Sandy Hook Shooting: Was Adam Lanza Lashing Out Against Treatment?
Two media reports suggest that Sandy Hook shooter Adam Lanza’s mother
was seeking mental-health treatment for him – perhaps including
involuntary commitment. Experts say seeking treatment against someone’s
will is fraught with difficulties.
By Stacy Teicher Khadaroo | Christian Science Monitor December 19, 2012
Sandy Hook <http://www.csmonitor.com/tags/topic/Sandy+Hook> shooter
Adam Lanza <http://www.csmonitor.com/tags/topic/Adam+Lanza> may have
been motivated by anger at his mother because of plans to have him
committed for treatment, Fox News
<http://www.csmonitor.com/tags/topic/FOX+News+Network+LLC> reported
Thursday, citing comments from the son of an area church pastor and an
unnamed neighborhood source. Fox also cited an unnamed senior law
enforcement official saying anger at plans for “his future mental-health
treatment” were being investigated as a possible motive.
While the Fox reports are still uncorroborated, other media reports
paint a general picture that suggests Ms. Lanza was growing increasingly
concerned about the mental health of her son.
These reports are bringing to light a debate over where to set the bar
when it comes to forcing an individual into treatment – and whether
those caring for people with mental-health issues have enough resources
available to head off potential crises before they happen.
On one hand, warning signs are often apparent, so making it easier to
commit someone forinvoluntary treatment could save lives.
The young adult men who end up being violent often “have others in their
lives … who are trying desperately to get help before something bad
happens. They can see it coming down the pike,” says Liza Gold, a
clinical professor of psychiatry at Georgetown University School of
Medicine
<http://www.csmonitor.com/tags/topic/Georgetown+University+Medical+Cente
r> . But caregivers “have run up against these commitment laws that are
so restrictive – that come down so far on the side of civil liberties
and privacy – that it is almost impossible to contain, hospitalize,
treat someone with a chronic and escalating mental illness.”
On the other hand, forced treatment can also be emotionally wrenching
for the patient and cause lingering anger, mental-health experts say.
“People who are forcibly treated so often feel traumatized by it,” says
Robert Whitaker, author of “Anatomy of an Epidemic: Magic Bullets,
Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America
<http://www.csmonitor.com/tags/topic/United+States> .” “Women in
particular will sometimes talk about it almost like a quasi-rape,
because sometimes they are held down and injected,” he says.
For its part, Connecticut
<http://www.csmonitor.com/tags/topic/Connecticut> leans strongly toward
supporting the civil liberties of individuals, making involuntary
treatment difficult. It is one of six states that does not provide the
option of “assisted outpatient treatment,” which allows qualifying
individuals to receive court-ordered treatment in the community without
being committed to a facility.
Moreover, an individual needs to be dangerous before intervention is
possible. The state’s standard does not take into consideration an
individual’s past psychiatric history, such as repeated hospitalizations
or symptoms of psychiatric deterioration that could culminate in
violence.
“Connecticut’s civil commitment laws are among the most restrictive in
the nation when it comes to getting help for a loved one in psychiatric
crisis,” said Kristina Ragosta, senior legislative and policy counsel
for the Treatment Advocacy Center in Arlington, Va.
<http://www.csmonitor.com/tags/topic/Arlington+County+(Virginia)> ,
which pushes to make it easier to commit people for treatment before
they become dangerous.
Connecticut does have a law allowing for someone to be sent to the
hospital for 72 hours for evaluation if he or she poses a danger to
himself or others, says Kate Mattias, executive director of the
Connecticut branch of the National Alliance on Mental Illness
<http://www.csmonitor.com/tags/topic/National+Alliance+on+Mental+Illness
> .
Emergency mobile psychiatric services in hospitals – including one in
Danbury <http://www.csmonitor.com/tags/topic/Danbury> , near Newtown –
can come to a home or other location to bring someone into the hospital,
she says. And after the 72 hours, if someone can demonstrate that he or
she is a continued threat, a judge can order a 14-day stay, she says.
But Ms. Mattias’s group and some other advocates oppose involuntary
commitment because it “creates an adversary relationship that really
poisons any relationship with providers, with caregivers,” she says.
