Why Wasn’t Loughner Committed?

January 12th, 2011 at 7:16 am | 27 Comments |

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What to make of Jared Lee Loughner’s reading list? His Internet rants and his political leanings?

Answer: not much.

In my other life, I’m a physician, and one who often deals with chronic mental illness. Obviously, I’ve never interviewed Jared Loughner, nor have I had the opportunity to speak to his friends and family. But given his age, his paranoid views, and his behavior, the suspect seems to be very mentally ill.

Media reports are a dime a dozen and, with such a hot topic, quality isn’t necessarily guaranteed. Still, consider this description of Loughner from the front page of the New York Times.

In a community college classroom here last June, on the first day of the term, the instructor in Jared L. Loughner’s basic algebra class, Ben McGahee, posed what he thought was a simple arithmetic question to his students. He was not prepared for the explosive response.

“How can you deny math instead of accepting it?” Mr. Loughner asked, after blurting out a random number, according to Mr. McGahee.

His writings and Internet rants have mentioned mind control, world currency, and his anger at the U.S. government because of control of “grammar.”

Some have speculated that he may have Schizophrenia. That seems reasonable speculation, though – again – all this is at a distance.

In the days since this tragic event, some emphasized the need to move past politics and blame. As hot as American political rhetoric has grown in the past years, Loughner seems driven by a chemical imbalance, and not some bad reaction to a radio show.

But let’s not quite excuse politics for the moment. Politics influences policy. And in this tragedy, we can take a moment to consider how we address chronic mental illness.

Consider that a decade ago, California college student Laura Wilcox was shot dead by a paranoid man who had refused treatment for his mental illness. The public outcry helped lead to the passage of Laura’s Law, which authorizes court-ordered treatment for individuals with severe mental illness who meet specific criteria.

As noted by the Treatment Advocacy Center, ten years after Laura’s death, the law she inspired has been implemented in only 2 of California’s 58 counties. And how does Arizona fare? “In the years leading up to the deaths in Tucson, Arizona distinguished itself as the second-worst state in the US for criminalizing mental illness and providing needed hospital beds,” according to this Center that was founded by the eminent psychiatrist E. Fuller Torrey. Arizona, for the record, has just 5.9 psychiatric beds per 100,000, versus the recommended level of 50.

The Treatment Advocacy Center, for the record, emphasizes the need for all states to have laws that enable court-ordered treatment for certain mentally ill. A handful of states still don’t even have that. And, after decades of lobbying by patients and civil libertarians, many of the laws on the books are weak or not enforced. Incredibly, some of this lobbying – allowing mentally ill patients to go untreated – has been funded by taxpayers. My friend and colleague Sally Satel writes well on this point, see here.

Would any of this have made a difference in Arizona? At this point, we simply don’t know.

But if there is any good to come out of this nightmare, perhaps it will spark a local and national examination of the way we as a society handle serious mental illness.

Recent Posts by David Gratzer



27 Comments so far ↓

  • Slide

    To answer the title of this post with another question, why would we have expected him to be committed? Do we really want the government to commit people to mental institutions based on what we know about Loughner? Disjointed internet ramblings? Behaving inappropriately in a classroom? Do you really think that should be sufficient cause to commit someone against their will?

    The criteria for involuntary committal is that a Psychiatrist (usually two) declare that someone is a danger to himself or another. There is nothing that I have seen that was publicly available about the shooter that would have reached to that level.

    As a former law enforcement officer I can tell you that unfortunately there are many many individuals much like Loughner amongst us in society. It is always easy after the fact to ask, Why didn’t he get treatment? Why didn’t anyone know? Why wasn’t he committed? It is just not reality gentlemen.

  • armstp

    Mr. Gratzer,

    What exactly was he to be committed for? Not sure I understand your point.

    Committed for having a distorted view of government? In that case have the nut-jobs on the right should be committed.

    Being disruptive in the classroom?

    He did not commit any acts of violence. There were really very few, if any, incidents involving this guy.

    Why are we not committing the people of the Westboro Church or the birthers of the truthers, etc. etc. etc.

  • jncohen

    I’m with Slide. You can either have a (1) well-funded public mental health system that can absorb all the state’s mentally ill, plus a law allowing states to institutionalize people more easily, or (2) you can have the ill running free, lower public expenditures on health care, and more fetters on the state’s ability to confine people. Don’t fool yourself into thinking that we can have small government, maximum personal liberty and a state that absorbs all the ill into treatment/confinement.

