Rethink Needed in Virginia Mental Health Services
The tragedy of Seung Hui Cho’s murder and suicide has reverberated across the country, yet many of the responses to Virginia Tech’s disaster will not prevent similar incidents from occurring because they fail to address the complexity of the problem—in Virginia and other states—in dealing with persons with mental illness. The current system is deeply flawed and needs fixing.
The recent Virginia Tech Review Panel’s report identifies 21 ways that things went wrong. Fingers are wagged at University officials—administrators, counselors, campus police, Dean of Students—for communication failures, lack of leadership, inadequate record keeping, confusion about possession of firearms on campus, and an inability to inform the public in a timely and comprehensive manner when such an event occurs. It makes sense that colleges across the country learn from Virginia Tech’s incident and put into place appropriate changes to improve organizational systems. Our university has created Mason on Alert—a Web site to inform people of internal or external crises.
However, the panel’s report and campus changes do not address what we must do when persons with mental illness are in deteriorating phases—as was the case of Seung Hui Cho. Mental health providers at Community Services Boards (CSB)—professionals responsible for mental health services in the community—know that our system is not working and asked ICAR last year to convene a series of stakeholder dialogues to identify what is broken and suggest it can be fixed.
Persons with mental illness, family members, police, magistrates, professional service providers and hospital staff —70 in total—participated in a series of meetings and verified that systemic changes need to be made at the local and state levels beginning with clarifying current legal language regarding whether or not an individual poses “imminent danger” to himself or the community. If so, he can be involuntarily committed to a hospital (report available on ICAR Web site: http://icar.gmu.edu).
Participants unanimously said that individuals with mental illness avoid commitment at all costs, as Cho did sixteen months prior to the shootings when he was ordered by a judge to receive involuntary commitment. Involuntary commitment is too traumatic and too demeaning, and families, while often the first to recognize signs of deterioration, cannot commit their adult children. The process reacts to a worse-case scenario while prevention- oriented processes are ignored. Currently, there is no early-warning system that helps detect mental illness crises. Priority is given to emergency response—not emergency prevention. Cho’s lack of treatment is an excellent example of this poor prioritization. There was no space in the system for Cho because until the shootings, there was no crisis point.
Participants at our dialogues also agreed on a number of other proposed changes. Legislators must revise the definition, criteria, and scope of law governing the involuntary admissions process so that it addresses all stakeholder concerns, especially the family members. There needs to be a continuum of intervention strategies available and offered earlier, including a variety of outpatient treatment options. While CSB professionals and hospital providers stand ready to offer more comprehensives services, funding remains an obstacle. Adequate and affordable legal support for family members to ensure the overall welfare of the individual is also needed. Equipped with legal advocacy, the individual may be more inclined to enter the commitment process willingly. Without it, youth like Cho will stay far away.
Guaranteeing public safety and preventing, detecting, and responding to mental illness are no easy tasks. Initiatives have been underway since 2005 to reconsider the laws regarding involuntary commitment, favoring and supporting voluntary treatment in the community or at a hospital. All that is needed is the commitment and resources to support these changes.
Efforts are currently underway to dedicate space in Norris Hall—the “ground zero” of Virginia Tech—as a Center devoted to “the study of international peace and crime prevention.” Of course there is a need in our troubled world to educate people about conflict and alternatives to violence. This is an excellent gesture to the family and loved ones of those who lost their lives. But there must also be processes that detect early warning signals and provide access to alternative psychological services to involuntary commitment. Then we are more likely to prevent another Cho-like.