shootings and mental health

[snowfreeze]

Does anyone else agree that the USA needs to get their act together on all issues of mental health? The lastest shooting could have been prevented if only the perpretrator could have been treated properly. He refused, and no one could do a thing about it due to his rights. Well he violated 33 peoples rights to live when he snapped. What can we do as health professionals to educate the public and change some laws in the favor of treating these troubled souls.

Mental illness remains a "closet illness".

[Simplepleasures]

My first job right out of nursing school was in the county mental institution, shortly after the chronically mentally ill started being dumped out on the streets. They would come back to the facility begging to be let back in, they were lost , scared, angry , confused people.Our physch care in this country leaves alot to be desired, but is still better for the severly mentally ill person, than being out in a unfriendly world.I do agree that there were many abuses of the committment laws in the past, but I think we have swung too far to the other end of the spectrum. Our country's mentally ill folks need to have better out patient care, better in patient care and continuing follow up, but even with improved care, the nature of shizophrenia and some of the other severe disorders will continue to be a threat to our society until we can get better drugs and treatment for these folks.I was at this facility for two years and what I saw there will never leave me, schizophrenia especially is SUCH a devastating disease.

[katienj]

I heard on the Today show that former roomates of Cho said that he claimed to have a girlfriend named, Jelly, and that she was an alien. He also called his roomie to tell him he was away on a road trip--with Vladamir Putin! How did his family not know these things? Did they turn their heads away to avoid seeing that their child was mentally unbalanced?

I agree that the laws need to be more stringent about mental illness, but the family needs to share some responsibility in this. And yes, I do feel bad for his family, but how do you close your eyes to this?

[user9876]

I heard on the Today show that former roomates of Cho said that he claimed to have a girlfriend named, Jelly, and that she was an alien. He also called his roomie to tell him he was away on a road trip--with Vladamir Putin! How did his family not know these things? Did they turn their heads away to avoid seeing that their child was mentally unbalanced?

I agree that the laws need to be more stringent about mental illness, but the family needs to share some responsibility in this. And yes, I do feel bad for his family, but how do you close your eyes to this?

i suppose they realized he was "off", but just never really thought he'd hurt anyone. i mean, his mental diagnosis deemed him a "danger to himself", but not a danger to others. so.. who knows..

[pickledpepperRN]

By Richard Spencer in Beijing and Toby Harnden in Blacksburg

Last Updated: 2:12am BST 21/04/2007

Cho Seung-hui was diagnosed as autistic after he arrived in America from his native South Korea, according to his family.

Kim Yang-soon, 85, his great-aunt, said that as a small boy Cho was quiet and withdrawn and became a great cause of concern to his parents.

She said: "He didn't talk. Normally sons and mothers talk. There was none of that for them. He was very cold….

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/04/21/wshooter321.xml

http://www.kevinmd.com/blog/2007/04/cho-seung-hui-autistic.html

[Ophelia78]

I heard on the Today show that former roomates of Cho said that he claimed to have a girlfriend named, Jelly, and that she was an alien. He also called his roomie to tell him he was away on a road trip--with Vladamir Putin! How did his family not know these things? Did they turn their heads away to avoid seeing that their child was mentally unbalanced?

I agree that the laws need to be more stringent about mental illness, but the family needs to share some responsibility in this. And yes, I do feel bad for his family, but how do you close your eyes to this?

A mental illness is not always that obvious. People can become quite adept at "passing" in the community. Families can be pretty uneducated about symptoms, especially the older generations. It can be easy to say, "he's just a quiet person who likes to keep to himself" or "he just has a strange sense of humor". As a caseworker, I had a client who, at age 50, had spent her entire adult life in the system, with frequent hospitalizations, on disability, had her children taken away, and "obviously" heard voices when decompensated. Her family refused to believe she had a mental illness. To them, she was just unpleasant, lazy, and mean. It seemed obvious to we professionals that when she stared at the ceiling moving her lips she was responding to internal stimuli, but to her family, it was just "her thinking too loud".

My own father has "passed" his entire life. He has schizophrenia, hears voices, has paranoia. It was a couple years of marriage before my mother, a nurse, figured out his quirks had more to them than she thought. He, like many with mental illness, weren't as obvious as others, like my aunt, who actually does stand on the street corner in a bedraggled state having arguments with imaginary people or hearing the devil's voice in the lamppost.

[rn/writer, RN]

I heard on the Today show that former roomates of Cho said that he claimed to have a girlfriend named, Jelly, and that she was an alien. He also called his roomie to tell him he was away on a road trip--with Vladamir Putin! How did his family not know these things? Did they turn their heads away to avoid seeing that their child was mentally unbalanced?

I agree that the laws need to be more stringent about mental illness, but the family needs to share some responsibility in this. And yes, I do feel bad for his family, but how do you close your eyes to this?

By law, none of the campus staff could divulge his "private" medical information to family members. From what I've heard and read, his family realized that he did not interact with other people normally, but they may have had little awareness of his most recent acutely abnormal and disturbing behavior. After all, he did function well enough to have qualified as a grad student.

Just a side note: Cho sounds like someone who may have had Asperger's syndrome. Asperger's people can have a tremendous sense of isolation and intense, frustration-based mood swings. He then took that a step further and became delusional. But his ability to function in a highly technical situation suggests AS to me.

