You might like Gri’ms take.

I’m reading more and more about people arguing against the use of psychiatry to prevent murders like the tragedy at VT.

Dr. Peter Breggin makes an argument against relying on the mental health profession to protect us from the Cho’s of this world. Police intervention is needed, and after debating this issue for a few days, I think I agree. University Police need to be better trained to intervene in cases of aggressive/violent behavior even if mental health issues seems to be an exculpatory cause.

The more I learn about the role and limitations of psychiatrists, the less I’m convinced they could be relied upon to keep the public safe. The police and administrative enforcement of suspension or other punishments for unacceptable behavior seem much more powerful institutions for dealing with campus violence and hopefully preventing mass murder.

And I write this, as you know, as an early believer that the University failed by not understanding and treating Cho’s paranoid schizophrenia. As Cousin Dave wrote above, universities are not mental health treatment facilities. I now believe the best role they can play is to seriously confront and punish aggressive/violent behavior.

I would love to hear what you think about this critique of all the knee jerk reactions like mine.

Dr. Peter Breggin writes:
http://www.huffingtonpost.com/dr-peter-breggin/the-real-mental-health-l_b_46327.html

The answer to vengeful, violent people is not more mental health screening or more potent mental health interventions. Reliance on the whole range of this system from counseling to involuntary treatment failed. There is not a shred of scientific evidence that locking people up against their will or otherwise “treating” them reduces violence. As we’ll see, quite the opposite is true.

So what was needed? Police intervention. Almost certainly, the police were hampered in taking appropriate actions by being encouraged to view Cho as a potential psychiatric patient rather than as a perpetrator. It’s not politically correct to bring criminal charges against someone who is “mentally ill” and it’s not politically correct to prosecute him or to remove him from the campus. Yet that’s what was needed to protect the students. Two known episodes of stalking, setting a fire, and his threatening behavior in class should have been more than enough for the university administration to bring charges against him and to send him off campus.

Police need to be encouraged and empowered to treat potentially dangerous people more as criminals than as patients. In particular, men stalking women should be handled as definitively as any perpetrator of hate crimes. Regardless of whether the victims want to press charges, the police should. Cho shouldn’t have been allowed to get away with it a second time.

How would a police action have affected Cho? Would it have humiliated him and made him more violent? There’s no way to have certainty about this, but anyone with experience dealing with threatening people knows that a good dose of “reality,” a confrontation with the law, is much more of a wake up call and a deterrent than therapeutic coddling. Furthermore, involuntary psychiatric treatment is one of the more humiliating experiences in American society, and tends to make people more angry, not less.

Mental health interventions do not protect society because the person is almost always quickly discharged because his insurance coverage has run out or because mental health professionals, who as a group have no particular capacity to make such determinations, will decide that the patient is no longer a danger to himself or others. Indeed, in December 2005, when the university obtained a temporary detention order against Cho, a magistrate referred him for a mental health evaluation that found “his insight and judgment are normal.” Need I say more about the hazards of relying on mental health screening and evaluation to identify dangerous perpetrators–even after they have already been threatening people?

Psycho babble and relying upon the “state” or some other heirarchy to protect people, is itself fundamentally flawed. Not only because it never works given the slowness of heirarchies, but because people just aren’t motivated in saving strangers. But you, you are motivated in saving your life, and that motivation equals things getting done. That’s why relying upon individuals to save their own lives and the lives of people the ycare about, is not only efficient, but it is more ethical.
ymarsakar | Homepage | 04.19.07 - 8:38 pm | #

http://cheatseekingmissiles.blogspot.com/2007/04/can-we-learn-what-made-him-go-cho.html

Yes, I agree. But this is the discussion America has been conducting for its entire history and especially within the past 6 years, isn’t it? The tango between liberty and order. How much should we have of one to maximize the other?…

Ymarsakar,

I agree that one of the things sorely lacking in America that we used to have in spades is the notion of personal responsibility for our own actions. I blogged on that earlier this week in response to Bookworms’ post.

http://thomaschronicles.com/2007/04/19/response-to-bookworms-post-today/

I think societal ills cannot be cured through legislations and protocols, though in some instances government can mitigate the damages. Perhaps what we need to do is return to our code of honor just in our not-so-distant past…

After posting this piece, it suddenly occurred to me that the KGB were obsessive about psychology and used it regularly as an excuse to send people off to gulags. China does as well.

Actually, come to think of it, modern secular police states tend to use psychology as an excuse to silence dissidents more than anything else. There is a reason many communists states called concentration camps “re-education camps”. And theocratic dictatorships like Iran, well, do they need an excuse?

