Shining a Light on Aurora

Most of us were shocked and deeply saddened by the tragedy that occurred last Friday at the movie theater in Aurora, Colorado. Twelve people lost their lives and another 58 were wounded – 11 critically – during one of the worst mass shootings in US history.

Coming just two days before the anniversary of the massacre in Norway, and close on the heels of such US-based tragedies as the shootings at Virginia Tech, Fort Hood, Tucson and Columbine High School, what happened in Aurora has sparked considerable debate and controversy.

Questions being asked repeatedly in print, on the internet, and over the airwaves include: How could a 24-year-old PhD student with a promising future in neuroscience deliberately plan and implement an early morning rampage that left so many dead or wounded? What caused him to commit such a heinous act? Could the violence have been prevented had their been stricter (or perhaps looser) gun controls in place? These are all important questions to ask.

What is unfortunate is that the primary focus of the current debate has been on the last of these questions. Many of the pundits featured in the media following the shootings in Colorado have talked primarily about gun control and our Second Amendment right to purchase and own firearms. Nearly every candidate in the upcoming November elections has already weighed in on this issue, as have the various special interest groups funding their campaigns.

In addition to gun control, however, what we really should be talking about is the problem of undiagnosed and untreated mental illness in the US. Moreover, we should not be looking solely to the government or to the mental health industry for solutions to this vexing problem. Rather, we also need to look inward and ask ourselves why we are so reluctant to reach out and help those struggling with mental health issues. Doing so would be more likely to prevent future tragedies than resurrecting the ban on assault weapons or expanding open-carry laws.

If we look to the killings at occurred at Columbine and Tucson, for example, it becomes clear that many of those who commit extreme acts of violence make their intentions known well in advance. Dylan Klebold, one of the perpetrators of the Columbine massacre, wrote of such acts in several of his school compositions. His high school English teacher raised concerns about these writings, but school officials and Dylan’s parents dismissed these warnings; his violent writings were seen as mere works of creative fiction.

Jarod Loughner, the Tucson man who killed six and wounded twelve (including former US Representative Gabrielle Giffords), posted similar materials and threats on both his MySpace and YouTube accounts. He was also so prone to violent outbursts and confrontations while attending Pima Community College that school officials had him suspended. He later dropped out after refusing to undergo the mental health evaluation required for him to re-enroll. Once he dropped out, however, no one at the college ever reported their concerns or fears to mental health professionals. Family and friends likewise failed to notice or report signs of the impeding massacre to relevant medical personnel or legal authorities.

I will not be surprised if, in the coming weeks, it turns out that the suspect in the Aurora shootings showed signs of mental illness. These will likely have gone unnoticed or unheeded by his friends, family and those he worked with.

Even when we have a colleague or loved one who is acting irrationally, it is often difficult to ask questions about their mental stability. We may not feel it is our place or our responsibility to raise these concerns. After all, few of us are trained psychiatrists or psychologists, and the potential threat of harm may seem remote.

Given the stigma associated with mental illness, we may be reluctant to label a close friend or family member as such. We may also be scared of those who are mentally ill, going out of our way to avoid or ignore them (such as crossing the street to get away from the unkempt individual on the corner who is mumbling incoherently to themselves).

Finally, even if we want to help we may feel powerless to do so. Current state and federal laws make it difficult to hospitalize or treat someone against their will. Forty-four states, including Colorado and New York, have assisted outpatient treatment laws that can be used to compel patients to get mental health care. However, compulsory treatment is limited to those patients who meet certain criteria, including a diagnosis of mental illness, a history of not complying with care and a record of violent or antisocial behavior. Few if any perpetrators of recent massacres met that definition.

Clearly there is no quick fix to this problem. Despite my personal aversion to firearms, for example, I do not think that stricter gun laws are an obvious panacea. Rather, I think the answer lies with each and every one of us. We need to be more willing to reach out to friends and family members who are behaving erratically, rather than be afraid or ashamed of them. We need to be willing to talk with them about their problems, to encourage them to seek treatment, and to be willing to seek care of their behalf if they are reluctant to do so.

We will never be able to prevent every potential massacre, but if we can stop just one future Aurora the effort will be well worth it.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on July 26, 2012. It is also available on the WAMC website.]

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About Sean Philpott-Jones

A public health researcher and ethicist by training, Sean holds advanced degrees in microbiology, medical anthropology, and bioethics. He is currently Chair of the Bioethics Department at Clarkson University's Capital Region Campus and Director of the Bioethics Program of Clarkson University-Icahn School of Medicine at Mount Sinai, and Director of two Fogarty-funded programs to provide research ethics education in Eastern Europe and in the Caribbean Basin. Until his term expired in August 2012, he served as Chair of the US Environmental Protection Agency’s Human Studies Review Board, an advisory panel that reviews the scientific and ethical aspects of research involving human participants submitted to the EPA for regulatory purposes.
This entry was posted in Crime, Media, Mental Health, Policy. Bookmark the permalink.

4 Responses to Shining a Light on Aurora

  1. According to a story in the New York Times, the University of Colorado is likely to be sued by victims’ families for negligently failing to address Holmes’ mental health issues. While I agree completely with what Sean says, it is absurd to expect a university to monitor the behavior of graduate students. Moreover, universities are seriously hamstrung in investigating mental health issues by privacy laws. This does come down to the responsibility of family and friends — not the graduate program. Having said that, I think that universities should be ALLOWED to contact family members if they suspect serious mental health problems in students. The way the privacy laws are now written, they cannot do that (must less be held responsible for failing to do it).

  2. Barry Shuster says:

    I believe Sean’s and Bonnie’s recommendation have great merit from a legal and policy standpoint. If privacy law can adequately protect the university when it has reasonable suspicion of a student’s mental health problems (or inclination to cause harm to others), it would promote reasonable and moral behavior rather than risk avoidance. In general, I believe imposing common-law or statutory duties to warn (e.g. Tarasoff) on institutions and employers, let alone friends, families and acquaintances only invites dysfunction on many social levels, starting with the U.S. tort system, which is already a mess.

  3. Sue K says:

    It is so very difficult to help a loved one with mental illness (or suspected mental illness) even as a family member. We have been trying for over five years to convince a family member to seek treatment. We have attended family support groups, gone to seminars, workshops, and speakers to learn all we can about mental illness, how to interact with someone with mental illness, how to advocate, etc. etc. It has gotten us nowhere. Because our loved one has not committed a crime, only tells a select few people her stories, and because she is free to choose to continue to live with this illness, there is nothing we can do to force her into treatment. Calls to local mental health agencies and even to law enforcement during a domestic issue did nothing. Because of her illness and her paranoia, she walked away from a good job, her own apartment, and her family. Various relatives have taken her in, given her a place to stay, and tried to convince her to get some help but to no avail. Now she is living on the street somewhere and will not speak to her family because of the things we have suggested to her. Everyone tells us this will force her into seeking treatment but I can tell you, as her loved one, I feel like we treated our dogs better (at least they get meals and a roof over their head). The family tried to help but the laws have prevented us from doing so. How do we overcome that?

  4. Turns out that the suspect in the Aurora shootings was seeing a mental health professional, who informed the University of Colorado’s Behavioral Evaluation and Threat Assessment team about her concerns. The University failed to take action because the individual in question was ” in the process of dropping out of school.”

    http://usnews.nbcnews.com/_news/2012/08/02/13081771-report-psychiatrist-warned-university-about-aurora-suspect-weeks-before-massacre?lite

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