The Role of CIT in Preventing Violent Tragedies ~ NAMI

By Laura Usher
NAMI CIT Coordinator

The recent tragic shootings in Arizona have raised painful questions about what went wrong. And while we all think about how to prevent these tragedies in the future, it’s important to keep in mind the bigger picture. For many, this debate has been about guns and civil commitment laws, but the real culprit is a failing mental health system.

While media reports focus on the role of mental illness in this tragedy, incidents of violence by people living with mental illness are extremely rare, and the total contribution of people living with mental illness to violence in society is very small. This is the view of the U.S. Surgeon General and is supported by research.

Although research suggests that there are factors that may increase risks of violence – such as co-occurring substance use, or not being engaged in treatment – people living with mental illness are 10 times more likely to be victims of violence than perpetrators. Homelessness, incarceration and poverty increase these risks.

When violence does occur and mental illness is involved, we know that it’s a sign that something has gone terribly wrong with the mental health system--a person who desperately needed treatment could not access it.

Too often, when a person living with mental illness is in crisis, law enforcement are the first responders--not necessarily because the person is dangerous, but because there are often no alternatives. Sadly, people in crisis often can get more help from police than they can from the mental health system.

Because of this Catch-22, NAMI enjoys strong partnerships with law enforcement agencies and others in the criminal justice system around the country. These are some of our most valued partnerships, because law enforcement officers share our concerns about this broken system, and through involvement with crisis intervention team (CIT) programs, put their hearts into helping people in crisis navigate a flawed system.

Although it is impossible to know, it is unlikely that a CIT program could have prevented the Arizona tragedy. But that does not leave NAMI and its many partners in criminal justice without a role moving forward. Preventing these tragedies will take all of us working together.

First and foremost, states need to stop cutting mental health services and instead support evidence-based, integrated (with substance abuse) services for people living with mental illness. Early identification and intervention strategies, as well as joint planning between law enforcement, mental health providers and schools, can link people with the services they need.

CIT is a model for communities because it is not just a one-time training to put a band-aid on the problem, rather it builds partnerships that work to improve the systems that serve, or should serve, people living with mental illness. Successful CIT programs often serve as springboards for broader efforts, including advocacy by judges, chiefs and sheriffs in support of community mental health services; the creation of mental health courts and other programs that use the power of the criminal justice system to get people treatment, not jail time; and efforts to reach out to schools and young families in the form of CIT for Youth. In all of these cases, partnerships prove to be a powerful force for systems change.

A violent tragedy, no matter how heart-breaking, does not change the course of our work, but it does give us an opportunity to evaluate how we can do more. Our criminal justice partners around the country can help us to prevent these tragedies in the future by continuing to stand with NAMI in support of stopping the cuts to mental health services.

To learn more about cuts to mental health services, read our report,State Mental Health Cuts: A National Crisis at www.nami.org/budgetcuts.

Kentucky Teen Charged With Murder in Death of His Guardians

The report states the trouble teen was frequently suspended from school. I wonder if the school ever ask to have him evaluated for a underlying mental illness and perhaps some needed supports to stay in school? If his Mother couldn't deal with his behavior and his father is in prison ... did the lack of appropriate evaluations/treatment set this young man up for a life behind bars? Will he receive a mental health evaluation in prison?

Another sad case. One that no one will ever know the real truth.
Read more here:
http://www.foxnews.com/us/2011/03/23/kentucky-teen-charged-murder-death-guardians/

Pacific NW | Eleanor Owen's tireless battle for mental-health care | Seattle Times Newspaper

Pacific NW | Eleanor Owen's tireless battle for mental-health care | Seattle Times Newspaper
what an incredible journey ~

“Mental Defectives” HB 308: Taking Action on Funds - Not Guns Would be the REAL Difference Maker

By Kelly Gunning

The Kentucky House of Representatives voted 97-1 on Monday in favor of House Bill 308; a bill proposed by Representative Bob Damron. The measure would require Kentucky to report to the FBI when a person is committed, by a court, to a mental institution or if they have been declared mentally ill by a court. Federal law, in terribly offensive language, prohibits the sale of guns to individuals “adjudicated as a “mental defective or who have been committed to a mental institution” - previously; Kentucky had been one of many states that did not participate in this notification process. One can’t help but think that the recent shootings in Arizona contributed to the passage and proposal of this bill. The issues that present themselves in these high profile, mass shooting, incidents deserve our sharpened focus on preventing future tragedy but they are also complex and represent crucial, sensitive and long-standing questions that we as a society must grapple with while trying to balance individual liberty, privacy and public safety. It is impossible to eliminate all risks - even logical risks and easy to resort to reactionary policy making. The truth is; we can expect more tragedy’s like Arizona and Virginia Tech whether there is beefed up law enforcement, more lists and more reporting. More of those things will not change the course of these recurrent tragic events. The only thing that would impact this discourse in a positive way would be – MORE TREATMENT for severe and chronic mental illness. Recent reports in the last two weeks by several leading news outlets highlighted reports that incoming college freshman are coming in with higher rates of mental illness. It was reported that 63% of college freshmen self-identified as having some level of mental health issue. We also know that college age years are when many serious illnesses become apparent and require intervention and treatment for the first time yet there is little funding for early prevention diagnosis and prevention of these brain diseases – unlike the bombardment of info on STD’s , date rape and pregnancy.

