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

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

    Quote Originally Posted by humbolt View Post
    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.
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    Re: U.S. Navy was warned that Washington shooter 'heard voices'

    Quote Originally Posted by Grant View Post
    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.
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    Re: U.S. Navy was warned that Washington shooter 'heard voices'

    Quote Originally Posted by Maenad View Post
    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.

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

    Quote Originally Posted by humbolt View Post
    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.
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    Re: U.S. Navy was warned that Washington shooter 'heard voices'

    Quote Originally Posted by Maenad View Post
    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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    Re: U.S. Navy was warned that Washington shooter 'heard voices'

    Quote Originally Posted by Grant View Post
    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.
    If you knew the history of our mental institutions, you would know that distrust has been well earned. I always had over a thousand patients everywhere I worked. I would say a good third of them were baseline psychotic, but they were not a threat to self or others because they knew the voices were hallucinations. It is not always possible to obliterate the voices. And for those who deal with them appropriately it is inappropriate to keep them locked up. Your mother could think you are Jesus Christ, but that isn't criteria to lock her up. You can be as crazy as you wanna be, but unless you show yourself to be dangerous you cannot be denied your liberty under the Constitution. And the provider who does deny someone their liberty illegally can be jailed.
    Redneck, hillbilly, fundie, Bible thumper, cracker, split tails, geezer, loon, xenophobe, islamaphobe, and homophobe are not words of tolerance.

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

    Quote Originally Posted by Maenad View Post
    If you knew the history of our mental institutions, you would know that distrust has been well earned. I always had over a thousand patients everywhere I worked. I would say a good third of them were baseline psychotic, but they were not a threat to self or others because they knew the voices were hallucinations. It is not always possible to obliterate the voices. And for those who deal with them appropriately it is inappropriate to keep them locked up. Your mother could think you are Jesus Christ, but that isn't criteria to lock her up. You can be as crazy as you wanna be, but unless you show yourself to be dangerous you cannot be denied your liberty under the Constitution. And the provider who does deny someone their liberty illegally can be jailed.
    Yes, I agree that there have been many problems in many institutions but it might have been better to upgrade these institutions rather than allow dangerous people out in the streets.

    I suppose it's a priority of where money is going to be spent but society is beginning to recognize that even more common disorders, such as depression, can be a great cost to the economy. Those with more violent tendencies, such as this shooter and his predecessors, should have been taken in sooner, though I'm not sure how the Constitution would apply in this area.

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

    Quote Originally Posted by Grant View Post
    Yes, I agree that there have been many problems in many institutions but it might have been better to upgrade these institutions rather than allow dangerous people out in the streets.

    I suppose it's a priority of where money is going to be spent but society is beginning to recognize that even more common disorders, such as depression, can be a great cost to the economy. Those with more violent tendencies, such as this shooter and his predecessors, should have been taken in sooner, though I'm not sure how the Constitution would apply in this area.
    Most of them are not dangerous. And case in point, this shooter had not had ANY treatment that we know of. So it's apples and oranges. You are switching from one topic to another. Getting someone well, and keeping them well are two different animals. I have done both for many years. I never had anyone who did anything like this. Whatever color your eyes are, what you are saying is like saying we should lock up everyone up has your eye color. Blue? Brown? Most of them have managed pretty well in the community. Exception I think of is Andrea Yates. But her MD knew she had postpartum psychosis and let her keep having babies, the family know she was sick, too.

    AND FYI, Tennessee got a brand new psychiatric institute in the early 2000s. http://tn.gov/mental/mhs/MiddleMHI.html

    The days are over when thousands of people who posed no danger were kept locked away because 'normal' people found them offensive.
    Redneck, hillbilly, fundie, Bible thumper, cracker, split tails, geezer, loon, xenophobe, islamaphobe, and homophobe are not words of tolerance.

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

    Quote Originally Posted by Maenad View Post
    Most of them are not dangerous. And case in point, this shooter had not had ANY treatment that we know of. So it's apples and oranges. You are switching from one topic to another. Getting someone well, and keeping them well are two different animals. I have done both for many years. I never had anyone who did anything like this. Whatever color your eyes are, what you are saying is like saying we should lock up everyone up has your eye color. Blue? Brown? Most of them have managed pretty well in the community. Exception I think of is Andrea Yates. But her MD knew she had postpartum psychosis and let her keep having babies, the family know she was sick, too.

    AND FYI, Tennessee got a brand new psychiatric institute in the early 2000s. Tennessee Department of Mental Health

    The days are over when thousands of people who posed no danger were kept locked away because 'normal' people found them offensive.
    You might enjoy this column by Charles Krauthammer, a trained psychiatrist as well as a political commentator.

    Charles Krauthammer: The real Navy Yard scandal - The Washington Post

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