    By the way, if you have a problem with inadequate public mental health care, your beef is with Reagan.

  • TerryF98

    If the level of proof to commit someone is what is currently publicly available then there are at least 5 birthers on this board who would qualify. They have weird irrational views, they also have a deep distrust of government.

    The rush to attach the schizophrenic tag to this guy even before he has been examined by a qualified psychiatrist is just an ass covering exercise by the right. They feel if they can do an instant “lunatic” label it somehow totally washes away the other 50 acts of violence Tommybones has been posting about the last two days.

    It’s the proverbial “shiny object”, look over there not at what is happening in America.

    Now it very well may be that this guy has a mental condition, but please enough with the instant diagnosis. It reminds me of the Terry Shiavo case, and look how foolish the right was in that sad affair.

  • Joe In NH

    It has been my experience with cases I personally know that even if paranoid and delusional and likely a danger to yourself or others, the individual likely will NOT be committed. Not that there are not solid legal grounds for doing so but there are not enough beds for everyone that should be treated. Instead the individual is sent back to the community until they commit a crime(usually not a serious violent crime) then they get help in the form of a bed and medication in prison. (Question:anyone know what is the largest mental health institution in the US? Answer: a wing of the LA county jail.) Likely this guy would not have been sent to a mental hospital because of the lack of funding of mental health.

  • ProfNickD

    Good question Mr. Gratzer.

    But if you’ve been reading the posts here by progressives/Leftists, it is unambiguously apparent that they don’t believe that Loughner did anything wrong — the post by TerryF98 above this one indicates how quick the Left is to absolve Loughner.

    The Left, however, was quick to place the blame for the shooting with Palin, Beck, Limbaugh, and Hannity.

  • ProfNickD

    jncohen,

    Ah, blame the conservatives again.

    Point in fact, deinstitutionalization of the mentally incompetent began in 1955 — I believe at the time Reagan was still making movies.

  • JeninCT

    I agree ProfNick. The question should be why wasn’t Loughner under observation? Committing him might not have been necessary if he had been evaluated and treated. He was not evaluated, as far as I can tell, and that is why he fell through the cracks.

    The fact that Arizona doesn’t have enough beds is irrelevant as long as his friends and family took no action on his behalf. I know that fact that he is 22 means his parents are ‘technically’ off the hook for his actions, HOWEVER, he was living under their roof so they should have known the college expressed concerns, AND the college should have made completely sure Loughner’s parents were made aware. If there is blame, it’s not with the state, it’s with those who were closest to him and could’ve stopped him. There is also the possibility that no one close to him knew how sick he was because he behaved differently among people he trusted. I don’t really know.

  • armstp

    ProfNickD,

    “it is unambiguously apparent that they don’t believe that Loughner did anything wrong ”

    What exactly did Loughner do wrong to deserve to be institutionalized? Please explain. I thought you conservatives were for free speech and the constitution. Nothing wrong with having strange ideas. Now obviously you should be held responsible for your ideas and speech if something liable happens, but before this shooting nothing really came out of any of this guys loony episodes that rose to the level of locking someone up. I am not sure what exactly you are defending. That we should lock people up for expressing conspiratorial views? You conservatives always want to seem to have it both ways. Now if a right-wing talking head or politician preaches violence and people act on that speech, then the talking head should be liable in one form or another.

  • Slide

    ProfNickD // Jan 12, 2011 at 10:35 am:

    But if you’ve been reading the posts here by progressives/Leftists, it is unambiguously apparent that they don’t believe that Loughner did anything wrong — the post by TerryF98 above this one indicates how quick the Left is to absolve Loughner.

    ProfNickD you are profoundly stupid if that is what you got from TerryF98′s post

    Joe In NH // Jan 12, 2011 at 10:03 am “It has been my experience with cases I personally know that even if paranoid and delusional and likely a danger to yourself or others, the individual likely will NOT be committed.”

    Having also been involved with many involuntary committals as a law enforcement officer I can tell you that Joe in NH is absolutely correct. It is very very difficult to commit someone in this country unless they are naked and dancing on the support cables of the Brooklyn Bridge while singing the second aria from La Traviata.

  • TerryF98

    “ProfNickD // Jan 12, 2011 at 10:35 am

    Good question Mr. Gratzer.