We all shake our heads and claim disbelief when we observe what has become the normal deluge of reporting and commentary when a tragedy such as Arizona pulls the spotlight on to mental health issues in this country - we talk about it 24/7 - but then within a few days “the next big thing” happens, the rhetoric fades and with the exception of a few reactionary changes we move on…until it happens again and it will.
It will… because since the 1950’s there has been a 90% reduction in the number of available psychiatric hospital beds. We have gone from 1 bed for every 300 people to one bed for every 3000 people since 1950 to the present.
It will… because the criminal justice system is providing those “beds” and is overrun with and serving the psychiatric care needs of 2 million people.
It will… because we refuse to adequately fund community treatment and wrap around services like housing for folks early on in the course of their illness.
It will… because we cannot seek help for our mentally ill loved ones until they meet one very important criteria – DANGEROUSNESS.

To me, something is very wrong when the law voraciously protects my loved one’s right to be untreated and mentally ill to the point of dangerousness to himself and the community…but then doesn’t mind being quick to act on limiting other rights such as; being sure he can’t exercise his constitutional right to keep and bear arms. Guess they don’t mean THAT dangerous.


Kelly Gunning is operations director of the National Alliance on Mental Illness in Lexington.

Read the full story, (edited version here)...

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Read comments here on Kentucky.com: http://www.kentucky.com/2011/02/18/1640059/mental-health-treatment-ought.html#more#ixzz1EK9mNCHc

Steps to Keep the Mentally Ill from Buying Guns

By: Steven Mangine OP-ED for the Lexington Herald-Leader

Posted: 12:00am on Feb 13, 2011

For an alienated and unbalanced young college student, chronic misery is fast spiraling into violent desperation.

In the classroom, he laughs with no cause, stares, expounds bizarre numerological theories. He proclaims his college itself unconstitutional. A professor worries aloud that the young man could shoot up the classroom. When the institution finally dismisses him, he becomes still more agitated, sleepless, paranoid. He enters a Sportsman's Warehouse store and picks out a Glock 19 semi-automatic pistol.

The clerk calls in the required background check — usually cleared while the customer waits — and is told that this customer cannot buy a firearm. Officials at his college had petitioned a local judge to suspend his ability to buy a weapon, and the suspension was entered immediately into the federal database established by the Brady Bill.

A Jan. 8 "Congress on Your Corner" meeting in Tucson, Ariz., proceeds without incident.

Alas, the account above is fictional. No such procedure for preventing a mentally ill and dangerous person from buying a firearm actually exists.

On Nov. 30 of last year, Jared Loughner did purchase the pistol he used to kill six people and injure 14 others five weeks later. Three years before, Seung Hui Cho, despite a history of mandated mental health treatment, bought the Glock semiautomatic pistol that cut down 32 people at Virginia Tech University.

Despite multiple police contacts and obvious signs of mental illness, both Loughner and Cho bought their weapons legally. Clearly we need a procedure for preventing such individuals from buying firearms — the sooner, the better.

Many have blamed the Tucson disaster on a failure of the mental health system. After all, Loughner showed signs of mental disturbance and aggression so obvious and public one classmate always sat near an exit, poised to flee on the grisly day she knew was coming. Surely, the mental health system should have intervened, compelling treatment with or without his consent.

Unfortunately, in a free society, managing potentially violent mentally ill persons poses daunting legal and ethical dilemmas.

Some existing laws do attempt to balance the demands of public safety with the rights of mentally ill citizens. For example, a therapist must break confidentiality and inform the police if a client makes a direct threat against another person. Likewise, any citizen can petition a judge to authorize the involuntary hospitalization of a mentally ill person who presents a danger to self or others.

It is doubtful, however, that either of these legal options could have prevented Virginia Tech or Tucson.

Since neither Cho nor Loughner was in treatment just before the shootings, no therapist had any information to disclose. Pima Community College could have petitioned for Loughner to be hospitalized against his will. But legal standards for involuntary hospitalization require not only bizarre behavior or verbal aggression, but a clear threat of harm to self or others. It is unlikely either Cho or Loughner would have met that strict legal standard before their crimes.

The following relatively simple, twofold legal mechanism might have prevented both tragedies and a significant number of suicides, since research shows many firearm suicides are completed with newly purchased weapons:

■ Any citizen could petition a judge to suspend an apparently aggressive or suicidal person's right to buy a firearm. The potentially dangerous person would not have to be in treatment to be subject to this suspension.

■ Any licensed health care professional with reason to believe a patient posed a danger to self or others could enter an order to block firearm purchases directly into the federal database.

In either case, the affected person would have the right to challenge the suspension, via either a full psychological examination or a legal hearing.

This public safety measure seems as commonsensical as allowing a physician or a judge to suspend the license of a driver impaired by uncontrolled epilepsy or Alzheimer's disease. If you agree, spread the idea around.

It would certainly not prevent every potential tragedy, but it could buy precious time in many situations.

For some husband, wife, parent or friend, that could make the difference between a heart-rending loss and a near miss.

About the author Steven Mangine is a clinical psychologist practicing in Lexington and an adjunct faculty member in the University of Kentucky's department of psychology.

Read more: http://www.kentucky.com/2011/02/13/1633372/steps-to-keep-mentally-ill-from.html#more#ixzz1DswJQ1F

For additonal info about Rep. Bob Damron, D-Nicholasville; Gun Loophole Bill for those with mental illness click here:
http://www.lrc.ky.gov/record/11RS/HB308.htm
http://kyhealthnews.blogspot.com/2011/02/bill-filed-to-fill-gap-in-law-and-keep.html

Mental health care needs more champions in Kentucky

Read entire article in our "solution section", written by Bruce Scott, Interim executive director of Mental Health America of Kentucky. Thank you Mr. Scott.

State (of the union) of Mental Health, with Candy Crowley

Excellent program on today's CNN State of the Union. Check the website for more info and access in case you missed it. Click here to view the interviews with Pete Earley and Dr. Fred J. Frese.

Please forward this to every Federal or State public official you know. It's time to work together for change.