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U.S. Navy was warned that Washington shooter 'heard voices'

I know that. I was asking for a personal opinion, not a legal one. :)

Let me think on that one for a minute or two. I spent years following the letter of the law. In many cases, I had people who I knew in my gut were dangerous, but nowhere does the law state that my gut feeling was enough to take someone's liberty.
 
If you add hearing voices to his previous shooting incidents I see a very distinct line.

It depends on what the 'voices' were determined to be. At one point, he thought it was noisy neighbors. No one can say it isn't.
 
OK, Dan, I've thought a couple of minutes about where I think the line should be. Not sure I can answer to your satisfaction. I think most people see this as a failure of the justice system, or the legal system, or the military. But from my perspective, I see it as a failure of the medical community because everyone goes to the doctor. Medicine is so specialized and the primary care provider doesn't treat much but colds these days. Everything else is a referral. I worked with an MD who was overtly hostile to having to see a patient who might have a psych problem. He often said indignantly, "I didn't go to medical school to treat mental illness." Other primary care providers were not that overtly hostile, but none of them could assess a patient for a mental problem. I would get these 'emergencies' that were nothing and they would give me referrals into the future that were the actual emergencies. Bottom line is that medical providers are not qualified to decide who is mentally ill and who is not unless they specialize. BUT everyone goes to the doctor at some time or another, and that would, IMO, be the best place to spot if a problem is developing.

And yes, psych problems develop. A person who legally owns a large collection of guns may fall and hit his head becoming psychotic, or suffer some horrible loss, or have a stroke, or a spate of other situations that would change his mental status. You just can't look at a person at any static point in time and say, 'he is OK' or 'he is not OK' forever and always. But until enough people know how to spot and intervene with the people who have problems, these situations will continue to occur.
 
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A criminal background check does not turn up psychiatric information because psychiatric charts are privileged.

Nope, but it would've turned up his criminal record. As to whether or not that would've been an impediment, I have no idea.
 
And yes, psych problems develop. A person who legally owns a large collection of guns may fall and hit his head becoming psychotic, or suffer some horrible loss, or a spate of other situations that would change his mental status. You just can't look at a person at any static point in time and say, 'he is OK' or 'he is not OK.' But until enough people know how to spot and intervene with the people who have problems, these situations will continue to occur.

We not only have to know what mental illness is, but also what it isn't. In general, our mental health system stinks and until it drastically improves debilitating (and in some cases dangerous) conditions will continue to go undiagnosed and untreated.
 
Nope, but it would've turned up his criminal record. As to whether or not that would've been an impediment, I have no idea.

I'm not sure either. But one thing I know, all the many disciplines that deal with the mentally ill are NOT on the same page.
 
We not only have to know what mental illness is, but also what it isn't. In general, our mental health system stinks and until it drastically improves debilitating (and in some cases dangerous) conditions will continue to go undiagnosed and untreated.

The full problem does not fall at the feet of the mental health system. No provider is responsible for the patients they have never seen. The problem I see is that the various systems, legal, military, medical are just not all on the same page. If they don't like to deal with the mentally ill, they just won't. Someone knew this guy had problems. Someone always seems to know. Most of the school shooters were already in 'counseling.' But the laws we have served as an impediment to helping him. And yes, before this happened, HELP is what he needed.
 
No I am adding 1+1 and getting 2.
How dare you? Truth is, at some point rational, responsible people are required to make a judgement. If I was confronted with the security clearance of a person possibly hearing voices, with past fire arm issues, and with a somewhat troubled military service record, I know what I'd decide.
 
I just don't know what to say about this except WTF????

" Rhode Island police warned the U.S. Navy last month that Washington Navy Yard gunman Aaron Alexis had reported "hearing voices," raising further questions about how he gained security clearance at the complex where he went on a shooting rampage."

U.S. Navy was warned that Washington shooter 'heard voices' | Reuters

so another example of a state doing its job and the feds dropping the ball this is why need to give power back to the states and take it away from the feds
 
How dare you? Truth is, at some point rational, responsible people are required to make a judgement. If I was confronted with the security clearance of a person possibly hearing voices, with past fire arm issues, and with a somewhat troubled military service record, I know what I'd decide.

