Thoughts on the Tucson shooting
From all accounts, the shooter appears to be schizophrenic, probably paranoid schiz, and was giving significant signs of being dangerous long before the shooting. Fellow students and teachers were fearful enough to where the college suspended him unless he could provide a psychiatric evaluation showing he wasn't dangerous, and they sent campus police to make sure he got the message. But nobody seems to have given a thought to getting the guy committed for treatment -- perhaps because doing so would have been so burdensome that running the risk of his going violent was the easier course.
Our present system for commitment is the result of the movement to deinstitutionalize the mentally ill, which hit its peak in the early 1970s. I recall an issue of the Arizona Law Review back then on the subject. Back then, there were few limits on committing a person beyond the fact that they had some mental disorder, and there was little in the way of medication. Of course being locked up in a sort of barracks with dozens of other screaming lunatics didn't do much to improve mental health. The end result was that a lot of people who were disordered but harmless wound up being warehoused for the rest of their lives. Of course, books and movies such as One Flew Over the Cuckoo's Nest, in which the protagonist (not insane) winds up under a tyrannical nurse, is tortured by electroshock treatments, and turned into a lobotomized zombie, popularized the concerns.
Can't help but wonder if the pendulum swung too far the other way, The present Arizona standard is that the person must be a danger to self or others, or utterly incapable of caring for themselves. A county attorney once told me of a mental case who would walk down the street "keying" cars. Someday she was going to get beaten up over it, but it was impossible to show sufficient danger to self or others, and arresting her was useless because she was solidly within the criminal law's standard for not guilty by reason of insanity.
I was just looking over the Arizona statutory system... very complex, designed to make it very difficult. A person must apply to have someone committed, and it must be based on their own observations, not hearsay; then a peace officer can be requested to take them in. The officer cannot act on his own unless he does so on personal observations and it is an emergency. Then there are procedures to get a court hearing; if an application isn't filed within 24 hours, the person must be released. He may not be treated during this time without his consent. He must be informed of the right to an court-appointed attorney. If the court allows him to be held for evaluation, it cannot exceed 72 hours.
At the subsequent hearing, doctors must testify based on their own observations (again, no hearsay, altho experts are generally allowed to use such), two doctors must attest to dangerousness. What they must address is spelled out: "Such testimony shall state specifically the nature and extent of the danger to self or to others, the persistent or acute disability or the grave disability. If the patient is gravely disabled, the physicians shall testify concerning the need for guardianship or conservatorship, or both, and whether or not the need is for immediate appointment. Other persons who have participated in the evaluation of the patient or, if further treatment was requested by a mental health treatment agency, persons of that agency who are directly involved in the care of the patient shall testify at the request of the court or of the patient's attorney. "
The court's decisionmaking is likewise dictated. Among many other requirements:
"B. The court shall consider all available and appropriate alternatives for the treatment and care of the patient. The court shall order the least restrictive treatment alternative available.
C. The court may order the proposed patient to undergo outpatient or combined inpatient and outpatient treatment pursuant to subsection A, paragraph 1 or 2 of this section if the court:
1. Determines that all of the following apply:
(a) The patient does not require continuous inpatient hospitalization.
(b) The patient will be more appropriately treated in an outpatient treatment program or in a combined inpatient and outpatient treatment program.
(c) The patient will follow a prescribed outpatient treatment plan.
(d) The patient will not likely become dangerous or suffer more serious physical harm or serious illness or further deterioration if the patient follows a prescribed outpatient treatment plan."
My gut feeling is that all this procedure, and heavy stacking of the deck against commitment, may be outmoded in an era when physicians are not reflexively inclined toward commitment, when the standard is dangerousness, and when real treatment is often possible. Clayton Cramer blogs a lot on this issue. Here's one of his recent posts; he's even working on a book on the subject.
My wife's manager had her daughter involuntarily committed for a 72-hour evaluation due to depression, suicidal thoughts, and child endangerment (her newborn). It happened very quickly, and the judge did so without issue. She really wasn't that bad off and the intervention worked.
