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Mental health services should be part of the discussion in wake of Arizona shooting

January 10, 2011|Steve Lopez

Predictably, politics has dominated the reaction and commentary about Saturday's deadly rampage in Arizona, with no shortage of wild speculation as to whether festering national divisiveness was to blame for the shootings.

But it's far more likely, judging by the disjointed and delusional rantings of the alleged shooter — and the puzzling behavior described by those who knew and feared him — that 22-year-old Jared Lee Loughner has a major mental disorder.

Sure, Loughner's homicidal outburst might have been affected by anti-government rhetoric and political diatribes on the Internet or on the airwaves. But we're missing the point if that's all we focus on.

Arizona has implemented dramatic cuts in mental health services in the last few years, as have states across the nation. And if the national healthcare reform bill is repealed, as government-shrinking crusaders are promising, more mental health services will be lost.

Loughner was able to buy a gun — the gun authorities said he used to shoot Rep. Gabrielle Giffords and 19 others at a supermarket — despite numerous interactions with authorities suggesting he was unstable. If you're surprised, you shouldn't be. Many in this country have worked hard to make it easier to get guns than mental health services, even after the Virginia Tech massacre of 2006, in which 32 people were killed by a young man who was mentally ill.

Now let me pause here to clarify something, because the last thing I want to do is make the stigma surrounding mental illness worse than it is, or to suggest that you ought to pick up the phone and call authorities every time you see someone who acts a little peculiar.

The vast majority of people with mental illness aren't dangerous. But a small minority will become violent, especially those with severe symptoms that go untreated. Ironically, one reason so many don't seek help is because of the stigma, along with the fact that this country has never given mental health treatment the priority it deserves. If you doubt that, just take a look at recent reports on the military's disinclination to diagnose and treat traumatic brain injury in soldiers from Iraq and Afghanistan.

What the Arizona tragedy ought to spark is not a hysterical conversation about politics, but an honest conversation on the need for earlier diagnosis and better education about mental illness. Since the first signs of delusional behavior often emerge in the late teens and early 20s, teachers and staff at high schools and colleges should be trained to recognize the signs of mental disorders and intervene effectively.

I know from experience that it isn't always easy to convince someone to seek help or to predict the behavior of someone who has severe mental disorders. But although mental illness can't be cured, it can often be treated and managed in a way that relieves suffering for those afflicted, as well as for their families, and helps prevent tragedy.

Reports out of Arizona suggest Loughner had five run-ins with campus police at Pima Community College.

"We have a mentally unstable person in the class that scares the living crap out of me," one classmate wrote to a friend in an e-mail published by the Washington Post. "He is one of those whose picture you see on the news, after he has come into class with an automatic weapon."

The school finally suspended Loughner, telling him in a letter that he needed clearance from a mental health official stating he didn't "present a danger to himself or others." There's also a report that Loughner made death threats aimed at various Arizonans.

Did school officials or police ever follow up to see whether Loughner got help?

I don't know the answer. In Los Angeles, we're fortunate to have a program run jointly by the Los Angeles Police Department and the county department of mental health, which exists in part to intercede before it's too late.

Why was Loughner able to buy a gun despite his apparent instability?

I don't know that answer, either. There are federal laws against selling weapons to those who are mentally ill. But records aren't always accurate or up to date.

Bob Carolla, a spokesman for the National Alliance on Mental Illness, sees an irony in the shooting. Arizona is a state, he said, in which authorities have broad powers to involuntarily commit those with mental disorders. But service cuts have made it more difficult to identify and treat those who need help, including those who might be a danger. And not just in Arizona.

"The national mental health care system is broken," Carolla said.

Dr. Marvin Southard, director of the Los Angeles County Department of Mental Health, happens to be from Tucson. He said he was struck by the comments of a classmate of Loughner who said he was strange and didn't try to engage students, and they steered clear of him.

"Finding ways of engaging with people who are odd, or out there in some way, can go a long way toward solving their problem," Southard said. "In so far as they isolate themselves … then the delusions are likely to grow larger rather than smaller."

A 9-year-old girl was senselessly killed. Five others are gone. Rep. Giffords fights for her life.

The horror was unspeakable, and nothing can change what happened Saturday. But if we hope to prevent future attacks, we need to stop pointing fingers and making political points. We need to support the services that can improve lives. We need to get past our fears and ignorance of mental illness, and in so doing, protect ourselves.

steve.lopez@latimes.com

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