I dunno. Thanks for the comment

Alcatholic,

I’m not so sure the dissemination of information about mental illness would prevent this event from happening again. I told me friend once, “A little bit of knowledge of psychology is a dangerous thing,” and I stand by that statement. I can’t tell you how many times I’ve heard people sit around vivisecting each other’s mental processes; it’s like people sitting around a circle jamming red-hot poker sticks at each other. Needless to say, they weren’t psychologists. The only avenue I can think of where an increased awareness of mental illness might be beneficial would be if the police, security guards and other security personnel were instructed.

However, I do quite agree that an intensive administrative review is in order; not so much for the increase in awareness of mental illnesses, but for the purpose of how to deal with such an event should it occur again. Perhaps more security guards are required per square acre of campus ground. Perhaps emergency booths should be more visible and closer together. Colleges and high schools can take actions along these lines.

But if we are looking for comprehensive, preventative measures to take, I think we would find it wanting. We can’t legislate mental health into being, and we shouldn’t incarcerate people without a concrete crime… that is, if we want to keep our liberty.

We keep searching for a one size fits all solution to mental illness and it’s just not there to be had. You wrote that medication allows people to attend college who would otherwise be dysfunctional and maladjusted. However, as I read more about this mad gunman, one of the things that pushed him off the cliff was the system forcing him to take medication and counseling, evinced by his repeated statements that the system is painting him into the corner and that he’s not going to take it laying down.

There are just no easy answers here.

This is the same model that is behind the insurgency. If you don’t provide the protection and the local infrastructure, then the Shia or the Sunnis will just find someone else to do it for them, and that someone else might be our mortal enemy. But people say “let the Shias in Iraq alone, they’ll ally with Iran anyways, so why should we shed blood for our enemies”, while somewhere else similar people were saying “America needs more allies and friends to do our dirty wor”.

Somebody’s got to do the dirty work. People wouldn’t have to depend upon the state, if people knew that they could depend upon themselves. America didn’t become as powerful as she is because she relied upon over-specialization. Don’t Americans believe that America is what it is because of the American can do attitude of self-sufficiency and work ethics? This can result in specialization, but specialization is not the source of the strength, self-sufficiency is the source. Money is not stopping people from learning of other trades. Time isn’t, given how much technology we have to save time. Lack of food isn’t, we aren’t starving and required to conserve our calories per day. Resources aren’t the reason, we aren’t lacking in vital fuel or spring steel or munitions. So what is the reason people don’t learn how to survive? Because… they don’t need to? Or maybe it only appears they don’t need to, and that this appearance itself is an illusion that evil makes use of.

I’m the commenter whose reaction/proposal you eloquently criticize.

I was somewhat emotional when I wrote, and looking for dialogue to help process the tragedy. But I was self-aware enough to try to focus the discourse by writing in such black and white terms. I also consciously asked if anyone thought I was way off base. I think only you and a few others were concerned enough to attack my ideas.

I respect that totally. Thanks for writing so eloquently on the dangers of my initial idea.

My own thoughts on this have changed as I’ve reflected and listened to others during the course of the debate. I agree we must have very sober deliberations and only enact the most wise policy changes, if any. I’m becoming much more aware of the protections that must be afforded the wide spectrum of “mentally ill” persons on our Universities. I’m less concerned that there is negligence involved in the VT tragedy, and I’m learning more about the information firewalls that have developed to protect us all from malicious involuntary internment.

On the other hand, I do feel an serious administrative review is required. More resources may need to be offered to students and faculty concerned about students on the spectrum of mental illness, including police resources and training.

Also, I think it is important to recognize as a society that medications allow more and more troubled people to function in our society. Isn’t there a legitimate issue that those mentally stabilized via medications face a responsibility to maintain their stability? I refer to the increasing number of students who are able to enter college with the help of medications who before would not have been stable enough to meet the standards.

My last concern, is that as a public we seem so uninformed about diseases such as paranoid schizophrenia. We don’t know what dangers exist and don’t exist, or when to be concerned. That public awareness can be raised to the benefit of all.

On a lighter note, it is ironic that I’m lumped with O’Reilly and as you note my type of comment is present on both the left and the right. I don’t take it personally, but it turns out I’m the opposite of an O’Reilly fan. I’m probably more left than the next guy, so to speak: active MoveOn member, anti-hillary, Daily Kos/MyDD reader, etc. The only reason I was commenting on a site called Neo-neocon was because I’ve been using the HotAir.com blog updates to follow the tragedy and thus Neo-neocon was the first psych blog I came across. I must admit hotair was among the best covering the story, IMO. And I didn’t find any worthwhile ongoing indepth coverage on the left blogosphere.

I hope we might continue the dialog. I’m of the open-minded type.