The cop who discerned the man was hearing voices probably had every right to take him straight to the an emergency room for an evaluation for inpatient treatment and evaluation, but instead chose to let him go and warn the Navy. The Duty to Warn is clear cut. And in most states so is the right to take a psychotic person to the ER for a psych eval, but good luck on that one. I just don't know what the DC law says, and I'm not inclined to look for it.

In many of these instances someone dropped the ball. Premeditated terrorist acts are excluded, though. There has been no evidence that terrorists have been psychotic. Some have suggested this man may have been exposed to radical islam in another country, but there is no real evidence of this. He sounds like your garden variety psychotic.
 
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The cop who discerned the man was hearing voices probably had every right to take him straight to the an emergency room for an evaluation for inpatient treatment and evaluation, but instead chose to let him go and warn the Navy. The Duty to Warn is clear cut. And in most states so is the right to take a psychotic person to the ER for a psych eval, but good luck on that one. I just don't know what the DC law says, and I'm not inclined to look for it.

In many of these instances someone dropped the ball. Premeditated terrorist acts are excluded, though. There has been no evidence that terrorists have been psychotic. Some have suggested this man may have been exposed to radical islam in another country, but there is no real evidence of this. He sounds like your garden variety psychotic.
I hate to use this analogy, but I will. No smoking gun is required to lower or eliminate a security clearance. Reasonable doubt is sufficient. The government knows they blew it. The big question is who blew it, and why. Some of us are not mentally stable, and those of us who aren't shouldn't be working in secure facilities and probably shouldn't have access to fire arms and other lethal stuff. We could debate the reasons for this guy's condition forever and not know anymore at the end of it than we do now. We would have more success taking prudent actions to protect our society from such people and also not inconsequentially protect such people from themselves. A psychiatric degree is not required to make the determination that someone is ****ing nuts, and in the case of a security clearance it's a no brainer.
 
The cop who discerned the man was hearing voices probably had every right to take him straight to the an emergency room for an evaluation for inpatient treatment and evaluation, but instead chose to let him go and warn the Navy. The Duty to Warn is clear cut. And in most states so is the right to take a psychotic person to the ER for a psych eval, but good luck on that one. I just don't know what the DC law says, and I'm not inclined to look for it.

In many of these instances someone dropped the ball. Premeditated terrorist acts are excluded, though. There has been no evidence that terrorists have been psychotic. Some have suggested this man may have been exposed to radical islam in another country, but there is no real evidence of this. He sounds like your garden variety psychotic.

Laws changed around the time of the publishing of "One Flew Over The Cuckoo's Nest" by Ken Kesey wherein the inmates of the institution were portrayed as sympathetic characters ( and should be) but the people who run the institutions were portrayed as power hungry monsters. Other books and movies also had the same effect on the public perception and for the sympathy of the institutionalized., The inmates were quite normal though perhaps a bit more eccentric and were just doing their thing. It was the leaders of these institutions who were always made out to be the villains.

So according to the trends of the day they let them out, not just in the US but in other countries as well. We now see the consequences of these decisions all too frequently. Mental illness should not be treated casually as it does not do the patient, nor those who may become their victims, or their loved ones, any good whatsoever.
 
I hate to use this analogy, but I will. No smoking gun is required to lower or eliminate a security clearance. Reasonable doubt is sufficient. The government knows they blew it. The big question is who blew it, and why. Some of us are not mentally stable, and those of us who aren't shouldn't be working in secure facilities and probably shouldn't have access to fire arms and other lethal stuff. We could debate the reasons for this guy's condition forever and not know anymore at the end of it than we do now. We would have more success taking prudent actions to protect our society from such people and also not inconsequentially protect such people from themselves. A psychiatric degree is not required to make the determination that someone is ****ing nuts, and in the case of a security clearance it's a no brainer.

Well, I do have a specialty NP license in psychiatry. It was the cop who let him go once he learned the guy was hearing voices who blew it assuming the DC mental health law allows him to have the person evaluated. But the one who took his word that shooting into another apartment was an accident also blew it. With most situations like this, you will often see several junctures where something could have been done. Hindsight is 20:20.
 
Laws changed around the time of the publishing of "One Flew Over The Cuckoo's Nest" by Ken Kesey wherein the inmates of the institution were portrayed as sympathetic characters ( and should be) but the people who run the institutions were portrayed as power hungry monsters. Other books and movies also had the same effect on the public perception and for the sympathy of the institutionalized., The inmates were quite normal though perhaps a bit more eccentric and were just doing their thing. It was the leaders of these institutions who were always made out to be the villains.