[katienj]

I think that Aspergers is more of a possibility than autism. He does fit the criteria of AS, from what I have heard, but there was also some type of mental disorder along with that. He definitely had anger management issues along with delusions. Who knows what else he was suffering from. As far as the mental hospital saying that he was a danger to himself--is that not a reason for further investigation for some type of commital or referral to follow up care with a threat of commital if the person is non-compliant?

[rn/writer, RN]

I think that Aspergers is more of a possibility than autism. He does fit the criteria of AS, from what I have heard, but there was also some type of mental disorder along with that. He definitely had anger management issues along with delusions. Who knows what else he was suffering from. As far as the mental hospital saying that he was a danger to himself--is that not a reason for further investigation for some type of commital or referral to follow up care with a threat of commital if the person is non-compliant?

Let me clarify something I said earlier.

Cho sounds to me like someone who had Asperger's Syndrome, one of the hallmarks of which is the inability to communicate easily and comfortably with others. AS kids tend to function poorly in social settings because they have a right-brain impairment that makes it difficult for them to correctly interpret (or sometimes even notice) non-verbal cues (which make up as much as 80% of our communication) and often take a very literal view of the words being said, apart from their context. AS people sometimes end up feeling extremely isolated and lonely. They also have a strong tendency to become absorbed/obsessed with a particular subject or topic and focus overmuch on this aspect of their lives in which they feel some level of comfort, control, and expertise. This combination of social discomfort and ineptitude along with areas of obsession can leave AS people feeling and functioning as societal misfits, unable to enjoy the companionship of friends without putting forth a great amount of effort to remain appropriate. They are often disappointed in themselves and with their circumstances.

HOWEVER, and this is a big however, AS is a developmental disorder and NOT, NOT, NOT a mental illness, which I most sincerely believe Cho developed in addition to--and perhaps as a result of--having AS.

Many AS folks do learn to have productive social interactions, even though they have to work at what comes naturally to most of us. They, in effect, learn to fly by instruments where people generally fly by sight. This means they have to actually learn and practice the casual interplay that the rest of us just pick up as young children and build on without thinking much about it. Some AS people are absolutely brilliant, although they would never be described as "people" persons. Bill Gates is a good example. Obsessive computer geek who has never been a social whiz kid, but, boy, has he made his mark in the world. There are many other people who are considered competent, capable, and even expert in a particular area (oftentimes a technical field or something well-defined such as history) but who shun social settings and keep their non-professional contacts to a minimum. The author Temple Grandin is a fascinating example. She writes about how she has learned to function in a world which has always felt somewhat foreign to her.

AS is not mental illness, but it's easy to see how mental illness could develop and flourish in an atmosphere of isolation and alienation. Much of Cho's video diatribe and disturbed writing focused on feelings of alienation and hostility. The accounts of classmates, his roommate, his family and others describe an individual who saw himself as alone in an enemy world. Just as sensory deprivation can cause someone to hallucinate, social deprivation and an absence of the cues that most of us subconsciously receive on a constant basis can bring about delusional thinking. If you look at the world through a distorted lens, you end up with bizarre responses and believe them to be normal and warranted.

At any rate, I thought it was important to stress that AS is a developmental condition rather than a disease.

[katienj]

I am very familiar with all aspects of Aspergers and I never said that it was a mental illness. I said that he had some type of mental illness along with AS. I am well aware the AS does not mean the person is mentally ill. Cho's isolation, intelligence and poor communication skills do fit the criteria for Aspergers. However, he obviously had some type of mental disorder--not related to Aspergers, possibly schizo affective disorder.

[rn/writer, RN]

I am very familiar with all aspects of Aspergers and I never said that it was a mental illness. I said that he had some type of mental illness along with AS. I am well aware the AS does not mean the person is mentally ill. Cho's isolation, intelligence and poor communication skills do fit the criteria for Aspergers. However, he obviously had some type of mental disorder--not related to Aspergers, possibly schizo affective disorder.

Please, my post was meant to clarify what I said for anyone who might have misunderstood. Many people read these posts and I had hoped to make it clear that I was not equating AS with mental illness. I only included your post to illustrate why I thought I might created some confusion, not to cast any aspersions on your level of knowledge. The general population is not readily acquainted with AS and I was concerned that someone might misunderstand my statements. That is all. No offense intended.

[katienj]

No offense taken. I just wanted to reiterate that I am familiar with AS and it is often confused by many as a mental illness. Afterall, it is taught along with Mental Disorders in nursing school, but is clearly not a reason for Cho to commit those horrendous crimes. My point was to ask why his family did not recognize any of these symptoms. How sad that they did not. So many innocent lives could have been saved.

You obviously know a lot about this disorder. Do you know someone personally with AS?

[SoxfanRN]

I am familiar with the Autistic spectrum and mental illness. I have been a psych nurse my entire career. While Cho does sound like he had symptoms of AS and some other psychotic process, I think we are missing the point. The point is that people can have AS or other developmental D/O or psychosis or other mental illness without being violent. Likewise, people can have no mental illness or developmental D/O and be extremely violent. In this country, we like to look for labels and reasons why disasters happen. Then, we want our government to develop laws to prevent further incidents. Problem is that when the governement gets involved, people who do not deserve to lose freedoms, like those of us who own and use guns, lose. Human behavior is extremely variable.

Bottom line is that it all comes down to the early recognition of violent tendencies and disturbed behaviors. But this is not so easy, is it? This responsibility falls largely to parents. But parents are too emotionally involved and denial plays a large part in ignoring those early signs. Also, with a divorce rate of 50% and a large single-parent family population, the responsibility of looking for early signs of violence becomes that much more difficult.