From what we've read in the press about Jared's behavior, his parents certainly could have done the same. I have to disagree that AZ law would have made it hard to get him involuntarily committed.
Firstly, Jared is the one to blame for the murders. Secondly, the intervention failure is on all those that knew his behavior was erratic and did nothing about it. This is squarely a societal issue, not one of statute.
Posted by: Cory Brickner at January 13, 2011 11:25 AM
David, Can't agree with you on this one. There is no reason to change the standard. If one believes that somebody is a threat, then follow the steps provided for by law. Saying there is to much paper work or to many steps involved, to have somebody committed, is simply a "crazy" idea.
Posted by: 5thofNov at January 13, 2011 11:30 AM
My best friend had to have her daughter (who is 8) committed under the 'danger to herself' part. She went in that evening, and was in for right around a week. The procedure was not onerous.
Freeing up the current regulations can allow someone who is simply different to be locked up unnecessarily. Think back a few months, and the guy that was sent in for observation simply because his manager thought he MIGHT be disgruntled after being let go. No proof, but because the firearm registration laws in that state showed he had guns, he was treated to a SWAT team asking him to pretty please come with them. Remember how we were all howling at how wrong it was then? Loosen up the commitment standards and anyone who has firearms that frowns in public could end up in a rubber room.
Blaming the system because he didn't get treatment is like blaming the gun laws because he shot people. You're just beating someone else's horse instead of them beating yours. I suggest you rethink, consider how your ideas could be used against you and yours, and then consider a change of position. I believe you're wrong on this one.
Posted by: PhillipC at January 13, 2011 12:07 PM
Dave: Arizona's law is generally considered the easiest in the country for commitment. Oregon's law is so bad that the Portland Oregonian did a series several years ago listing case after case when mentally ill people starved themselves to death while family, friends, and police watched helplessly.
Posted by: Clayton E. Cramer at January 13, 2011 02:04 PM
By the way, the book is complete. There's a problem finding a publisher interested in the subject. I cover the variety of destructive effects of the legal change in increased death rates for the mentally ill, increased homelessness, the rise of what used to be an incredibly rare event--random mass murder.
Posted by: Clayton E. Cramer at January 13, 2011 02:12 PM
"Freeing up the current regulations can allow someone who is simply different to be locked up unnecessarily."
Yet this does not seem to have been terribly common back in the bad old days. I've looked pretty hard for examples--and they seem to have been pretty few and far between. As late as 1963, ACLU's representatives at Congressional hearings was unable to give a single example of such misuse of commitment power--just a concern that it could be misused.
Posted by: Clayton E. Cramer at January 13, 2011 02:14 PM
Phillip - a parent can put their child in the hospital rather easily, a person who is having troubles might consent to a voluntary committal if they acknowledge they have a problem and want treatment, but an INvoluntary commitment of an adult requires the above steps and requirements.
Posted by: James at January 13, 2011 02:42 PM
While everyone is taking issue with what wasn't done and the outcome of it please take into account the tone that you are setting with your post. I work in mental health. Granted I do not work in mental health in the state the incident happened, however with that said, your post is coming across like those people that blame guns for people getting killed instead of the person that pulled the trigger. After something like this happens people always realize what they should have seen, signs they should have caught. It's very easy to say that they system doesn't or didn't work, however, in my opinion it did.
The person in question from my understanding, declined help. So then someone was supposed to have them committed...okay, and if that had happened and he had still committed this act, what would we all say then?
Posted by: JenniferF at January 13, 2011 07:35 PM
"So then someone was supposed to have them committed...okay, and if that had happened and he had still committed this act, what would we all say then?"
That we made a serious effort to prevent it. Perfection isn't possible. That's no reason to not try to do better.
Posted by: Clayton E. Cramer at January 14, 2011 08:58 AM
A chilling slippery slope. American society and culture will survive this latest high profile, tragic shooting. What the USofA won't survive is a system to throw social/political malcontents, contraries, and troublemakers into the gulag like the old Soviet System did.
