Mental Health Issues Raised by the Loughner Shooting

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LM K
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Mental Health Issues Raised by the Loughner Shooting

Postby LM K » Sat Jan 29, 2011 9:31 pm

I thought it would be good to have a separate thread to discuss the mental health issues surrounding the shooting in AZ on Jan 8th.I will post real stuff tomorrow, but wanted to open the thread now. :-bd

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LM K
Posts: 8257
Joined: Fri Jan 23, 2009 5:59 pm

Mental Health Issues Raised by the Loughner Shooting

Postby LM K » Mon Jan 31, 2011 2:55 am

Hey all,





In the [link]Gabby Giffords,http://www.thefogbow.com/forum/viewtopic.php?f=55&t=5215[/link] thread, we began talking a lot about mental health issues raised by the Loughner shooting. I took the liberty of cutting and pasting some of the posts from the last 2-3 days and posting them here. This will allow us to continue talking about the mental health issue here while keeping the Giffords thread open for Giffords related info.





The first 3 letters of each post contains a link to the original post.





PART 1





[quote name=TollandRCR][link]In partial confirmation,http://www.thefogbow.com/forum/viewtopic.php?p=207352#p207352[/link] of the data and anecdotes reported upthread,





New York Times Jan. 27, 2011 [link]Record Level of Stress Found in College Freshmen,http://www.nytimes.com/2011/01/27/education/27colleges.html?_r=3&hp[/link]





The emotional health of college freshmen — who feel buffeted by the recession and stressed by the pressures of high school — has declined to the lowest level since an annual survey of incoming students started collecting data 25 years ago.





In the survey, “The American Freshman: National Norms Fall 2010,” involving more than 200,000 incoming full-time students at four-year colleges, the percentage of students rating themselves as “below average” in emotional health rose [a higher percentage of women always scores themselves higher on this measure than do men, i.e., they are less likely to consider themselves to be mentally healthy]. Meanwhile, the percentage of students who said their emotional health was above average fell to 52 percent. It was 64 percent in 1985.


...


Campus counselors say the survey results are the latest evidence of what they see every day in their offices — students who are depressed, under stress and using psychiatric medication, prescribed even before they came to college.





The economy has only added to the stress, not just because of financial pressures on their parents but also because the students are worried about their own college debt and job prospects when they graduate.





[link]Does the Military Have a Suicide Problem?,http://www.theatlanticwire.com/features/view/feature/Does-the-Military-Have-a-Suicide-Problem-3047[/link]





Death is one of the tragic realities of war, but what about suicide? The US military released the suicide numbers for service members in 2010 last week, and the statistics were eye-opening: for the second year in a row, more troops were lost to suicide than to combat in Iraq or Afghanistan--at least by Congressional Quarterly's John Donnelly's count. "The suicide rate is a further indication of the stress that military personnel live under after nearly a decade of war," writes Donnelly. He also describes the difficulty and complications around tracking such a statistic. "Should returning soldiers who take their own lives after being mustered out [discharged] be included?" he wonders.





Donnelly also points out the number of suicides that fall through the cracks in the military's accounting. The services reported 434 suicides Donnelly says, but many reservists with the Air Force and Marines as well as a unit called the Individual Ready Reserve, a group of more than 123,000 people who are not assigned to particular units, were left out when the military reported their statistics. So too were veterans who have recently left service in Iraq or Afghanistan.





There were 462 US military deaths in combat last year, and as Donnelly reports: "Even if such veterans and members of the Individual Ready Reserve are excluded from the suicide statistics, just taking into account the deaths of reservists who were not included in last week's figures pushes the number of suicides last year to at least 468. That total includes some Air Force and Marine Corps reservists who took their own lives while not on active duty, and it exceeds the 462 military personnel killed in battle."





Maybe it is time to start a thread on the mental health of youth of college and military service age. LM K?










[quote name=LM K][quote name=cbreitel][quote name=LM K]


[snip]


[link]Arizona is in,http://www.thefogbow.com/forum/viewtopic.php?p=207656#p207656[/link] a unique situation legally; AZ has a law that allows anyone to call a hotline number to start an investigation for someone who is mentally ill and may be a threat to themselves or others. AZ is the only state that has this law, and I don't think anyone really knew the law existed (including security staff at PCC). All of the textbooks say that a person has to be an imminent threat to their self or or others in order for law enforcement to hospitalize that individual; it is possible that many in the education and health fields had no clue about this law.


[snip]




LM K: I know many people in these fields, in Arizona. Most seem very aware of Arizona's law on involuntary commitment, as they should be as part of their professional backgrounds. I'm also certain that Arizona is not the only state with an involuntary commitment law. In fact, most if not all states have such provisions, with only the specific procedures and evidentiary requirements changing from one state to another. These laws are significant enough that the U.S. Supreme Court took them on in 1979 to clarify what the constitutional guidelines should be in enforcing them: Addington v. Texas , 441 U.S. 418 (1979).




You are correct; almost every state has laws allowing for involuntary commitment. My point was that the AZ law is unique because it is less stringent than the laws of the other 49 states. In AZ, anyone can call a hotline or contact law enforcement to provide information that may lead to the investigation of a person who may have a mental illness that is spiraling out of control. AZ is the one state in which someone can be involuntarily committed even if the are not an imminent threat to themselves or others. So, if a person is mentally ill and shows that they have the potential to become a threat to themselves or others, they can be involuntarily committed for 24 hours. In the rest of the country, the individual must be a threat at the moment that they are being evaluated.





There isn't a single textbook that I have encountered that points out that AZ's law is different than the laws in the remaining 49 states. Which is why I think there is a high likelihood that many are unaware of the law even if they should be aware of the law. Most mental health professionals aren't involved in the involuntary commitment of the mentally ill. More than 1/2 of those who are psychologist don't work with the mentally ill at all.





In most states, mental health professionals have to contact law enforcement to initiate the involuntary commitment process; thus, it becomes the responsibility of law enforcement to actually get the patient to the hospital. Mental health professionals make a call and share info. Then it is all on law enforcement to pick up the person who may be a/at risk, and then to get in touch with either the patient's mental health providers (if they have one) or the mental health providers who work for the state/city/county.





PCC is getting a lot of blame for following the law. Loughner didn't break any laws while on campus; if no law is broken, the school doesn't have the right to involve the local police (PCC did call the local police once only to be told that there was nothing that the local police could do since Loughner wasn't breaking the law).


[snip]







The standard for arresting someone on criminal charges is different from the standard for involuntary commitment, so PCC's claim that he wasn't "breaking the law" is a non sequitur. He was being disruptive in class, repeatedly, and was scaring his teachers and classmates. Many of those teachers and classmates have given interviews in the media making it clear that they feared for their safety because of his behavior. As a result, the extraordinary step of expelling him from campus was taken. PCC (I'm a former student by the way) could have very easily, on its own, invoked the law and initiated at least an evaluation of him. The results of that evaluation may not have prevented the shooting. On the other hand, they may have. We will never know.





See above. In addition, there is no reason to assume that anyone at PCC knew that AZ had a law that provided a hotline or other processes that would initiate an investigation into an individual's mental health even in that person was not an imminent threat. Community colleges don't have counselors/clinicians who see a student more than a few times. Most community college counselors work as academic advisers who occasionally see students for mild mental health issues (stress, testing anxiety, mild depression, relationship issues) and refer those students to resources in the community. Community colleges usually do not provide psychological counseling for students.





From [link]PCC's website, regarding their advising/counseling dept,http://www.pima.edu/studentserv/studentresfaq/AdvisingCounseling.shtml[/link]





When should I meet with an advisor?





We recommend meeting with an advisor or counselor at least once each semester. Located at each campus, they support your academic goals by guiding you through procedures for classes, majors, unofficial degree checks and transferring. Counselors additionally assist with general college procedures, student success skills and personal concerns and crises.





[link]PCC's Health and Wellness info,http://www.pima.edu/studenthealth/[/link]





Healthy students mean successful students. Pima's services aim to keep mind, body and spirit in top shape.





Phone Numbers for Immediate Help


Medical or safety emergency: 911.


Personal crisis: Help-on-Call Crisis Hotline, 323-9373. [note]


Crisis assistance: Southern Arizona Mental Health (SAMHEC), 622-6000.





No mention of crisis assistance here.





snip.....





College Counselors


Counselors help students deal with personal issues and find community resources for assistance.





Counselors do what I described previously; they refer students to the community for mental health care.





[link]ULifeline,http://www.ulifeline.org/main/Home.html[/link] [note]


This online resource has information on suicide prevention, drugs and mental health. Just select "Arizona", then "Pima Community College" to get information and contacts to help with the stresses of college life.





[link]WebTribes,http://www.webtribes.com/[/link] [note]


An online support destination for students and others faced with mental health issues. WebTribes is made up of social networking support communities.





[link]Student Counseling Virtual Pamphlet Collection,http://www.dr-bob.org/vpc/virtulets.html[/link]


Links to college and university web pages with information for students on health and wellness concerns.





Information and Referral Services


This Tucson organization guides the public to community programs throughout Southern Arizona. For personal and family aid, call 881-1794 or 1-800-362-3474.





The only options for PCC were:


1) Boot Loughner from campus


2) Call the hotline or initiate other proceedings to get Loughner investigated (which they may have done or may not have done)





It is very possible that even if PCC initiated the application process for involunatry commitment:





1) Loughner would have been stable enough at that time to pass the evaluation. Schizophrenic episodes come and go. At times they last for long periods of time and at times they are brief.





