Wednesday, April 18, 2007

Hindsight, Foresight & A Troubled Mind at Virginia Tech

I’ll leave the blaming to others, but the details now coming out about the shooter at Virginia Tech are indeed troubling and open the doors to much conversation about how society and our institutions should handle troubled individuals.

I don’t think anyone wants to go back to the days when we would lock a person suspected of having a mental problem away in a “Snake Pit” mental hospital never to be free again (The Snake Pit was a 1948 movie where Olivia de Havilland wakes up in a state insane asylum with no clue as to why she’s there). Yes, there are people who must be locked away to protect society and themselves, but today we are more apt to turn to pills and the family doctor to handle some rather serious mental health problems. And that’s if the problem is going to be addressed at all.

Pretty much the mantra has become, “if he’s no threat to himself or others.” Well, perhaps, it’s time to reevaluate this idea. Yes, I believe in a free society and an open society, and this is part of the troubling part. How do we get the help to people who don’t want it? At what point should we intervene? Must there first be a crisis? Most health insurance coverage limits mental health benefits. I think this is dangerous.

Right here in Alabama we had a federal court case, Wyatt v. Stickney, that largely influenced how states care for those with mental health problems. U. S. District Court Judge Frank M. Johnson, Jr., for many years guided and watched over that case which set what’s been called the Wyatt Standards regarding the right to treatment: humane psychological and physical environments; qualified staff in numbers sufficient to administer adequate treatment; individualized treatment plans; and services in the least restrictive environment.

Court monitors, special masters and 33 years later, a predecessor of Judge Johnson’s finally felt that Alabama had done what the law and justice required. How ironic it is to me that Judge Johnson, the judge who took Brown v. Board of Education of Topeka and applied its principles to civil rights case after case involving the Montgomery Bus Boycott, voting rights, the Ku Klux Klan, the Selma to Montgomery March, Freedom Riders and so on, lost his own 28-year-old son to suicide, coming after years of harassment over his father’s high profile decisions.

I don’t have the answer. But we need to be thinking about this.


natalie said...

I agree with you on this, Sheila. I think that key on college campuses is for students to speak up about other students who exhibit "strange" behavior -- and then for staff and administrators to take those concerns seriously making sure that the student isn't going to harm herself or others. I remember my freshman roomate. She was in serious need of professional help. When she started to scare me with her dark comments and tales of having been abused by her parents, I contacted my dorm staff immediately. I was moved to another room, and she was required to see the school pyschologist. She lasted the rest of the semester, but did end up leaving school before the next half of the year started. She enrolled in school again a year or so later, but I gathered from others that in that time she received the professional help she needed. I hope she has been able to move on with her life. I realized quickly, though, that her problems were more than a homesick freshman like myself could handle in that situation. but you're right, our whole system of how we handle mental health care has to change in order to support positive action.

AlexD said...


We must be on the same wavelength. Because I agree that the insane should be chemically restrained. And in extreme cases placed in institutions to be cared for. I have had years of dealing with the mentally ill and believe me it comes down to payment. Simply put, pills are a cheaper alternative to padded rooms.

This was a GREAT POST, keep up the good work.


Sheila said...

Natalie, you did the right thing to help that roommate get the attention she needed. College is a stressful time and I believe I read where just starting or ending college adds 45 points on the stress-o-meter. After a while, enough of these stresses can cause a even a fairly well-balanced individual emotional distress. Amplify that for a person who is already emotionally unbalanced and we get real trouble.

Alex, I guess I see the real challenge is to first convince a person he or she is better off seeking help from a mental health professional. Then, to persuade that person to give the medicine or therapy a chance. Even then, it takes a trial and error period to find what is working. One pill doesn't fit all. And, the person must take the medicine regularly. We are working too against the societal view and stigma that mental illness is somehow worst than a physical ailment. Until we can reverse that thinking, people are going to continue to be reluctant to seek and receive the help they need to function in this crazy world.

We are talking and that's a tremendous step in the right direction.

Jay Croft said...

Alexd, I'm a bit concerned about your terminology. "the insane" can mean anything. There are hundreds of types of mental illnesses--take a look at the Diagnostic and Statistical Manual (otherwise known as "DSM-4.")

Not all need "chemical restraint." Depression is the most common mental illness; my wife, who is a clinical psychologist, calls it "the common cold of mental illness." There are various medications to lift the mood. However, "talk therapy" is essential, also.

Careful diagnosis is a key. This is not always easy, especially if the professional is dealing with a client whose culture the professional is not familiar with.

Jay Croft said...

By the way, Louise Fletcher, who starred in "One Flew Over the Cuckoo's Next," is the daughter of my pre-predecessor in a Birmingham church. I E-mail with her occasionally.

I used to visit her parents regularly when they were residents in a retirement home in Alexandria VA.

Sheila said...

Jay, I'm sure your wife has more insight into a lot of the mental health issues being discussed lately. This is one of those tough issues we as a society face. I've worked a little with mentally unstable people and for many years saw directly my own father struggle. I don't have a lot of experience--just enough to know that there are no easy remedies or pills to "make everything better."

Not that Louise Fletcher would care, but I found her Nurse Ratched so compelling and disturbing. That movie left a mark on me. She did a wonderful job and well deserved all the accolades she received. And now that you mention her father was your predecessor, I seem to recall reading, I believe, that her parents were deaf.

Tracey said...

You pose some very interesting questions, Sheila. I used to work in an area of town that was infested with drug dealers and addicts. Young women, teens, with children being raised on the street while they got their mamma got her fix. I witnessed prostitution on the street in broad daylight, right in front of my store. Not just the money transaction, but the blow job. I had a customer in the store with me. Thank God there were no children with her!

Even people who appear 'harmless' are harmful to society. Too many of us think that handing a dollar to the guy on the corner is actually going to do him some good, but instead it gives him money to buy drugs or alchohol. We're killing them with kindness.

Our local mayor blamed President Reagan, saying he'd shut down the mental hospitals so these people could fulfill their destinies under the bridges of America. Great quote, eh? But here in this state, our govenor shut down those institutions long before Reagan ever came into office.

Anyway, great post. No simple solutions, but sometimes we need to make the hard choices in order to really help someone.

Sheila said...

Tracey, thanks for your comments. Do we give to the homeless man on the street to really help him or because we feel guilty? In my mind you are right. We aren't helping him.

The whole issue of what do we do with people who need mental health care is troubling. In the last few days I have heard at least two mental health professionals say the system is broken. We now know that not fixing broken systems can have devastating consequences.

Maybe we will talk about this serious problem until a bright and shiny piece of tinfoil captures our attention and we move on to be fascinated with it.