Posted by: Mark-1 at January 14, 2011 11:38 AM
Mark-1, that's pretty much my point. I know there are people on the left that would love to put Clayton Cramer into an institution, because his obsession with guns must be unhealthy. Mr. Hardy's obsession with some old, outdated part of the Bill of Rights has to be unhealthy, too, so we should put him away...
Make it easy, and it'll be used against you. Haven't we learned anything from the legislation passed after 9-11 that made so many things terrorism?
It really saddens me to see people I thought were on the side of freedom espousing ways to take that freedom away from people.
Posted by: PhillipC at January 14, 2011 12:32 PM
Make it easy, and it'll be used against you.Except that no one is proposing to make it easy. It wasn't easy in 1960. It was easier, and yes, it could have been abused. But no more than the criminal justice system could have been abused.
Haven't we learned anything from the legislation passed after 9-11 that made so many things terrorism?Care to give me a list of things made into terrorism after 9-11 that weren't?
Posted by: Clayton E. Cramer at January 14, 2011 01:09 PM
"What the USofA won't survive is a system to throw social/political malcontents, contraries, and troublemakers into the gulag like the old Soviet System did."
Oddly enough, even in 1960, it does not appear that this was a widespread problem in the U.S. Perhaps there were other differences between the U.S. and the U.S.S.R. that you have overlooked?
Posted by: Clayton E. Cramer at January 14, 2011 01:12 PM
"I know there are people on the left that would love to put Clayton Cramer into an institution, because his obsession with guns must be unhealthy."
And if there are enough of them to make that a practical possibility with the sort of mental health due process that we had in 1960, it is already time for a revolution. Do you honestly think that the only thing preventing the government from coming and locking up gun owners is the ACLU?
Posted by: Clayton E. Cramer at January 14, 2011 01:14 PM
"Normal" is a real relative term, Guy.
Sorta smacks head first into "Living Constitution".
Posted by: Mark-1 at January 14, 2011 08:23 PM
"...Perfection isn't possible. That's no reason to not try to do better..."
Wow -- that's pretty much a verbatim quote from the leftard-hoplophobes shrieking for more 2A abrogation.
Personally, I think Liberty includes the right to be bat-s**t crazy - even to the point of starving oneself to death - provided they're not a danger **TO OTHERS**.
This moke in question had made threats - direct, clearly-stated THREATS - to harm other people. There are reasons to believe they were swept under the rug due to Mom's connections in the county .gov.
The Liberty I referenced above DOES NOT include the right to make clearly-stated threats to harm other people, and SHOULD be grounds for involuntary committal and evaluation.
Further - in the event of such threats - said committal should be for as long as necessary to ensure the person is stable enough to no longer constitute a threat to others.
If you're making threats with the apparent ability to carry them out (the legal definition of "assault") then one of two things must be happening:
1) You're sane and aware of your actions and their ramifications - in which case you're a dangerous criminal who should be charged and tried, and if convicted imprisoned for as long as it takes to ensure you're no longer a threat.
2) You're NOT sane - you're unaware of your actions and/or their ramifications - in which case you're a dangerous mental-patient who should be involuntarily committed for evaluation - and (if the eval verifies the illness) kept "on ice" for as longas it takes to ensure you're no longer a threat.
Under our "old system" there were some pretty horrific abuses - my mother worked as a psych social-worker and I've heard of many she witnessed personally.
As usual, our .gov overreacted in turning many of these people out onto the streets, and our current "system" now puts many in prison who are in reality in need of treatment.
"crazy" should not be enough to lock anyone up against their will - even if (IMHO) they're a danger to self.
Those who are a danger to OTHERS OTOH should be handled -- even "warehoused" if necessary to protect the innocent.
This shouldn't be all that difficult...
Posted by: Dedicated_Dad at January 14, 2011 10:33 PM