalyst]

02:30 AM on 01/12/2011

I'd give a vet more of a pass. Especially this cohort. Make sure he was ok, was able to differentiate between what he felt and what the world expects. If he couldn't he would need referral to VA or other care. Sounds like this guy got railroaded by a bunch of scared people.

[DarkKarma]

02:16 AM on 01/11/2011

"Should schools be compelled to give troubled students mental health support?"

In two words, He-- No !

Society is tiring of being surogate parents !

[Daly]

05:14 AM on 01/11/2011

I agree... the schools should be obligated to reoport the issue; nothing more.  who is going to underwrite this... tuition is costly enough.

[Turukano]

09:09 AM on 01/11/2011

It gets mirky when schools start reporting their students to law enforcement.

[Shirty63]

12:57 PM on 01/11/2011

I am not necessarily in favor of schools providing treatment or whatever, but if people like this end up in situations like this--very sick, untreated, angry, dangerous, with access to a gun--then we should get ready for this to happen again and again. If nothing changes, then nothing changes, and this sort of thing will keep happening.

[healthanalyst]

02:33 AM on 01/12/2011

They might not be able to follow up , but they should do some intervention. If there is a health center or say psych graduate school or medical school, they could do some intervention. Just blowing it off is not the answer.

U Texas used to have about a dozen suicides a year in the student body. And they had mental health available.

[opinionated4eva]

01:42 AM on 01/11/2011

You all act as if all schools have the resources capable of addressing these types of issues which is not the case. Keep waging wars while giving unequal tax cuts to the wealthy and not funding mental health clinics and hospitals and this is what you get.

[knasky]

12:16 AM on 01/11/2011

With very few exceptions, you can not force someone to be psychiatrically evaluated and/or treated against their will. Someone has to be considered imminently dangerous to self or others before they can be involuntary admitted, and let me tell you, the bar is set very high for that to occur.

Also, I hardly doubt this was an "access to care" issue. Chances are, this young man would have outright refused psychiatric care. Most paranoid schizophrenics lack insight into their illness, i.e. they don't think they're sick. Furthermore, they're paranoid, and often that paranoia is directed towards the 'establishment,' thus they're not going to be amenable to efforts by "the establishment" to get him into treatment.

Again, even if you were able to compel someone like this to get evaluated, the criteria for involuntary hospitalization is so stringent, the likelihood of a 'catch & release' scenario is high (like the Cho case). I'm a psychiatrist, and I can't tell you how many times I've seen acutely psychotic individual s refuse treatment and walk out of an ED. Unless they are imminently suicidal or homicidal, or showing evidence of grave deficits in self-care, you can't make a case for involuntary admission.

I don't have an answer. After a tragedy like this, the pendulum will undoubtedly swing towards "Why don't we commit these people against their will?", but then you get into a debate about civil rights, patient autonomy versus medical paternalism, and a host of other very valid issues.

[Bellanova]

08:26 AM on 01/11/2011

Good points, all, K. It is time we admit that as a society we are totally unprepared to deal with people like Jared and mentally ill in general.

But instead of coming out with such an admission, we continue our denials and shifting responsibility: Why didn't his parents do something? Why didn't school do more? Why didn't law enforcement intervene? Etc.

We need to realize that "it takes a village," to use the trite but true expression, to help emotionally disturbed young (and not only young) people. We may not have all (or even any good) answers, but we need to be able to communicate our concerns and coordinate our helping efforts with many different people and across various societal agencies. Passing the buck in the belief that "this is not my responsibility" and "the other guys should do it" results in tragedies like the one in Tucson.

And I know it sounds controversial (and I well understand why), but we need to re-evaluate our privacy laws with respect of young people with emotional problems. The fact that a college student is an adult, chronologically, should not stop the school from contacting the parents (who pay for his college and otherwise support the kid) with concerns about his behavior, in an attempt to alert them to his problems and needs, and enlist their cooperation in getting help for him.

[knasky]

02:02 AM on 01/12/2011

Though not a specific solution, you have touched upon the general direction we as a society need to strive towards: coordination of mental health screening and care across agencies and professions. Some of what's actually working in the military (there are some success stories) adopts this strategy: coordinated efforts between command, religious ministry (when appropriate), mental health professionals of all stripes, medical, substance abuse counselors, etc. Essentially, "a village," like you said.

I consider myself a civil libertarian, but I do agree with you that we should take a look at our privacy laws. Re-writing privacy laws would be no easy task. Somewhat a lot smarter than me would have to thread that needle. I fear a world where people can be coerced into involuntary treatment based on suspicions of odd behavior. (Essentially Foucault's fears/concerns coming to fruition!)

[Turukano]

09:10 AM on 01/11/2011

Exactly.