2) The application wouldn't be acted upon for 2-5 days.





D. [link]The screening agency,http://www.azleg.gov/FormatDocument.asp?inDoc=/ars/36/00520.htm&Title=36&DocType=ARS[/link] shall offer assistance to the applicant in preparation of the application. Upon receipt of the application, the screening agency shall act as prescribed in section 36-521 within forty-eight hours of the filing of the application excluding weekends and holidays. If the application is not acted upon within forty-eight hours, the reasons for not acting promptly shall be reviewed by the director of the screening agency or the director's designee.





In addition, unless the situation is declared an emergency, an individual cannot be forced to cooperate with the screening agency and cannot be detained:





Except in the case of an emergency evaluation, the person to be evaluated shall not be detained or forced to undergo prepetition screening against the person's will.





What happens if a person refuses to be evaluated?





[link]If prepetition screening is not possible,http://www.azleg.gov/FormatDocument.asp?inDoc=/ars/36/00521.htm&Title=36&DocType=ARS[/link], the screening agency shall prepare a report giving reasons why the screening was not possible and including opinions and conclusions of staff members who attempted to conduct prepetition screening or otherwise investigated the matter.





Things get tricky here. If the person investigated calmly says no, and is properly groomed and appears healthy, all the state has to go on is the word of the person who submitted the application. That doesn't automatically mean that hospitalization will happen. If anything, I suspect that the state wouldn't hospitalize the individual.





Should the hotline have been used? Absolutely. But, quite frankly, we don't know that it wasn't. We don't know that PCC didn't call the hotline.


[snip]







PCC hasn't said they called any hotline, but more importantly, it's not all about a hotline. Arizona law allows "any responsible individual" to prepare an application to a court of law indicating a fear that a person is in need of mental health treatment. PCC could have acted on its own. The funding questions you raise in the rest of your post are certainly legitimate, and I totally agree with you that Arizona is among the worst states in the nation for funding mental illness treatment. But funding is not an issue here. He was not turned away because of a lack of funding. The system wasn't given the chance to turn him away in the first place.





As a lawyer, would you recommend that PCC say anything more to the media about this? My guess is no, but I could be wrong.





The hotline is linked to the process you note. I mention the hotline because it is often the process used to initiate the process you describe in better and greater detail. The average person would call the hotline to get this started. But I should have read more about the process.





Again, there is no evidence that PCC did or did not apply to the court or did or did not call the hotline. There is record that PCC tried to get local law enforcement active in their problems with Loughner, which tells me they did more than many think they did. PCC went way beyond what most colleges do when they suspend a student. They had security go to Loughner's home instead of just mailing Loughner a letter. That tells me that PCC did take this seriously and that they took greater precautions with Loughner than many colleges have.





Since local law enforcement was in contact with campus security, they obviously knew of some of Loughner's behavior. They could have just as easily (if not more easily) initiated an investigation into Loughner's mental health.





Loughner hadn't been a student at PCC since April, 2010 the end of Sept, 2010, 8 2.5 months before the shooting. I have a difficult time holding PCC accountable for a student that they worked very hard at controlling and for someone who hadn't been their student for some time. They suspended Loughner both to protect their campus and to encourage him to get help.





In your post you make many good points about attitudes toward mental illness in our society, the lack of funding, and other issues, all of which I agree with. But my concern about PCC's actions in this matter is being expressed with my lawyer hat on, not my "emotional witness to the carnage in my hometown" hat on. My prediction is that lawsuits will be filed against the school, by any one or more of the 19+ families affected by the shooting, where the specific question of why PCC failed to do more will be thoroughly investigated and pursued. The families have until early July of 2011 to file their notices of claim.





I have no doubt that PCC will be sued. Which is why they are no longer talking with the media. PCC gave much more info to the public than most schools would have done. One of the reasons they did so was because Loughner's online videos linked him to PCC on a very serious level and because students spoke to the media.





Cbreitel, I think that you think that I am saying your wrong. I am not. I am saying that we really don't know about all of PCC's actions where Loughner is concerned. I am also saying that AZ has done a very poor job in telling the public about their law for involuntary commitment. As you noted, anyone could have initiated an investigation. I believe that few in AZ knew about the law; if I am wrong about that, then anyone who knew Loughner on any significant level bears blame.





A question for you (which may not be answerable). Who at PCC should have known about the AZ law allowing anyone to initiate an investigation of anyone they believe was mentally ill and a risk? No one on the PCC campus is involved in treating or working with the mentally ill.





According to AZ Statute 36.520, any application made by PCC may have been destroyed:





I. If the application is not acted upon because it has been determined that the proposed patient does not need an evaluation, the agency after a period of six months shall destroy the application and any other evidence of the application.





I would encourage all to look at the [link]application,http://www.treatmentadvocacycenter.org/storage/tac/documents/arizona_-_application_for_emergency_admission_for_evaluation.pdf[/link] used in AZ to initiate an investigation of someone they feel is a risk or at risk due to mental illness. The person who initiates the application is required to give their name, all of their contact info, and to notarize the application. I can understand why many would be hesitant to provide such information when reporting someone that they think may be dangerous.





Some additional info I found:





[link]The Shortage of Public Hospital Beds for Mentally Ill Persons,http://www.treatmentadvocacycenter.org/storage/tac/documents/the_shortage_of_publichospital_beds.pdf[/link]





Arizona has less than 20% of the needed hospital beds for mentally ill patients. It is entirely possible that Loughner was reported, investigated, found to be a risk, only to find that there was no place to put him. At that point, there is little for the state to do. My guess would be that if the person was an imminent threat, they might be sent to the local jail if stable enough to handle the jail. If the person wasn't an imminent threat, they would fall through the cracks.





[edit]The stats on hospital bed shortages are from 2004-2005. I believe it likely that there are fewer hospital beds for the mentally ill since AZ slashed their mental health services by 50% in July, 2010.[/edit]





[edit]#2 Fixed dates and reworded a sentence because it was awkward.[/edit]







[quote name=Smithereens]
LMK - [link]Edit: The stats on,http://www.thefogbow.com/forum/viewtopic.php?p=207671#p207671[/link] hospital bed shortages are from 2004-2005. I believe it likely that there are fewer hospital beds for the mentally ill since AZ slashed their mental health services by 50% in July, 2010.


from an article I posted on Jan. 12 (p. 28) in this thread:


In Arizona, public mental-health services are among the worst in the nation. In a 2008 survey by the Treatment Advocacy Center, Arizona ranked next to last among all states in the number of psychiatric hospital beds per capita. If you don't have hospital beds and outpatient clinics to treat mentally ill people, those people don't get treated. Thus the tragedy was somewhat more likely to happen in Arizona because mentally ill individuals are less likely to receive treatment there. Although Arizona is the worst state, except for Nevada, in psychiatric-bed availability, there is no state that currently has enough beds for its mentally ill population, according to the Treatment Advocacy Center study. This tragedy occurred in Arizona, but it could easily have happened in any state.


I think they mixed up Nevada and Arizona in the article, not that it makes any difference. If you're mentally ill in these states you can just wander out into the desert and start your own religion. {SMILIES_PATH}/pray.gif





http://online.wsj.com/article/SB10001424052748703779704576073973345594508.html?mod=WSJ_Opinion_LEADTop


Dr. Torrey is the founder of the Treatment Advocacy Center










[quote name=cbreitel][link]I know many,http://www.thefogbow.com/forum/viewtopic.php?p=207673#p207673[/link] Arizonans in the fields of mental health, education, and law enforcement, LM K. My mom is a school psychologist. Friends are teachers. One is a psychiatrist. Another is a nurse employed by the state. I represent cops, in my practice. The list goes on. I've lived here since childhood, after all. While you say that the law of involuntary commitment here is a surprise to you, I live here and that is not my experience. More importantly, it is absolutely not an excuse. These people are (a) expected to know what the law is, and (b) are trained on what the law is as part of their mandatory licensing and annual educational obligations. It's in their manuals, field guides, rule books, and training materials. I frankly suspect that PCC failed to act because they were lazy. If they got rid of him from campus, they would probably not have to deal with him again. It's that simple.







[quote name=TexasFilly][link]I haven't read,http://www.thefogbow.com/forum/viewtopic.php?p=207674#p207674[/link] anywhere that Loughner's parents ever tried to get him any mental health care. That doesn't mean they didn't, but I would think after he was not permitted to return to college, coupled with their own observations of his behavior, that might have been a time when they certainly could have sought help. I'm not saying this in any way absolves PCC, but I still wonder where the parents were in all of this. We know all too well that it is difficult to get mental health intervention for an adult child, but it seems in AZ it is a bit easier than in most places.







[quote name=cbreitel][quote name=TexasFilly][link]I haven't read,http://www.thefogbow.com/forum/viewtopic.php?p=207804#p207804[/link] anywhere that Loughner's parents ever tried to get him any mental health care. That doesn't mean they didn't, but I would think after he was not permitted to return to college, coupled with their own observations of his behavior, that might have been a time when they certainly could have sought help. I'm not saying this in any way absolves PCC, but I still wonder where the parents were in all of this. We know all too well that it is difficult to get mental health intervention for an adult child, but it seems in AZ it is a bit easier than in most places.




