Newtown School Massacre Raises Issues for Veterans, Mental Health and Law Enforcement
Last Friday, America was forced to confront the problem of evil. And we may yet again fail to recognize it where it exists.
I do not use the word ‘tragic’ or tragedy when referring to the outrage that took the lives of 20 schoolchildren and seven adults. The word applies where those who fell died because of some fault of their own – the tragic flaw of Greek and Shakespearian drama. Tragedies are, by definition, self-inflicted at some level.
This was not the case in Newtown, nor Clackamas, nor at Columbine, the Aurora Theater or Tuscon.
Tragedy has logic. This was simply murder.
The shooting has naturally resulted in calls for increased restrictions on legal gun ownership – and gun rights advocates have also resorted to the usual arguments in favor of 2nd Amendment rights.
The Newtown incident has also resulted in more calls for reforms in mental health care – a welcome development, and certainly one of interest to veterans in the VA system as well as to the general population.
But large swathes of the mental health care advocates likewise miss the target – the problem of evil.
The mental health industry – including families struggling with mental illness or personality disorders within their own homes – would argue that we need better access to mental health treatment, early intervention, up to and including involuntary commitment for individuals who have not yet committed a crime.
The mental health industry is part of the health care complex in the United States, and has adapted itself to define mental health issues in such a way as to maximize reimbursement from health insurance plans, including Medicare and Medicaid. In order to do this, it has adopted a medical treatment, documentation and financing model for mental illnesses of all stripes.
In many cases, this is absolutely appropriate. Some mental illnesses, including bipolar disorder, schizophrenia and some forms of depression respond very well to medication. The mental health industry has also adopted a medical model to treat drug and alcohol addiction – though with less success.
And then there are the so-called personality disorders: Borderline personality disorder, narcissism and sadism – a cluster of sociopathologies that the medical model continues to have trouble addressing. This is because the medical model has trouble identifying the difference between genuine mental illness and evil. If the system cannot identify evil, it cannot address it.
Public discourse on the shooting centers on keeping guns out of the hands of the “deranged,” but we fail to define our terms beyond that.
Meanwhile, we run the risk of eroding valuable constitutional freedoms.
We are already seeing that within our own community of veterans – a recent bill before Congress sought to strip veterans under VA care of their 2nd amendment rights simply on the say-so of a mental health professional, without any kind of a priori judicial review.
A VA bureaucrat social worker, under the proposed law, could refer a veteran to the FBI simply because he was bad with money.
And history is replete with state abuse of the mental health system to warehouse those who were perfectly sane, but whose ideas were considered a threat to the power structure. Imperial Japan had the Tokk? – quite literally referred to as the “thought police” between 1925 and 1945. Its function was to stamp out and suppress “dangerous thought.” Among the dangerous thoughts it suppressed: Opposition to the simultaneous war with China, the United States and Great Britain which ultimately resulted in the country’s utter devastation.
If mental health workers have a reputation for referring struggling patients to law enforcement – or committing them involuntarily to mental institutions, the potential for perverse effects is obvious: Those with enough cognizance to be extremely deadly criminals will avoid seeking care, or will say what they think the shrink wants them to say, and therefore fall outside the system’s grasp, even as the constitutional rights of less maladjusted people are eroded.
Meanwhile, the mental health field will continue to struggle with the problem of evil that cannot be medically addressed. There was nothing insane nor irrational about men like Timothy McVeigh, or MAJ Nidal Hassan. They knew exactly what they were doing. They had a goal and set about to kill to achieve it. They knew full well the devastating impact their actions would have on their victims and their victims’ families. They just did not care.
No amount of medication, nor cognitive ‘talk therapy,’ nor any number of billable hours, will correct that, no matter how skilled the practitioner.
Hassan’s case is particularly revealing: As an Army psychologist himself, Hassan was routinely in contact with many other military health care professionals – yet despite tipping his hand several times in formal presentations as an adherent of radical and violent Islam, the Army mental health care system could not identify an evil right under their noses.
In the case of the Tuscon, Arizona shootings and the Aurora. Colorado Theater shooting, we have a more ambiguous case. Clearly, neither shooter was playing with a full deck of cards. In these cases, perhaps some early intervention could have prevented the problem. The warning signs were there – and recognized by people around them at the time. James Holmes, the shooter in Aurora, was actually regularly seeing a mental health professional at the time. So access to mental health care was not the problem.
Holmes himself had actually received a degree in neuroscience, with highest honors, and had been described as a “very effective group leader” as an undergraduate. He would have had access to counseling and health care as an undergraduate student, and as a graduate student at the University of Colorado, where he was still technically enrolled at the time of the shooting. His psychological decompensation seems to have been rapid, though.
Jared Lee Loughner, the Tuscon murderer, had a long history of borderline psychosis, perhaps as a result of the chronic use of hallucinogenic drugs. Loughner had already been identified as a criminal risk, and was barred from reenrolling at Pima Community College until he received a clearance from a mental health professional stating he was not a risk for violent behavior.
Seung Hui-Cho, the murderer in the Virginia Tech Shootings who took the lives of 32 people and wounded 17 in 2007, was identified as a danger as young as 15, when he was transfixed by the Columbine murders and wrote that he wanted to repeat them. In this case, mental health care officials intervened early, and he was placed in special education with an emotional disorder and excused from a number of routine events in high school, such as group presentations. He eventually began to refuse treatment.
Privacy laws, such as HIPAA, prohibited his mental health care professionals from notifying Virginia Tech officials of his violent tendencies.
A professor of his at Virginia Tech had already removed him from her class because of menacing behavior. He was also involved in at least three incidents of stalking while enrolled at Virginia Tech, but was allowed to remain a student. Professors had already alerted the dean and campus police that Cho was a problem, but were informed that there was nothing they could do until Cho committed a crime.
In 2005, Cho was actually found by a magistrate to be a danger to himself and others around him. But the magistrate in question, Special Justice Paul Barnett, sentenced him to outpatient treatment, rather than committing him full time to an institution.
In each of these cases, mental health professionals were already involved, and clearly there was plenty of early warning in most of them. In each case, the mental health professionals and court apparatuses could not or would not take decisive action to remove these individuals from society. Access to mental health care was not an issue. The issue was the recognition of evil.
The medical model has no structural incentive to attribute to evil what it can attribute to something billable.
But that brings us back to veterans: If we adopt a system in which we are quicker to involuntarily commit those we suspect of being psychotic, or with severe personality disorders, to mental institutions, bias and prejudice against combat veterans and ignorance about PTSD will ensure that we are first in line for detention.
There are certainly reforms that can be made, both to the system that regulates firearm distribution and ownership, as well as mental health reforms. But is the 2nd amendment that guarantees the government can never have the power to create a Tokk? of its own, and allows the weak and good to defend themselves against criminals who are strong, armed, evil and/or crazy.
There are constitutional concerns in strengthening the mental health industry’s pull – and they have powerful financial incentives to commit more and more patients to their care. Meanwhile, for every Cho, there are thousands of people who enter the system who would be harmless, yet have their freedoms abridged all the same.
We should be very cautious of broad, ham-handed measures in either field to prevent future shootings. Evil has always been among us, and while you can regulate away the ability of law abiding citizens to defend themselves against people like Cho – and more run-of-the-mill criminals – you cannot treat away nor regulate away the presence of evil.