    But if you’ve been reading the posts here by progressives/Leftists, it is unambiguously apparent that they don’t believe that Loughner did anything wrong — the post by TerryF98 above this one indicates how quick the Left is to absolve Loughner.

    The Left, however, was quick to place the blame for the shooting with Palin, Beck, Limbaugh, and Hannity.”

    What sort of effing fool are you? Please tell me where I absolved this guy of blame for this tragedy? He killed these people there is no doubt about that. He is responsible for his actions and when tried and if found guilty he should face the death penalty.

    All I said is that the right has diagnosed the reason for the crime even before a medical examination. Is that the correct thing to do?

  • TerryF98

    Calling ProfNickD!

    Oops he ran away and hid.

  • Thanos316

    LOL, Arizona’s saving insignificant pennies by getting rid of publically-funded organ transplants, a policy that’s already resulted in two patient deaths since it began. Does anyone seriously think that the Brewer/Pearce/TeaBircher state government of that ridiculous place would have given a tinker’s damn about providing any medical help for people like Loughner? Anyone who thinks so sure hasn’t been keeping up on their Ayn Rand.

  • Cforchange

    Well Dr Gratzer, one can only hope that the supervision of the mentally ill will be examined. But a sampling of current events like Jaycee Dugard, mass shootings on an Army base, the LA Fitness Center shootings, Mr. Richard Poplawski, VA Tech shootings, the Holocast shootings don’t illicit action so why would this?

    Obviously we have become very tolerant of these shocking events. Maybe like the street gangsters who hold the perception that shooting guns has no consequence, the general population too is no longer able to identify abnormal. Maybe the passiveness of our society has penetrated too deeply. One can only wonder if MADD would have gathered traction today. Oklahoma City would have been the time for action and simply nothing has ever been done.

    Slide is right that there are many amongst us just like Jared – but that doesn’t mean it’s good or proper. Especially considering Law Enforcement one can only hope that this problem becomes more than Law & Order entertainment for the masses.

  • Joe In NH

    Stopping picking on AZ- there only is bad and worse when talking about mental health services in this country. Only place the seriously mentally ill can be sure of getting help is in prison.

  • lessadoabouteverything

    profnickd is himself nuts, I wonder how he manages to type with a straight jacket on.

    Jeninct: The fact that Arizona doesn’t have enough beds is irrelevant

    How is that irrelevant? If they had tried to get him treatment he would have been turned away, how the hell is that not relevant. And he would have been turned away because there is no money to treat him.

    In Arizona they canceled S-Chip for children without Health insurance. That is right, the rat bastard Republicans in that state are perfectly willing to screw over uninsured Children. CHILDREN. And Gratzer wants to pretend that the state would have done something about Loughner.

    Here is the comment from Arizona itself: The KidsCare Office is unable to approve any new applications. Enrollment in the KidsCare Program has been frozen since January 1, 2010 due to lack of funding for the program,

    So if your parents lost their jobs and health insurance, you are screwed in Arizona. We are talking about CHILDREN.
    For the record there are many good Republicans about this issue, Huckabee, Hatch, etc. But that doesn’t mean Brewer is not a total heartless jackass.
    So go ahead, defend letting children die because evil teabaggers don’t want to pay a penny more in taxes.

  • JeninCT

    lessadoabouteverything wrote:

    “How is that irrelevant?”

    It’s irrelevant because he may not have needed a bed. He may have been treatable on an outpatient bases, but unless his family sought treatment that determination could not have been made and there is no way to know if there could’ve been a different outcome.

  • jg bennet

    hmm it could be that the “conservative” leadership of az thinks spending money on mental illness is as much a waste of “the peoples money” as are organ transplants.

    MONDAY, JULY 19, 2010
    As economy takes toll, mental health budgets shrink

    Here are some examples of states that have made big cuts:

    To fill a $1 billion hole in its 2011 budget, Arizona slashed this year’s budget for mental health services by $36 million — a 37 percent cut. As a result, advocates say 3,800 people who do not qualify for Medicaid are at risk of losing services such as counseling and employment preparation. In addition, more than 12,000 adults and 2,000 children will no longer receive the name-brand medications they take to keep their illnesses in check. Other services such as supportive housing and transportation to doctor’s appointments also will be eliminated.