Their son just got weirder and weirder with time, it seems. I don't know what most parents would do, especially once he'd reached adulthood. Having someone involuntarily committed is a severe and drastic step for any parent. I can't even imagine the trauma it would cause to any family.





This is a family that is at least 3 generations deep in the Tucson community. I'm sure leaving Arizona forever has crossed their minds. Though, they likely have 2 or 3 years to go of visiting their son in local prisons while he awaits trial. Once the federal trial's resolved, he still needs to go through state proceedings, which for their part I speculate will take place in Phoenix. (Pretrial publicity will rule out Tucson, but since the proceedings are in state court they won't be transferred to another state as the feds might do).







[quote name=listeme]
[link]Their son just,http://www.thefogbow.com/forum/viewtopic.php?p=207819#p207819[/link] got weirder and weirder with time, it seems. I don't know what most parents would do, especially once he'd reached adulthood. Having someone involuntarily committed is a severe and drastic step for any parent.





I haven't yet seen anything in the writings of Loughner or the testimonies of other people that would be enough to involuntarily commit someone in my state. I'm not sure it would even be enough for a 72-hour hold in my state. His writings were bizarre. His behavior made people uncomfortable, VERY uncomfortable. But I don't remember any of it being in the nature of threats towards others or towards himself. The recent picture I saw (at a literary event?), he looked well put together.





I'm not talking about what should happen. I'm talking about what the law allows.





Wording it as "a severe and drastic step for any parent" implies that the parents had any ability to make such a thing happen. Without certain specific behaviors, they wouldn't have had the choice to begin with.










[quote name=cbreitel][quote name=listeme]
[link]Their son just,http://www.thefogbow.com/forum/viewtopic.php?p=207828#p207828[/link] got weirder and weirder with time, it seems. I don't know what most parents would do, especially once he'd reached adulthood. Having someone involuntarily committed is a severe and drastic step for any parent.





I haven't yet seen anything in the writings of Loughner or the testimonies of other people that would be enough to involuntarily commit someone in my state. I'm not sure it would even be enough for a 72-hour hold in my state. His writings were bizarre. His behavior made people uncomfortable, VERY uncomfortable. But I don't remember any of it being in the nature of threats towards others or towards himself. The recent picture I saw (at a literary event?), he looked well put together.





I'm not talking about what should happen. I'm talking about what the law allows.





Wording it as "a severe and drastic step for any parent" implies that the parents had any ability to make such a thing happen. Without certain specific behaviors, they wouldn't have had the choice to begin with.




The issue here is that, if he had simply been evaluated, we have no idea what that would have led to. Confinement is not the only possible outcome that could have resulted from someone reporting him to mental health authorities. Perhaps he himself might have been convinced to start taking medication or undergoing therapy. Perhaps his parents would have become better armed with knowledge and information to urge him to do so. There is no doubt that they must wish that they had such options now, so that they could have saved their son from what will now be his horrible and tragic fate.










[quote name=Sugaree][quote name=LM K]


[link]You are correct;,http://www.thefogbow.com/forum/viewtopic.php?p=207865#p207865[/link] almost every state has laws allowing for involuntary commitment. My point was that the AZ law is unique because it is less stringent than the laws of the other 49 states. In AZ, anyone can call a hotline or contact law enforcement to provide information that may lead to the investigation of a person who may have a mental illness that is spiraling out of control. [highlight=#ffffbf]AZ is the one state in which someone can be involuntarily committed even if the are not an imminent threat to themselves or others. So, if a person is mentally ill and shows that they have the potential to become a threat to themselves or others, they can be involuntarily committed for 24 hours. In the rest of the country, the individual must be a threat at the moment that they are being evaluated.[/highlight]





>massive snip<

Ok, I am finally violating my vow to never, ever (ever) post on legal issues, much less "the law", largely since I can't introduce opinions and speculation with "IANAL, but". Nevertheless, because mental health law *was* once my area of expertise, I can no longer resist - with the disclaimer that I have not conducted research in a looong time concerning the status of mental health statutes in states other than Illinois.





Contrary to apparently widespread public & professional belief as expressed in this thread and elsewhere, so-called "dangerousness" is not the sole prong or criterion on the basis of which involuntary admission or commitment can occur. In all states to my admittedly outdated knowledge and definitely in Illinois, there is a "basic needs" provision that was much more commonly used IME to detain and commit persons petitioned for admission to a mental health facility due to mental illness - at least with women. It was employed in a very patronizing manner or so I thought from a defense perspective.





For example, Section 1-119 of the IL Mental Health and Developmental Disabilities Code provides in relevant part that a





"Person subject to involuntary admission on an inpatient basis" means:


(1) A person with mental illness who because of his or her illness is reasonably expected, unless treated on an inpatient basis, to engage in conduct placing such person or another in physical harm or in reasonable expectation of being physically harmed;


(2) A person with mental illness who because of his or her illness is unable to provide for his or her basic physical needs so as to guard himself or herself from serious harm without the assistance of family or others, unless treated on an inpatient basis;





[/break1]ilga.gov/legislation/ilcs/ilcs4.asp?DocName=040500050HCh.+I&ActID=1496&ChapterID=34&SeqStart=100000&SeqEnd=4700000]http://www.ilga.gov/legislation/ilcs/il ... nd=4700000





Now, the second or "basic needs" language did not include "without the assistance of family or others" in my day. It was also construed in radically different ways by the state or prosecution compared with the view of my office, which represented patients, respondents and/or recipients. Interpretation also varied according to jurisdiction or location. The state attys in what I called the "condo court", where I occasionally appeared, always contended that a home (or condo ;) constituted a basic need. We argued the standard articulated in O'Connor v. Donaldson, 422 U.S. 563 (1975), which held that there is no Constitutional basis for involuntarily confining persons with mental illness if they are not dangerous and can live safely in freedom. (and/or "on the street", as I recall)





The judges at condo court almost invariably agreed with the State. However, we almost always succeeded in obtaining reversals on appeal, especially on this point. That court & associated institution, along with virtually every UST detainee & NGRI acquitee in the state, are mere miles from the residence of one Sharon Ann Moron. Consequently, I've had my share of commitment fantasies, inasmuch as anyone can (or could) initiate such a petition here and mental health pros are (or were) required only for certification.





In contrast, courts in the 1st District (primarily Chicago) were quite a bit less patronizing, for better or worse, and for obvious reasons. But these standards would not likely come into play until one was older and no longer sheltered by parents, as Loughner was. I likewise wondered to thunderous silence on Twitter whether his parents sought any help whatsoever for their son or even noticed his ever so slightly unusual behavior.





In addition to the basic needs prong and much to MY disbelief and then outrage, I discovered in writing this posting that Illinois not only enacted an outpatient commitment statute in recent years, but also has greatly expanded the scope of persons eligible for involuntary inpatient tx as detailed in the PS below. Persons not "adequately" complying with meds orders & even mere denial seemingly suffices for commitment. There was at least one other state with such provisions (NY, I believe), along with several providing for commitment for chemical dependency, back in my day. While the latter was totally forbidden in IL (addiction NOT MI by legal definition/case law), there was much advocacy by NAMA and Dr.Torrey to institute the former in as many states as possible.





In any event, it appears that textbooks do not accurately reflect casebooks or statutes, unless again there has been significant change since I was practicing and my reading comprehension has accordingly declined in the interim.





**********************************


PS. Since some seem to think- from a level 1.5 skim on my part at least, that AZ is "loose", I thought I'd include the additional criteria recently added in IL. This incredibly vague, subjective, highly objectionable & arguably unconstitutional language follows the semi-colon at the end of (2) above:


(3) A person with mental illness who:


(i) refuses treatment or is not adhering adequately to prescribed treatment;


(ii) because of the nature of his or her illness, is unable to understand his or her need for treatment; and


(iii) if not treated on an inpatient basis, is reasonably expected, based on his or her behavioral history, to suffer mental or emotional deterioration and is reasonably expected, after such deterioration, to meet the criteria of either paragraph (1) or paragraph (2) of this Section.


In determining whether a person meets the criteria specified in paragraph (1), (2), or (3), the court may consider evidence of the person's repeated past pattern of specific behavior and actions related to the person's illness.


(Source: P.A. 95‑602, eff. 6‑1‑08; 96‑1399, eff. 7‑29‑10; 96‑1453, eff. 8‑20‑10.)





[edit]Because I did not notice that addition of "family and others" before writing most of the foregoing posting, my focus on condos or shelter as the apparent gist of the basic needs provision was misleading. Basic needs specifically referred to eating, sleeping and the like. Ya know, REALLY basic needs. Running out in the middle of rush hour traffic attired only in a t-shirt during a deep freeze or neglecting to eat for days due to delusional ideation would be better examples of what the legislature originally had in mind when drafting Illinois' Mental Health Code. For perhaps varying reasons, I believe Jared Loughner's behavior could have met an AZ equivalent of a basic needs test had he been brought to the attention of the appropriate parties before acting out in a homicidal manner.[/edit]







[quote name=A Legal Lohengrin][quote name=LM K][link]You are correct;,http://www.thefogbow.com/forum/viewtopic.php?p=207976#p207976[/link] almost every state has laws allowing for involuntary commitment. My point was that the AZ law is unique because it is less stringent than the laws of the other 49 states. In AZ, anyone can call a hotline or contact law enforcement to provide information that may lead to the investigation of a person who may have a mental illness that is spiraling out of control. AZ is the one state in which someone can be involuntarily committed even if the are not an imminent threat to themselves or others.