“This is one of the lingering fears that people who are living with
mental illness have when you start to talk about involuntary commitment
– you raise this specter of, ‘They’re going to put me away and throw
away the key.’ “
According to Fox, Joshua Flashman, a US Marine
<http://www.csmonitor.com/tags/topic/U.S.+Marine+Corps> and an
acquaintance of the Lanzas, said Ms. Lanza “was petitioning the court
for conservatorship and wanted to have him committed…. Adam was
apparently very upset about this. He thought she just wanted to send him
away.”
Fox was not able to confirm that with a court official, who said such
records are sealed.
Later Thursday, the New York Daily News
<http://www.csmonitor.com/tags/topic/Daily+News+LP> reported that a
family friend said Ms. Lanza had brought her son to a psychiatrist as he
became increasingly antisocial. But the unnamed friend said Ms. Lanza
was not planning to have him committed. “Nancy was so dedicated to
Adam,” the friend said. “She would never send him away. She just
couldn’t do that.”
Experts say it is plausible that Mr. Lanza’s actions could have been
triggered by anger over the possibility of forced treatment. “Generally
we know that a great many violent acts, particularly between intimates,
are triggered by moments of perceived loss,” says Christopher Ferguson
<http://www.csmonitor.com/tags/topic/Christopher+Ferguson> , a professor
of psychology and criminal justice at Texas A&M
<http://www.csmonitor.com/tags/topic/Texas+A%26M+University>
International University in Laredo. There’s a heightened possibility of
violence, for instance, after a stalker or abuser is charged or served
with a restraining order, he notes.
But even if people are willing to be committed, it’s not easy to get
such treatment, because the US moved away from the asylum system in the
1950s and ’60s, Ferguson says.
There were good reasons for this, but perhaps the pendulum has swung too
far and made it overly difficult for people to get mental health
treatment, voluntarily or otherwise, he and some others suggest.
“The funding is so limited that the average length of stay is three to
seven days, but most psychiatric medications take two to six weeks to
kick in,” says Professor Gold of Georgetown.
There should be an easier way for people to at least be “contained”
temporarily to calm down if someone close to them can see that they are
in crisis and could become dangerous, says Gold. “These crises pass.
These people don’t wake up every day of their lives [homicidal],” she
says.
The details certainly aren’t clear yet about what kind of treatment, if
any, Ms. Lanza previously sought, or wanted in the future, for Mr.
Lanza.
She had talked about moving to Washington State
<http://www.csmonitor.com/tags/topic/Washington+State+University> with
her son because of a school there that she thought could help him,
according to a Concord Monitor
<http://www.csmonitor.com/tags/topic/Concord+Monitor> article that
quoted Mark Tambascio, an owner of My Place, a Newtown restaurant
frequented by Ms. Lanza.
Other media outlets have reported that Mr. Lanza spent time in a variety
of school settings and had also been home-schooled by his mother.
Parents of troubled young people may need therapeutic support
themselves, says Mattias of theNational Alliance on Mental Illness.
There’s a strong stigma in society where parents get the message that
their child’s problems are somehow the parents’ fault, she says, and
“parents over time can become isolated…. It’s very very hard to handle
these things on your own.”
Mothers are the highest percentage of the people murdered by mentally
ill young men, Gold adds. “The [young men] are usually living at home
because they are dysfunctional…. The moms don’t bail. These are their
children. They hang in with them, they try to get them help. And they’re
the ones that get killed.”
But mental-health advocates caution against drawing overly broad
conclusions. “You can’t predict what the reaction would be [to a family
member seeking to impose treatment] or whether it would increase
dangerousness,” says Michael Fitzpatrick
<http://www.csmonitor.com/tags/topic/Michael+Fitzpatrick> , executive
director of the National Alliance on Mental Illness.
Advocates also urge a renewed commitment to prevention, so that fewer
caregivers end up having to make such difficult choices
There have been comprehensive reports on how to improve mental-health
care, dating back to President Carter
<http://www.csmonitor.com/tags/topic/Jimmy+Carter> ‘s administration,
says Robert Bernstein
<http://www.csmonitor.com/tags/topic/Robert+Bernstein> , president and
CEO of The Bazelon Center for Mental Health Law
<http://www.csmonitor.com/tags/topic/Judge+David+L.+Bazelon+Center+for+M
ental+Health+Law> in Washington
<http://www.csmonitor.com/tags/topic/Washington%2c+DC> . Early
intervention and prevention are key, he says, but “when funding gets cut
those are the first programs to go…. What we have now is a system that
only in rare instances does anything preventive.”
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