    Arizona has been considered a progressive state because it provides the vast majority of mental health services through cost-effective outpatient community programs. By slashing these programs, experts say the state will force more people to use emergency rooms or end up in the criminal justice system, which will cost the state more.

  • armstp

    The whole state of Arizona has a mental health problem. If you want to read a great article on Arizona go to the link below. It is not a surprise this shooting occured in that basket case of a state.

    http://harpers.org/archive/2010/07/0083023

  • JeninCT

    I will be interested to hear if any help was sought for him by his family.

  • nwahs

    If the left had their way, they’d free Loughner and commit Palin.

    Your article touches on some very important points, but unfortunately will be ridiculed by that which slithers in this forum.

    We do have to balance human dignity with safety, and the first line of defense has to be family members and close acquaintances. I think a massive education campaign on the dangers of untreated mental illness ( mostly to the mentally ill)is in order. Perhaps with more public awareness of how the mentally ill fall off their medication and how schizophrenia usually begins to manifest in late adolescence/early adulthood, Loughner’s parents may have acted proactively. But you won’t find much honest conversation here. They’re too busy skinning Palin to worry about the actual problem.

  • Diomedes

    I will be interested to hear if any help was sought for him by his family

    I don’t often agree with Jenin, but this is one area he and I are in full agreement.

    It’s basically impossible for the government or law enforcement agencies to make a judgement call on whether this individual is mentally deficient or not. The people on the front lines, so to speak, are the parents.

    Now I am not trying to pass judgement here, but invariably, people like this usually demonstrate major signs of mental instability over a span of time. Which means, it is up to the parents to be mindful of their childs emotional well being. Now the fact that this guy’s father chased him in his truck just for taking a ‘black bag’ out of the trunk of the car leads me to believe they new he was up to something. Maybe it was just the belief that it was drugs. Maybe it was something more. Hard for me to say and frankly, I don’t want to rush to judgement.

  • JeninCT

    Diomedes wrote: “Now the fact that this guy’s father chased him in his truck just for taking a ‘black bag’ out of the trunk of the car leads me to believe they new he was up to something….I don’t want to rush to judgement.”

    I am female, and I agree. I have two teenage sons and I know when they are up to something. I also wish there was some honesty about this forthcoming from the local authorities.

  • think4yourself

    Mental health and family members is a touchy subject (I’m sure some of the posters on this site think I need some time away myself). Who decides who gets looked at? What constitutes emotional instability and when does that lead to dangerous behavior?

    I got a brother-in-law who is over 50, living in his mom’s garage and has been there 6 years. He won’t get his life together. He blames the gov’t (and especially Obama) for his problems (even though he has been in his mom’s garage 6 YEARS! – how do you blame Obama?). He’s worked half a dozen jobs, been on unemployment, been on disability – but manages to have enough money for 10 or so guns that he owns. Should I try and get him committed? He has never threatened, hit or abused anyone or done anything illegal that I’m aware of. Even if I thought he was a danger to society – and I have no evidence of that; no state or Federal agency would help, both because he doesn’t rise to the level of risk and they don’t have any money in which to do so. Am I concerned? Yeah, a little. Is there anything I can do about it? Nothing that I can think of.

  • lessadoabouteverything

    nwahs, yeah, Democrats have never been interested in funding mental health issues…uh huh…

    “I think a massive education campaign on the dangers of untreated mental illness ( mostly to the mentally ill)is in order.” And who do you think will be paying for this if not the taxpayer? Fact is Obama care greatly increases funding for mental health issues, clinical care, outpatient care, you name it and I can show you the relevant statute.

    Show me any posting anywhere where you have ever stated that you are in favor of your tax dollars going towards this type of treatment. You are nothing but empty words.

    By the way, nice projection, you have been arguing from day one that the guy is nuts, and if he is nuts he must also be clinically insane, therefore not culpable. I never made any such diagnosis.
    So you would be the one who would free him, not I.

  • nwahs

    “By the way, nice projection, you have been arguing from day one that the guy is nuts, and if he is nuts he must also be clinically insane, therefore not culpable. I never made any such diagnosis.
    So you would be the one who would free him, not I.”

    lol – you’re an idiot. I say the guy is nuts, and you in your daffy duck alternate reality think that translates to legally insane and I’m supposed to respond? Ok here you go. You’re an idiot.

  • DFL

    I guess Loughner won’t be available for a remake of “The Addams Family.”