I have problems with such a low standard of evidence. This means, at least as the actual language goes, that some random person can have you locked up for no reason as a crazy menace, regardless of the personal cost to you. So even a total liar who made up facially plausible lies about you could get you locked up. This liar could be someone who was in litigation with you, and deliberately used the process to cause you to miss a court date.





You may think this is far-fetched, but I have personally experienced adverse parties who not only would be willing to do things like this, but have actually done so. Nobody should be deprived of their liberty without due process.





If there is ever any process which allows random people to get other people locked up without any sort of judicial scrutiny, it not only can, but is guaranteed, to be abused by thugs.







[quote name=LM K][quote name=Smithereens]


[link]I think they,http://www.thefogbow.com/forum/viewtopic.php?p=207982#p207982[/link] mixed up Nevada and Arizona in the article, not that it makes any difference. If you're mentally ill in these states you can just wander out into the desert and start your own religion. {SMILIES_PATH}/pray.gif





http://online.wsj.com/article/SB10001424052748703779704576073973345594508.html?mod=WSJ_Opinion_LEADTop


Dr. Torrey is the founder of the Treatment Advocacy Center




I am afraid that that is the case anywhere in the US, Smithy. Hell, we finally have a law requiring that insurance companies treat mental health needs as fully as they treat "physical" illnesses. States have worked on those laws for decades. We finally have a federal law on this now.





For those interested in reading about Bipolar Disorder or Schizophrenia, I highly recommend Dr. Torrey's books:





[link]Surviving Schizophrenia: A Manual for Families, Patients, and Providers,http://www.amazon.com/Surviving-Schizophrenia-Families-Patients-Providers/dp/0060842598/ref=wl_mb_hu_m_T2_15_dp[/link]





[link]Surviving Manic Depression: A Manual on Bipolar Disorder for Patients, Families, and Providers,http://www.amazon.com/Surviving-Manic-Depression-Disorder-Providers/dp/0465086640/ref=ntt_at_ep_dpi_3[/link]





Dr. Torrey's most recent book is highly relevant to this discussion (I haven't read it yet):





[link]The Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens,http://www.amazon.com/Insanity-Offense-Americas-Seriously-Endangers/dp/0393066584/ref=sr_1_3?s=books&ie=UTF8&qid=1296265920&sr=1-3[/link]








[quote name=cbreitel]I know many Arizonans in the fields of mental health, education, and law enforcement, LM K. My mom is a school psychologist. Friends are teachers. One is a psychiatrist. Another is a nurse employed by the state. I represent cops, in my practice. The list goes on. I've lived here since childhood, after all. While you say that the law of involuntary commitment here is a surprise to you, I live here and that is not my experience. More importantly, it is absolutely not an excuse. These people are (a) expected to know what the law is, and (b) are trained on what the law is as part of their mandatory licensing and annual educational obligations. It's in their manuals, field guides, rule books, and training materials. I frankly suspect that PCC failed to act because they were lazy. If they got rid of him from campus, they would probably not have to deal with him again. It's that simple.




Fair enough.





I read some more on PCC and their experience with Loughner. I don't see a lazy campus. I see a campus that worked hard with Loughner; harder than many colleges do. I really don't know who you are referring to when you say "these people". The mandatory reporting laws often differ when dealing with adult students. In fact, federal law makes it possible for schools to be sued for discussing anything with anyone about a student unless there is an emergency; when PCC reached out to the local police, the police told them that Loughner's behavior didn't warrant their involvement.





[link]Pima Community College Statement on Today’s Tragic Events,http://www.tucsonsentinel.com/local/report/010811_loughner_pima[/link]





snip.....





Loughner was a PCC student from [highlight=#ffbfff]Summer 2005 through Fall 2010[/highlight], when he was suspended for Code of Conduct violations. The College's Code of Conduct is available at [/break1]pima.edu/studentserv/studentcode/studentcode-2-conduct.shtml]http://www.pima.edu/studentserv/student ... duct.shtml.





From February to September 2010, Loughner had five contacts with PCC police for classroom and library disruptions at Northwest and West campuses. On September 29, 2010, College police discovered on YouTube a Loughner-filmed video made at Northwest Campus. In the video, he claims that the College is illegal according to the U.S. Constitution, and makes other claims.





Working with legal counsel, College administration issued a letter of immediate suspension on [highlight=#ffbfff]September 29, 2010[/highlight]. That evening, [highlight=#ffbfff]two police officers delivered the letter of suspension to the student at his and his parents' residence and spoke with the student and his parents.[/highlight]





The suspension letter indicated that he was to contact the Northwest Campus to schedule an appointment to discuss the Code of Conduct process and suspension status. Other than for this appointment, he was prohibited from returning to the College.





[highlight=#ffbfff]Loughner and his parents met Northwest Campus administrators October 4, 2010.[/highlight] During this meeting Loughner indicated he would withdraw from the College. A follow-up letter was sent to him October 7, 2010 indicating that if he intends to return to the College, he must resolve his Code of Conduct violations and obtain a mental health clearance indicating, in the opinion of a mental health professional, his presence at the College does not present a danger to himself or others.








Earlier today I read through the [link]campus police record,http://s3.amazonaws.com/nytdocs/docs/556/556.pdf[/link] that were released by PCC; they include campus police reports, emails, a report from the Advanced Program Manager, Jared's transcript (grades are redacted) and some additional info. My read on this is that the campus saw a troubled kid. Some thought he was on drugs when he had one of his outbursts. When he interacted with campus police, he was compliant and repeatedly stated that he wanted to stay in school and would change his behavior in that class, which he did. In addition, Loughner's parents were also involved in talking with campus officials on several occasions. When asked to sign a release so that the campus could speak to Loughner's parents, he signed it.





I think that the school worked a lot with Loughner and communicated with Loughners' parents:





It was suggested by the EEO office that [highlight=#ffbfff]I include a counselor in our meeting with Jared and his mom[/highlight]. I asked Allison Ward to join us at the meeting. [highlight=#ffbfff]During the Jared signed a release of information form so that we could share specifics about the incident with his mom.[/highlight] I then proceeded to go over the issues. I asked Jared to give his account of what had happened but he stated that he had told the police and did not want to say anymore. When asked about the earlier conflicting statements about the right of the teacher to evaluate students Jared gave a scripted answer of, "I know 1have to follow Pima processes and write what the teacher wants." When Allison asked if Jared had a support network to help him be successful in school Jared again said that he did not want to talk about it and he would follow Pima policies. I explained that our next step would be for me to write up a behavioral contract that would outline the appropriate conduct that we had discussed throughout the meeting. Included in this contract would be agreed upon steps that Jared would take to avoid any further disruptions in any of his courses. It was agreed that he would come to my office Monday after class to sign the agreement. Throughout the meeting Jared held himself very rigidly and smiled overtly at inappropriate times. I am scheduled to meet with EEO this afternoon as to the best way to proceed.
Pg 40





In addition, Loughner's parents were part of the discussion that occurred at the Loughner home on Sept 29th (the evening that the suspension letter was delivered). That same evening, after speaking with Jared and his parents, Loughner's father had a private conversation with the officers. (Pg 34) Loughner's mother attended a meeting with campus administration in which the school and Loughner made a contract for him to stay at school. (Pg 40-41)





In addition, campus admin worked with Loughner to develop a plan to keep him in school while helping him behave appropriately.





I explained that our next step would be for me [highlight=#ffbfff]to write up a behavioral contract that would outline the appropriate conduct that we had discussed throughout the meeting. Included in this contract would be agreed upon steps that Jared would take to avoid any further disruptions in any of his courses. It was agreed that he would come to my office Monday after class to sign the agreement.[/highlight] Throughout the meeting Jared held himself very rigidly and smiled overtly at inappropriate times. I am scheduled to meet with EEO this afternoon as to the best way to proceed.
Pg 41





After reading the campus police reports, it is obvious that Loughner developed a relationship with one of the officers.





I now see a college that worked to help Loughner obtain his education and to help him out personally. Schools work with troubled kids all the time. It wasn't until the end of Loughner's time at PCC that the college developed concerns about Loughner's mental health. How did they deal with that? The dealt with that by getting permission from Loughner so that they could talk with his parents. Loughner signed a release allowing the college to discuss Loughner with his parents with Loughner and privately.





Based on what I read, (I fully acknowledging that I wasn't there on the campus), I think that the college felt that they helped Loughner to the best of their ability and in a compassionate manner. They asked Loughner if he had a support network and spoke repeatedly with Loughner's family. This is much, much more than many schools would do. There is no indication that the campus police or administration viewed him as a threat to the college until they saw his youtube. Their response was to talk with Loughner and his parents together and Loughner's dad in private. They also encouraged Loughner to seek mental health treatment.





I completely understand why the college did not initiate an investigation that might result in involuntary confinement; the campus thought they had addressed Loughner''s needs as best they could through their repeated interactions with his parents.