So according to the trends of the day they let them out, not just in the US but in other countries as well. We now see the consequences of these decisions all too frequently. Mental illness should not be treated casually as it does not do the patient, nor those who may become their victims, or their loved ones, any good whatsoever.

I was working in a state hospital in the mid 90s when the laws changed. Trust me, it really didn't have anything to do with One Flew Over. 1992 or so saw the advent of newer antipsychotics that had fewer side effects making patients more agreeable to take them. Also, people had been actually living in hospitals which was far too costly. The ones who could live independently were discharged, others put in boarding homes. Some had mandatory outpatient requirements from the courts. It was in this time that I became and NP, and I had several in my care who were under mandatory out patient treatment orders from the courts. If they didn't keep their appointments, we had a court date. The actual committal statutes did not substantially change. The person did then and does now have to be shown to be an imminent danger to self or others before he can be locked up. It is not feasible to just lock up everyone. Most people who have serious mental disorders have some level of psychosis, but it is not serious enough to cause them to be dangerous. Those are getting treatment and often case management. It is the ones like this who have never entered into any treatment who are the true loose cannons. Whether he would have made the correct noises to get admitted will never be known. But I can tell you that just 'hearing voices' doesn't do it. The 'voices' have to be telling the person to hurt himself or others in order to meet criteria for involuntary treatment.
 
Well, I do have a specialty NP license in psychiatry. It was the cop who let him go once he learned the guy was hearing voices who blew it assuming the DC mental health law allows him to have the person evaluated. But the one who took his word that shooting into another apartment was an accident also blew it. With most situations like this, you will often see several junctures where something could have been done. Hindsight is 20:20.
It is. It's a shame someone in his family wasn't around to facilitate an evaluation. Most of the general public, not being professionally capable in psychiatry, is unwilling to make such a judgement because of the sometimes profound implications. I don't mean that the public wouldn't know he's unstable - just that many are unwilling to take actions which would label the fellow as such medically. The fire arm incidents and a propensity for violence should've tipped the scale, one would think.
 
It is. It's a shame someone in his family wasn't around to facilitate an evaluation. Most of the general public, not being professionally capable in psychiatry, is unwilling to make such a judgement because of the sometimes profound implications. I don't mean that the public wouldn't know he's unstable - just that many are unwilling to take actions which would label the fellow as such medically. The fire arm incidents and a propensity for violence should've tipped the scale, one would think.

I have had many patients whose families know when they are decompensating. BUT they don't want to be the 'heavy.' They would always call me. But the law forbids the provider from doing a committal on a patient he/she has not seen face to face and evaluated. Because the families just wouldn't call the police and have them taken to the hospital the patient usually had to get far worse before he could get any better. There are many, many agendas and fears on the part of families. Some are even invested in keeping the person sick because the patient gets a check for being sick. If you think back, we have seen the likelihood of this in some high profile cases.
 
I was working in a state hospital in the mid 90s when the laws changed. Trust me, it really didn't have anything to do with One Flew Over. 1992 or so saw the advent of newer antipsychotics that had fewer side effects making patients more agreeable to take them. Also, people had been actually living in hospitals which was far too costly. The ones who could live independently were discharged, others put in boarding homes. Some had mandatory outpatient requirements from the courts. It was in this time that I became and NP, and I had several in my care who were under mandatory out patient treatment orders from the courts. If they didn't keep their appointments, we had a court date. The actual committal statutes did not substantially change. The person did then and does now have to be shown to be an imminent danger to self or others before he can be locked up. It is not feasible to just lock up everyone. Most people who have serious mental disorders have some level of psychosis, but it is not serious enough to cause them to be dangerous. Those are getting treatment and often case management. It is the ones like this who have never entered into any treatment who are the true loose cannons. Whether he would have made the correct noises to get admitted will never be known. But I can tell you that just 'hearing voices' doesn't do it. The 'voices' have to be telling the person to hurt himself or others in order to meet criteria for involuntary treatment.

The consequences of the distrust in our institutions, and not just the mental institutions, began long before the 1990's. I understand that 'hearing voices' just doesn't cut it anymore and that is part of the problem. Where do these people go? The problem is being ignored and groups like the ACLU have also contributed to the problem.

Mass shootings are a recent phenomena with a link to allowing the mentally ill to walk the streets. These sorts of happenings were once largely unknown.
 
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