(MENAFN- The Peninsula) When should society intervene if a person shows signs of mental illness?
As with the shooters at Virginia Tech University, in Tucson, Arizona and in Aurora, Colorado, there were ample warnings that Aaron Alexis was experiencing mental distress before he killed 12 people at Washingtons Navy Yard.
Police in Newport, Rhode Island, did nothing to help Alexis when he complained about hearing voices and being zapped by skin-vibrating microwaves.
They were not legally obligated to. In 1975, the US Supreme Court ruled in OConnor v Donaldson that the state "cannot constitutionally confine . . . a non-dangerous individual who is capable of surviving safely in freedom by himself or with the help of willing and responsible family members or friends."
That decision established the United States legal threshold of posing a danger to ones self or others.
The next year, a federal court ruled in Lessard v Schmidt that involuntary commitment is permissible only when "there is an extreme likelihood that if the person is not confined he will do immediate harm to himself or others." The court required that in civil commitment proceedings people with mental illness receive all the protections accorded to criminal suspects - including the right to counsel, the right to remain silent, exclusion of hearsay evidence and a standard of proof beyond a reasonable doubt.
These decades-old rulings have had a chilling impact.
In 2002, a Fairfax County, emergency room turned away because a college student, who was delusional and had been hospitalised twice for treatment of bipolar disorder, as he was deemed not sick enough to hospitalise. Police advised his father to claim he was dangerous to get him admitted. Three years later, the father called the countys Mobile Crisis Unit for help but was again told that he had to wait until his son became dangerous. When he did, that unit refused to come because the dispatcher decided, based on the call, that the son was too dangerous. Instead, the police came and shot the son twice with a stun gun.
The societal fear of involuntary commitment is rooted in the One Flew Over the Cuckoos Nest past, when innocents were warehoused in state asylums without legal protections and with little hope of release. But times and circumstances have changed.
Other nations have progressed to a "need for treatment" standard, which considers the potential for danger but does not require it.
Under the 1983 Mental Health Act in England and Wales, individuals can be forced into treatment if they have a mental disorder. Patients are examined by a licensed psychiatrist and a doctor, including one who has known the patient previously. If they agree that the person should be detained in the interest of his health, his safety or the protection of others, an order is presented to a social worker trained to determine whether commitment is warranted. Patients are held for up to 28 days before their cases are reviewed by a mental health tribunal composed of a doctor, lawyer and layman.
Adopting a "need for treatment" standard would enable relatives, police and mental health professionals to intervene earlier. But until the US builds and funds a community-based mental health system that provides user-friendly treatment oriented toward recovery, the threat of mass shootings will not be reduced.
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