[quote name=LM K][quote name=TexasFilly][link]I haven't read,http://www.thefogbow.com/forum/viewtopic.php?p=207983#p207983[/link] anywhere that Loughner's parents ever tried to get him any mental health care. That doesn't mean they didn't, but I would think after he was not permitted to return to college, coupled with their own observations of his behavior, that might have been a time when they certainly could have sought help. I'm not saying this in any way absolves PCC, but I still wonder where the parents were in all of this. We know all too well that it is difficult to get mental health intervention for an adult child, but it seems in AZ it is a bit easier than in most places.




When Loughner met with the psychic when he was 16, he told her that he was receiving treatment for depression. What kind of help is unknown.




[quote name=cbreitel][quote name=LM K]


[link]I read some,http://www.thefogbow.com/forum/viewtopic.php?p=208135#p208135[/link] more on PCC and their experience with Loughner. I don't see a lazy campus. I see a campus that worked hard with Loughner; harder than many colleges do. I really don't know who you are referring to when you say "these people". The mandatory reporting laws often differ when dealing with adult students. In fact, federal law makes it possible for schools to be sued for discussing anything with anyone about a student unless there is an emergency; when PCC reached out to the local police, the police told them that Loughner's behavior didn't warrant their involvement.







Not sure how you are reading various things into my very simple point here. I never said PCC was a "lazy campus" although I can tell you as a former student that there are many other reasons not relevant here why that could be an accurate description of it. The reason I suspect he was not reported for involuntary commitment is laziness. PCC would have to get their attorneys to prepare the application, support it with evidence, and then pursue it in court, which is a hassle and a pain in the ass for them. Instead, they essentially just told him to go away and stay away, which was a lot easier. For the public, that was literally a fatal decsion.





I think it's extremely clear from my original post who I'm referring to with "these people."





I don't see the point behind getting bogged down in your attempted defense of PCC. I have questions, based on my suspicions that poor decisions may have been made. There will be a time and place for those questions to be pursued, and a process to sort out the facts. With time, we will have answers. Right now, we don't.





Based on what I read, (I fully acknowledging that I wasn't there on the campus), I think that the college felt that they helped Loughner to the best of their ability and in a compassionate manner. They asked Loughner if he had a support network and spoke repeatedly with Loughner's family. This is much, much more than many schools would do. There is no indication that the campus police or administration viewed him as a threat to the college until they saw his youtube.





That's the problem. They perceived a threat, and expelled him.





Their response was to talk with Loughner and his parents together and Loughner's dad in private. They also encouraged Loughner to seek mental health treatment.





I completely understand why the college did not initiate an investigation that might result in involuntary confinement; the campus thought they had addressed Loughner''s needs as best they could through their repeated interactions with his parents.





Loughner's needs? I think this is where you are missing the issue. What about the community's needs? The 19 families whose loved ones were shot, some to death, will want to know where THEIR safety was taken into consideration by PCC, as it decided what to do about this man who was so mentally unstable and threatening that he had to be banned from campus. This isn't over and won't be for a long time.







[quote name=kimba]
[link]Loughner's needs? I,http://www.thefogbow.com/forum/viewtopic.php?p=208203#p208203[/link] think this is where you are missing the issue. What about the community's needs? The 19 families whose loved ones were shot, some to death, will want to know where THEIR safety was taken into consideration by PCC, as it decided what to do about this man who was so mentally unstable and threatening that he had to be banned from campus. This isn't over and won't be for a long time.





I think the conversation needs to center around - when do the needs/ rights of the many outweigh the needs/rights of a single person. I will be interested to follow whether PCC did everything they were legally allowed to do, if not, why not. If so, should we consider changing the laws? This is slippery ground when we start talking about institutionalizing people against their will or without their consent. Or labelling them in law enforcement in a way that may or may not be fair. I look forward to the conversation about lots of things - mental health, privacy rights vs. public safety, gun purchase control etc.





Have we had an update on Gabby since she moved to the rehab facility?







[quote name=LM K][quote name=cbreitel][quote name=LM K]


[link]I read some,http://www.thefogbow.com/forum/viewtopic.php?p=208221#p208221[/link] more on PCC and their experience with Loughner. I don't see a lazy campus. I see a campus that worked hard with Loughner; harder than many colleges do. I really don't know who you are referring to when you say "these people". The mandatory reporting laws often differ when dealing with adult students. In fact, federal law makes it possible for schools to be sued for discussing anything with anyone about a student unless there is an emergency; when PCC reached out to the local police, the police told them that Loughner's behavior didn't warrant their involvement.







Not sure how you are reading various things into my very simple point here. I never said PCC was a "lazy campus" although I can tell you as a former student that there are many other reasons not relevant here why that could be an accurate description of it. The reason I suspect he was not reported for involuntary commitment is laziness. PCC would have to get their attorneys to prepare the application, support it with evidence, and then pursue it in court, which is a hassle and a pain in the ass for them. Instead, they essentially just told him to go away and stay away, which was a lot easier. For the public, that was literally a fatal decsion.





I think it's extremely clear from my original post who I'm referring to with "these people."




Sorry, but it isn't clear. I went through your posts just now, all the way back to the 14th. You talk about the college but not whom or what department at the college was supposed to report Loughner. That was a question I asked you.





Yes, PCC did speak to their legal department about Loughner and acted on their legal department's advice.





I don't see the point behind getting bogged down in your attempted defense of PCC. I have questions, based on my suspicions that poor decisions may have been made. There will be a time and place for those questions to be pursued, and a process to sort out the facts. With time, we will have answers. Right now, we don't.





Based on what I read, (I fully acknowledging that I wasn't there on the campus), I think that the college felt that they helped Loughner to the best of their ability and in a compassionate manner. They asked Loughner if he had a support network and spoke repeatedly with Loughner's family. This is much, much more than many schools would do. There is no indication that the campus police or administration viewed him as a threat to the college until they saw his youtube.





That's the problem. They perceived a threat, and expelled him.





I find purpose to this conversation. When we target blame on one institution, we automatically take our attention away from other alternate possibilities. I discuss PCC because it is the organization you blame and because I think you do so unfairly. That is my opinion and not stated as fact. I have attempted to explain how students like Loughner are dealt with within the community college setting because I think that helps us all learn more about this entire situation and how the involuntary commitment process in Az, while progressive, is flawed. I find purpose in that as well because it helps focus us all on what can colleges and communities do differently to help those like Loughner in an attempt to prevent these kinds of events occurring again.





If you don't find value in the conversation, you don't have to respond.





Their response was to talk with Loughner and his parents together and Loughner's dad in private. They also encouraged Loughner to seek mental health treatment.





I completely understand why the college did not initiate an investigation that might result in involuntary confinement; the campus thought they had addressed Loughner''s needs as best they could through their repeated interactions with his parents.





Loughner's needs? I think this is where you are missing the issue. What about the community's needs? The 19 families whose loved ones were shot, some to death, will want to know where THEIR safety was taken into consideration by PCC, as it decided what to do about this man who was so mentally unstable and threatening that he had to be banned from campus. This isn't over and won't be for a long time.





If only we all had foresight.





I wasn't referring to Loughner's needs now. I was referring to them for the past 2 years, ending with them over 2.5 months ago. You know that.





As I mentioned; the vast, vast majority of those with mental illness are not violent.





I'm not stupid, cbreitel. I lived through the Thurston High School shooting. News of the shooting broke just as I was walking into class. I broke the news to my class. I had students with siblings and nieces/nephews at Thurston. I knew students at Thurston at the time of the shooting. My community has lived through a mass shooting. I also lived in Littleton, CO, working with middle-schoolers and high-schoolers. I was no longer living in CO when the Columbine shooting occurred. But the students that I worked with were students at Columbine when the shooting occurred.





So yes, I think there is value to this conversation. But I shall drop it with you and move it elsewhere because I mean you no harm or offense.





I am so sorry that this shooting occurred and that it occurred near you. I think we all feel that way.

User avatar
LM K
Posts: 8257
Joined: Fri Jan 23, 2009 5:59 pm

Mental Health Issues Raised by the Loughner Shooting

Postby LM K » Mon Jan 31, 2011 2:59 am

PART 2








[quote name=A Legal Lohengrin][quote name=cbreitel][link]PCC would have,http://www.thefogbow.com/forum/viewtopic.php?p=208242#p208242[/link] to get their attorneys to prepare the application, support it with evidence, and then pursue it in court, which is a hassle and a pain in the ass for them. Instead, they essentially just told him to go away and stay away, which was a lot easier. For the public, that was literally a fatal decsion.




To retain attorneys, or deploy ones already retained, costs money. If PCC chose not to pursue this action, it was probably due to lack of money, a lack of money which was deliberately created by the Grover Norquist "drown the baby in the bathtub" theory of government, which killed New Orleans and is currently killing the country.







[quote name=Whatever4]
[link]I find purpose,http://www.thefogbow.com/forum/viewtopic.php?p=208245#p208245[/link] to this conversation. When we target blame on one institution, we automatically take our attention away from other alternate possibilities. I discuss PCC because it is the organization you blame and because I think you do so unfairly. That is my opinion and not stated as fact. I have attempted to explain how students like Loughner are dealt with within the community college setting because I think that helps us all learn more about this entire situation and how the involuntary commitment process in Az, while progressive, is flawed. I find purpose in that as well because it helps focus us all on what can colleges and communities do differently to help those like Loughner in an attempt to prevent these kinds of events occurring again.





It's a tough no-win situation, as a few members of my family are finding out. A relative of mine spent last night in the ER sleeping off a dangerous level of alcohol, second time this year. (He's college-age in a college town, although he's not IN college.) His mother and grandmother kept insisting to the police and the ER docs that the kid has mental issues and needs to be evaluated. These women are experts on the state mental health system: one is on the board of the state mental hospital, the other is just frikkin' nuts, and both have experience with a sibling/child's schizophrenia. The pros just said that college kids get drunk and need to sleep it off.





If he won't get help, he can't be forced. If he does get violent, people will blame the family for not doing anything. But the family can't really do anything unless he agrees to it. At least if someone is in college, there's resources available and people who interact with the student on a regular basis. For the vast population of kids living in their parents' basements, there's not even that.







[quote name=TollandRCR][quote name=Whatever4]...[link]At least if,http://www.thefogbow.com/forum/viewtopic.php?p=208246#p208246[/link] someone is in college, there's resources available and people who interact with the student on a regular basis. For the vast population of kids living in their parents' basements, there's not even that.

This probably overstates both the resources that colleges have for dealing with mental health issues and the lilelihood that there would be knowledgable people who would regularly interact with the student. It is probably better for kids who are in college, but it is by no means adequate. This is a problem that is too big for the colleges to solve even for their own students. It takes a level of sense and sensibility that is not obvious in this society at this time.







[quote name=LM K][quote name=A Legal Lohengrin][quote name=cbreitel][link]PCC would have,http://www.thefogbow.com/forum/viewtopic.php?p=208268#p208268[/link] to get their attorneys to prepare the application, support it with evidence, and then pursue it in court, which is a hassle and a pain in the ass for them. Instead, they essentially just told him to go away and stay away, which was a lot easier. For the public, that was literally a fatal decsion.




To retain attorneys, or deploy ones already retained, costs money. If PCC chose not to pursue this action, it was probably due to lack of money, a lack of money which was deliberately created by the Grover Norquist "drown the baby in the bathtub" theory of government, which killed New Orleans and is currently killing the country.




If you look at the records I linked to, you will see documents from the college in which the refer to talking with their attorneys. Seeing that anyone could have submitted the court paperwork, I don't see this as a reason for not submitting paperwork. Anything is possible though. FSM knows that our educational system is near bankruptcy throughout the entire nation.







[quote name=LM K][quote name=Whatever4]
[link]I find purpose,http://www.thefogbow.com/forum/viewtopic.php?p=208269#p208269[/link] to this conversation. When we target blame on one institution, we automatically take our attention away from other alternate possibilities. I discuss PCC because it is the organization you blame and because I think you do so unfairly. That is my opinion and not stated as fact. I have attempted to explain how students like Loughner are dealt with within the community college setting because I think that helps us all learn more about this entire situation and how the involuntary commitment process in Az, while progressive, is flawed. I find purpose in that as well because it helps focus us all on what can colleges and communities do differently to help those like Loughner in an attempt to prevent these kinds of events occurring again.





It's a tough no-win situation, as a few members of my family are finding out. A relative of mine spent last night in the ER sleeping off a dangerous level of alcohol, second time this year. (He's college-age in a college town, although he's not IN college.) His mother and grandmother kept insisting to the police and the ER docs that the kid has mental issues and needs to be evaluated. These women are experts on the state mental health system: one is on the board of the state mental hospital, the other is just frikkin' nuts, and both have experience with a sibling/child's schizophrenia. The pros just said that college kids get drunk and need to sleep it off.





If he won't get help, he can't be forced. If he does get violent, people will blame the family for not doing anything. But the family can't really do anything unless he agrees to it. At least if someone is in college, there's resources available and people who interact with the student on a regular basis. For the vast population of kids living in their parents' basements, there's not even that.




That is horrible, W4. I am so sorry; I hope this relative gets help.





I wish I could say that I was surprised by your family's experience, but I am not. Docs know that the late teens and early 20's is the window in which mental illness manifests itself. I could understand the docs if the kid just came in with friends and they didn't have reason to even consider mental illness. But good grief; 2 family members with mental health experience get blown off as their son/grandson is in full-blown alcohol poisoning for the 2nd time?!





Even if there weren't beds in the psych unit, the staff could have tried to give your family members info to help get the kid plugged into some kind of system.





This probably overstates both the resources that colleges have for dealing with mental health issues and the lilelihood that there would be knowledgable people who would regularly interact with the student. It is probably better for kids who are in college, but it is by no means adequate. This is a problem that is too big for the colleges to solve even for their own students. It takes a level of sense and sensibility that is not obvious in this society at this time.





Exactly. I swear there are times when I feel like the only reason I hold office hours is to give mental health referrals to local low-cost clinics for students or their family members (or help getting food stamps, medical care, etc, etc). I think that many faculty are finding themselves in this position. There was a time when you could look up a phone number for the college counseling center or health center and send a student on their way knowing that they would be seen; hell, there was a time when you could walk a student to the counseling center/ health center knowing they would be seen. Not anymore.





Universities are definitely better equipped to help students with their mental and other health needs. But every state is cutting funding for higher ed, as well as cutting funding to health/mental health services provided by the state. Colleges are seeing a huge spike in the number of mentally ill students who are attending college, mostly because students have better medications which helps them function at first. Then the stress of college hits and they start to spiral.





Damn; I love my job but hate the system.







[quote name=TollandRCR][quote name=LM K]...


[link]Universities are definitely,http://www.thefogbow.com/forum/viewtopic.php?p=208289#p208289[/link] better equipped to help students with their mental and other health needs. But every state is cutting funding for higher ed, as well as cutting funding to health/mental health services provided by the state. Colleges are seeing a huge spike in the number of mentally ill students who are attending college, mostly because students have better medications which helps them function at first. Then the stress of college hits and they start to spiral.





Damn; I love my job but hate the system.

This is empirically documented in several ways, [link]one of which I reported above,http://www.thefogbow.com/forum/viewtopic.php?f=55&t=5215&p=207352&hilit=mental+health+suicide#p207352[/link]. That report of a rising incidence of mental illness was based upon self-reports, so it is admittedly not the same as a set of professional diagnoses. However, I take those data seriously. There may be a few students who are reporting their mental health to be less than satisfactory who are, in fact, perfectly fine and experiencing ordinary transitional anxieties such as being homesick. However, I would wager that those numbers underestimate the incidence of mental illness, because many psychoses are not perceived as such by the person who is ill. There is independent confirmation that about 25% of our students enter college while being on prescribed psychoactive medications such as Ritalin or Adderall, anti-depressants, and/or tranquilizers. This creates a community mental health problem that is beyond our capacity to address in the colleges and universities. We are not the fix for problems that began at home.





I believe that the problem is deeper than a simple lack of funding for mental health services. However, I can only voice my suspicions. Those suspicions involve less parental attention and less skill in parenting, dysfunctional, often poor single-parent families, serial marriages and partnerships, enormous achievement stress on both students and their families, the absence or weakness of communities such as extended families and functional neighborhoods, the prevalence of drugs in the society, and perhaps even changes in the biological and physical environment. I also put some blame on reality. The last ten years have been traumatic: 9/11, two very long wars, economic catastrophe, and a string of events like that which occurred at the Safeway in Tucson. I don't think our kids ignore the violence that has happened at public schools, colleges, churches, clinics, and museums around the country over the past decade, although they may shove their awareness down deep inside. This is exacerbated by a culture in which bad news and lying news travels unimpeded into the cell phones and computers of our kids. Conspiracy theory has become a big business, and it vomits up powerful memes like those of Zeitgeist. (You might be surprised to learn how many students have watched that video and believe it to be truth-bearing.) Frankly, I would not like to be 13 or 18 or 21 at this time. For that matter, I suspect being 50 is not all that easy.





I don't have a solution. I do think that there is enormous power in showing people, including our kids, that we love and respect them. There is power in providing examples for how a good life can be lived. There is power in simply listening to each other. There is power in random acts of kindness. These are not political or even economic issues; they are human issues. They are issues that require us not to be so self-absorbed and selfish.





On The Fogbow and Politijab we are missing the kids. There are those of us who interact often with a lot of them, but we don't hear from the kids themselves on these forums. Perhaps we should turn more of our attention to the people around us and spend more time with those we love. Orly Taitz and her noxious ilk do not matter, but what happens in our homes and public schools does matter. A lot less cynicism, a lot less hatred and fear, a lot less coarseness and incivility, and a great deal more openness and tolerance would or maybe only could make a difference. Have you noticed how, when things are tough, Foggy turns to his boys? More of us could do more of that. There is nothing of more importance than our kids. If they don't make it into healthy adulthood, we won't make it as a people.







[quote name=AuBricker][quote name=Whatever4][link]It's a tough,http://www.thefogbow.com/forum/viewtopic.php?p=208358#p208358[/link] no-win situation, as a few members of my family are finding out. A relative of mine spent last night in the ER sleeping off a dangerous level of alcohol, second time this year. (He's college-age in a college town, although he's not IN college.) His mother and grandmother kept insisting to the police and the ER docs that the kid has mental issues and needs to be evaluated. These women are experts on the state mental health system: one is on the board of the state mental hospital, the other is just frikkin' nuts, and both have experience with a sibling/child's schizophrenia. The pros just said that college kids get drunk and need to sleep it off.




I once had a similar experience as a public school teacher. One of my students was a wonderful child whose mother, I learned from another educator, had been raped and murdered a number of years earlier. In the middle of the school year, this girl began acting strangely. She would one moment talk to me as if I were her boyfriend, and the next moment react with extreme hostility. I took her aside when it became apparent that this unsuitable behavior was long term, and asked her to explain, but she said nothing. Later, one of her friends approached me and told me what was happening. I was informed that the girl was having intense dreams featuring me. These dreams were erotic and often violent. In them, the girl sometimes suffered the fate of her mother.





I immediately took action. I requested that the girl be placed in another class, and I asked the school psychologist to meet with her. Neither request was granted. I personally intervened with the psychologist and pleaded for her to meet with the student, arguing that the child was discovering her sexuality, and her path to discovery was warped by her mother's untimely demise. The psychologist turned me away, saying the girl was "a frigging idiot."










[quote name=A Legal Lohengrin][quote name=LM K][quote name=A Legal Lohengrin][quote name=cbreitel][link]PCC would have,http://www.thefogbow.com/forum/viewtopic.php?p=208386#p208386[/link] to get their attorneys to prepare the application, support it with evidence, and then pursue it in court, which is a hassle and a pain in the ass for them. Instead, they essentially just told him to go away and stay away, which was a lot easier. For the public, that was literally a fatal decsion.




To retain attorneys, or deploy ones already retained, costs money. If PCC chose not to pursue this action, it was probably due to lack of money, a lack of money which was deliberately created by the Grover Norquist "drown the baby in the bathtub" theory of government, which killed New Orleans and is currently killing the country.




If you look at the records I linked to, you will see documents from the college in which the refer to talking with their attorneys. Seeing that anyone could have submitted the court paperwork, I don't see this as a reason for not submitting paperwork. Anything is possible though. FSM knows that our educational system is near bankruptcy throughout the entire nation.




Yes, and doing so could subject the college to a highly expensive civil rights lawsuit. It is not as if filing the paperwork to commit some guy is necessarily the end of the legal proceedings. The guy you file this paperwork against could very easily sue you for doing so, under 42 U.S.C.S. § 1983. Many state officials might choose to avoid such liability.

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Mental Health Issues Raised by the Loughner Shooting

Postby TollandRCR » Mon Jan 31, 2011 8:55 am

Thanks for starting this thread and doing to work to compile pertinent messages, LM K.I sincerely hope that the school "psychologist" to whom AuBricker referred was not actually a trained psychologist but instead somebody with a four-year "guidance counselor" degree. Although I'm sure the problem is worse at the K-12 level, this could also happen in the colleges and universities. There is a shortage in colleges and universities of people with the actual psychological and psychiatric training that is needed to provide badly-needed crisis services.

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Postby Whatever4 » Mon Jan 31, 2011 11:38 am

What's the state of peer-to-peer counseling at colleges?

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Postby TollandRCR » Mon Jan 31, 2011 1:33 pm

What's the state of peer-to-peer counseling at colleges?

Decidedly mixed at my university. Some of our cultural centers, such as the African-American and Asian-American centers, offer peer counseling, although it is far more oriented towards academics than it is towards life crises. A problem is that male African-American students will not readily seek counseling for emotional matters or sometimes even for matters of personal relationships; this is not unique to the universities. The GLBT community has the Rainbow Center where students meet in safety, and some faculty have been trained and certified as "Allies" to provide immediate counseling (even to provide a place of refuge). Our Women's Center provides peer support services, and too often rape and date rape are the subject of the services. Physical abuse is also a problem, as it is for women all over the nation. I don't think there is any equivalent of the Women's Center for male students, and it is of course from male students where we have most often seen violence emerge. We used to have a suicide prevention center and hotline with a professional director and sort-of-trained student volunteers, but it is gone. There is also peer and professional counseling for alcohol and substance abuse. Undergraduate Residence Advisers are supposed to provide first-stage counseling; the great majority of our students lives on campus, and the RA's may be important.For a while, the University thought of itself as a small town offering a full range of small-town services, including qualified psychiatric services and a small ward. Now we have that offered by medical school students and interns who drop by. Budget cuts were part of the reason, even though student suicides (both obvious and perhaps accidental) have risen. Faculty are briefed on how to manage disturbed students, up to walking them over to the student health center. Then the students might go into a queue that is weeks long after the initial crisis has been dealt with. We have three professionals in what used to be our Dean of Students office, now renamed. In general, the hometown physician is supposed to prescribe needed medications and monitor the patient, but when students come from all over the country, that is mostly a fiction. On a couple of occasions I have told students that they must contact their parents and ask for help. So far as I know, that actually happened once. I cannot legally discuss these matters with a student's parents, much less call them myself.Had Jared Loughner presented here with the same complaints from teachers and students, and the same record with campus police, I am not at all sure that anyone would have done anything differently than did Pima Community College. At best, the student might have been referred to a tiny psychiatric hospital down the road that is a remnant of the state mental hospital system. Ironically, an old state psychiatric hospital, which is in town, was gifted by the state to the University as a white elephant; many of those buildings will be demolished when there is money to do that. Even the water supply system in that zone of the town is contaminated from years of neglect; the University has to buy bottled water. In fact, the water fountains in my own building have been shut off for years.I do not think that we have allocated the necessary resources or made the administrative commitment to care for our disturbed students. Another tragedy could be developing here. However, I suspect that is true of almost every campus in this country. We have not yet chosen as a society to deal with mental illness in any serious way; "in pills we trust." We look away from the mentally ill and disturbed; we do not offer proactive services.My syllabi always include a page of phone numbers for students seeking help of various kinds. I have no idea whether any student has ever found that page helpful.

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Postby listeme » Mon Feb 07, 2011 9:11 pm

I plan to take part in this thread. I know it's quiet now, but that's fine :) Right now I'm trying to determine how much exposure I'm comfortable with. As I've mentioned, I have personal experience and I think some of my experience would be useful and informative. I'm just trying to figure out the level that is right.But I will take part.
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Mental Health Issues Raised by the Loughner Shooting

Postby poutine » Thu May 19, 2011 5:37 pm

The Arizona Republic of Phoenix has obtained and posted a large volume of emails involving Loughner, including emails to and from him personally, on its website. Sampling a few of them, you get a sense of what his teachers and administrators were dealing with prior to the shooting.





Available [link]here,http://azdatapages.com/datacenter/jared-loughner-emails.html[/link].

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Mental Health Issues Raised by the Loughner Shooting

Postby verbalobe » Thu May 19, 2011 8:27 pm

The Arizona Republic of Phoenix has obtained and posted a large volume of emails involving Loughner, including emails to and from him personally, on its website. Sampling a few of them, you get a sense of what his teachers and administrators were dealing with prior to the shooting.





Available [link]here,http://azdatapages.com/datacenter/jared-loughner-emails.html[/link].

Thank you for posting. Only 1/4 of the way through, heartbreaking. I am in tears. A broken boy, and I assume a typical, and reasonably highly functioning administrative community, with people who cared and worked to care, in a situation where caring alone, unfortunately, was probably never going to forestall events. But who could know?

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Mental Health Issues Raised by the Loughner Shooting

Postby TollandRCR » Thu May 19, 2011 9:15 pm

The Arizona Republic of Phoenix has obtained and posted a large volume of emails involving Loughner, including emails to and from him personally, on its website. Sampling a few of them, you get a sense of what his teachers and administrators were dealing with prior to the shooting.





Available [link]here,http://azdatapages.com/datacenter/jared-loughner-emails.html[/link].

Thank you for posting. Only 1/4 of the way through, heartbreaking. I am in tears. A broken boy, and I assume a typical, and reasonably highly functioning administrative community, with people who cared and worked to care, in a situation where caring alone, unfortunately, was probably never going to forestall events. But who could know?

I'm not much further along, but what I have missed so far is any effort by Pima C.C. to contact his parents. Of all the people in the world, they would ordinarily have been the most willing and able to help him. They could have provided the counselors and administration at the C.C. information that might have made everybody see things in a different light. They might have been able to persuade him to enter mental health care. (So far as I have read, nobody in the Pima C. C. counseling staff or administration ever broached the topic of seeking professional help for Jared.)





I recognize that there has been little indication that either parent would have been available to help their son. They seem to have totally withdrawn from their son's life, perhaps after painful experiences. I also recognize that privacy laws might have posed an insurmountable barrier to contacting the parents. However, that is a societal flaw, and it can be remedied.

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Postby listeme » Thu May 19, 2011 9:23 pm

I'm not sure they would have been able to do so until going through law enforcement channels. Last week one of my family members went for a practice GED test, and I was her ride. When she was done, I went in to find her and the test administrator had her results. The administrator couldn't discuss the results with me -- with my family member standing there giving verbal permission -- until my family member signed her permission. This was in Virginia.The three of us had a little chuckle over it.I happen to agree that this is a flaw in the privacy system and I hope very much that we can find some rational fixes.
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Mental Health Issues Raised by the Loughner Shooting

Postby verbalobe » Thu May 19, 2011 10:01 pm

The Arizona Republic of Phoenix has obtained and posted a large volume of emails involving Loughner, including emails to and from him personally, on its website. Sampling a few of them, you get a sense of what his teachers and administrators were dealing with prior to the shooting.





Available [link]here,http://azdatapages.com/datacenter/jared-loughner-emails.html[/link].

Thank you for posting. Only 1/4 of the way through, heartbreaking. I am in tears. A broken boy, and I assume a typical, and reasonably highly functioning administrative community, with people who cared and worked to care, in a situation where caring alone, unfortunately, was probably never going to forestall events. But who could know?

I'm not much further along, but what I have missed so far is any effort by Pima C.C. to contact his parents. Of all the people in the world, they would ordinarily have been the most willing and able to help him. They could have provided the counselors and administration at the C.C. information that might have made everybody see things in a different light. They might have been able to persuade him to enter mental health care. (So far as I have read, nobody in the Pima C. C. counseling staff or administration ever broached the topic of seeking professional help for Jared.)





I recognize that there has been little indication that either parent would have been available to help their son. They seem to have totally withdrawn from their son's life, perhaps after painful experiences. I also recognize that privacy laws might have posed an insurmountable barrier to contacting the parents. However, that is a societal flaw, and it can be remedied.

Another question -- which I think was discussed, at least theoretically, upthread -- is what anyone expected to happen once Loughner WAS 'safely' suspended and then expelled from campus. Was there or should there have been a 'hand-off' from campus police to community police, or from campus health services to community health services? (And certainly one might have expected the parents to have been members of such a chain of communication.) But there's no evidence in THIS material of such a procedure (which doesn't mean it doesn't exist).





Were procedures followed? Ignored? Did Loughner not yet trip some bright line of danger? Were responsible agencies underfunded?





In retrospect it seems like the school did most of what they should and could have done, given what we see of his condition and warning signs. And even so, his breakdown could easily have targeted them, rather than the Giffords gathering (neither better or worse than the other, of course -- just from the standpoint of 'self-preservation' the campus and its students were ultimately by no means safe).





Hindsight, and all that......





[edit]grammar[/edit]

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Mental Health Issues Raised by the Loughner Shooting

Postby poutine » Fri May 20, 2011 9:58 am

Can we identify which privacy laws we're referring to here? I understand laws that prevent the dissemination of information about academic performance, grades, etc. But I'm confused as to why that pertains to a law enforcement situation. Or a mental health situation. I also don't see a difference between reporting to law enforcement versus reporting to PCCPD. (Pima College police.) The PD is just like any other police agency. In effect, PCC did report Loughner to law enforcement, which alone had several reported encounters with him of disturbing behavior.

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Mental Health Issues Raised by the Loughner Shooting

Postby poutine » Fri May 20, 2011 10:20 am

By Feb. 2010, Loughner was not only scaring students and teachers (one student emailed her teacher to report that the scary and crazy person next to her was carrying a pocket knife), but PCC documented that he was talking about killing people. This was 11 months before the shooting.I don't see one reference to civil commitment during the entire on-going conversation among administrators. Nor do I see one consultation with legal counsel. They went so far as to check with the ATF if he had a gun record, but no legal consults and no talk of civil commitments. I am baffled.

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Postby listeme » Fri May 20, 2011 10:24 am

I have no idea about privacy re: law enforcement. I only know the constraints when it comes to keeping family in the loop.
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Postby esseff44 » Fri May 20, 2011 10:40 am

By Feb. 2010, Loughner was not only scaring students and teachers (one student emailed her teacher to report that the scary and crazy person next to her was carrying a pocket knife), but PCC documented that he was talking about killing people. This was 11 months before the shooting.I don't see one reference to civil commitment during the entire on-going conversation among administrators. Nor do I see one consultation with legal counsel. They went so far as to check with the ATF if he had a gun record, but no legal consults and no talk of civil commitments. I am baffled.

Educational institutions are so afraid of lawsuits that they will bend over backwards to avoid them. There is a tendency to blame the instructor for 'not being able to handle' the situation and minimize the danger some students pose to everyone else. This has led to the early retirement of a number of people I know. This college did a lot more than others have done. The laws work at cross purposes when it comes to involuntary commitment.

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Mental Health Issues Raised by the Loughner Shooting

Postby poutine » Fri May 20, 2011 10:57 am

By Feb. 2010, Loughner was not only scaring students and teachers (one student emailed her teacher to report that the scary and crazy person next to her was carrying a pocket knife), but PCC documented that he was talking about killing people. This was 11 months before the shooting.I don't see one reference to civil commitment during the entire on-going conversation among administrators. Nor do I see one consultation with legal counsel. They went so far as to check with the ATF if he had a gun record, but no legal consults and no talk of civil commitments. I am baffled.

Educational institutions are so afraid of lawsuits that they will bend over backwards to avoid them. There is a tendency to blame the instructor for 'not being able to handle' the situation and minimize the danger some students pose to everyone else. This has led to the early retirement of a number of people I know. This college did a lot more than others have done. The laws work at cross purposes when it comes to involuntary commitment.

Fear of lawsuits should be indicated by consultation of the law. I see no evidence of that. And I see no evidence of involuntary commitment being contemplated in the first place, as a good or bad idea, which was the only defense the public ever had against this ticking time bomb.

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Postby listeme » Fri May 20, 2011 11:13 am

but PCC documented that he was talking about killing people.

Where was this? (I may have missed it.)
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Postby poutine » Fri May 20, 2011 11:15 am

but PCC documented that he was talking about killing people.

Where was this? (I may have missed it.)

Check the 9/29/10 emails.

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Postby poutine » Fri May 20, 2011 11:22 am

Call Pima and ask why they didn't notify LE. I'm just speculating, based on what came out of VaTech that colleges can't just call the police about students if no crime's been committed.

They did call LE.





It is incorrect to state that police can only be called if an actual crime has been committed. No police chief in the nation would agree with that statement.





Since the Republic had to [link]haul Pima College to court,http://www.azcentral.com/news/articles/2011/05/18/20110518giffords-shooting-loughner-email-pima-college-republic.html[/link] to gain access to these emails, I doubt they will answer my questions over the phone. Questions are being asked though, rest assured.

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Postby listeme » Fri May 20, 2011 11:26 am

Feb 2010, Pima DPS contacted after student made very "strange" comments after another student read a poemin class, comments were completely out of context, talking about abortion, wars, killing people, and strappingbombs to babies"

IIRC this was discussion of a classmate's poem that had pro-choice elements to it (or that Jared interpreted it that way). I'm not saying his comments weren't bizarre or inappropriate.To be clear, I would make a distinction between the following two sentences: "Jared was talking about killing people" and "Jared was making making bizarre statements in poetry class about abortion, wars, killing people, strapping bombs to babies". I believe that both should be taken seriously, but they do not mean the same things to me.
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Postby esseff44 » Fri May 20, 2011 11:49 am




Call Pima and ask why they didn't notify LE. I'm just speculating, based on what came out of VaTech that colleges can't just call the police about students if no crime's been committed.

They did call LE.





It is incorrect to state that police can only be called if an actual crime has been committed. No police chief in the nation would agree with that statement.





Since the Republic had to [link]haul Pima College to court,http://www.azcentral.com/news/articles/2011/05/18/20110518giffords-shooting-loughner-email-pima-college-republic.html[/link] to gain access to these emails, I doubt they will answer my questions over the phone. Questions are being asked though, rest assured.

The police can be notified, but then what? I don't know about the laws in Arizona, but I know what happens here. After a 72- hour evaluation, the mentally deranged person is back on the street. The funding for treatment programs has been cut to shreds and there are very few options available. Relatives of mentally unstable people who watch them deteriorate are in an impossible situation.





[/break1]wikipedia.org/wiki/5150_%28Involuntary_psychiatric_hold%29]http://en.wikipedia.org/wiki/5150_%28In ... ic_hold%29

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Mental Health Issues Raised by the Loughner Shooting

Postby poutine » Fri May 20, 2011 12:13 pm

Feb 2010, Pima DPS contacted after student made very "strange" comments after another student read a poemin class, comments were completely out of context, talking about abortion, wars, killing people, and strappingbombs to babies"

IIRC this was discussion of a classmate's poem that had pro-choice elements to it (or that Jared interpreted it that way). I'm not saying his comments weren't bizarre or inappropriate.To be clear, I would make a distinction between the following two sentences: "Jared was talking about killing people" and "Jared was making making bizarre statements in poetry class about abortion, wars, killing people, strapping bombs to babies". I believe that both should be taken seriously, but they do not mean the same things to me.

That's if you isolate the statement from its context, which won't be the case when answers to these many questions will have to be answered by PCC. And even if you look at the lines you quote in isolation, they alone directly led to security being called. So what is the context of those comments? On 9/29/10, Diane Deskin emailed Lorraine Morales a memo with the title, "Quick summary of police contacts and behavior issues Jared Loughner." She then listed every instance she was aware of involving disturbing, dangerous, and scary behavior, including:

* Students in different classes have expressed concern, think he is "dark" and "creepy"* Feb 2010, Pima DPS contacted after student read a poem in class, comments were completely out of context, talked about abortion wars, killing people, and strapping bombs to babies. * 5/17/10: Instructor and chair call police because they felt intimidated and that a confrontation with JL could become physical. 6/3/10: Dean calls police. JL wrote "Mayhem Fest" at the top of his math exam. Students (yet again) report feeling uncomfortable.9/23/10: Instructor calls police. JL became loud and belligerent when he only got half credit for a late assignment. 9/29/10: Pima DPS finds youtube video in which JL talks about "torture by Pima College", genocide, illegal behavior, etc.



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