Experts say more money for mental health may not prevent mass killings

After mass shootings at each of those places came the questions of what role mental illness played and what reforms can be made to mental-health policy to prevent such shootings in the future.

It will be no different when the Arizona Legislature convenes today, as House Minority Leader Chad Campbell has already put forth a proposal to keep guns out of the hands of mentally unstable people and pump $161 million into the public-health system. But some mental-health advocates question whether new laws and more money is the answer.

Eddie Sissons, executive director of the Arizona Foundation for Behavioral Health, said the money would be welcome, but it wouldn’t necessarily be a preventive measure because it would go toward people who are already identified as mentally ill.

“I would argue that sometimes the folks that go out and shoot up places may not have been identified by the system yet,” Sissons said.

Jared Loughner, who wounded former U.S. Rep. Gabriel Giffords and 12 others and killed six people, including a 9-year-old girl and a federal judge, wasn’t diagnosed with schizophrenia until after the shooting. Reports are that Adam Lanza, the 20-year-old gunman in Newtown, Conn., where 20 children and six adults lost their lives, suffered from Asperger Syndrome, which isn’t considered a mental illness. And while the sanity of James Holmes, the shooter in Aurora, Colo., who killed 12 and wounded dozens of others when he opened fired during a midnight screening of “The Dark Knight Rises,” will be an issue in his murder trial, all indications are he wasn’t diagnosed before the shooting.

Charles Arnold, a mental-health law attorney whose lawsuit, Arnold v. Sarn, laid the groundwork for the treatment of seriously mentally ill people in Arizona, said the state already has a law that might have prevented the Giffords shooting.

Like other states, someone can be involuntarily committed for psychiatric treatment if the person is a danger to himself or others, but Arizona has an extra factor for committal called persistent and acutely disabled, or PAD.

A person with a severe mental disorder meets the definition if there is a “substantial probability” he will suffer a loss of reality if he isn’t treated and the person can’t make an informed decision about his treatment.

“What that says is you don’t have to wait until something bad happens in order for the state to have the authority to treat somebody involuntarily,” Arnold said.

Arnold said Pima Community College, which had banned Loughner for his bizarre and threatening behavior, could have used the PAD provision to “knock down a domino” that may have led to his being treated before the shooting.

Arnold said he’s been advocating around the nation and on national television interviews for states to adopt the extra standard for involuntary commitment.

Arnold suggested requiring at least a superficial mental health screening for students entering college because mental illness typically manifests between the ages of

18 and 24.

Attorney Ann Ronan, who is now the lead attorney in Arnold v. Sarn, which has been pending for 31 years, said a more effective approach might be to make sure support and services, rather than new laws, are available for people suffering from mental illness on college campuses.

She said there has been a spate of lawsuits on the East Coast involving students who allege they went into campus clinics to report they are suicidal and were then kicked out of school.

“If there’s going to be a change, it can’t be about law, it has to be about how the system actually operates,” Ronan said.

One of Campbell’s proposals stems from the 2009 suicide of 24-year-old Kristi Stadler, who shot herself in the chest a day after Phoenix police returned her gun, which they had confiscated after she had threatened to kill herself a few months before.

According to a legal judgment in favor of the Phoenix Police Department in U.S. District Court, police followed the law in returning the gun to Stadler.

“We need to limit access to firearms for people who are dealing with mental-health issues,” said Campbell, whose proposal will also seek to place new restrictions on firearms sales.

Campbell said he wants to make it so a person who has been voluntarily or mandatorily committed can’t buy a weapon or have it returned until the person has been deemed to no longer be a threat.

Rep. Heather Carter, a Cave Creek Republican, said she is planning to meet with Stadler’s father, Terry Stadler, to talk about possible legislation, but she is going to do her homework first.

Carter said she is not going to use the issue to politically grandstand.

One approach advocates agree has been successful in identifying mentally ill people is Crisis Intervention Training. The program coordinated by the Phoenix and Mesa Police departments trains officers to recognize mental illness, interact with the mentally ill and navigate their way through the public mental health system.

Phoenix police officer Nick Margiotta has been conducting the training for 10 years and said the key to success has been the cooperation police officers get from the mental-health system.

Police officers learn how to recognize when someone is having a mental crisis and how to divert the person when it is appropriate for treatment instead of jail, Margiotta said.

Probably half the people who police divert to the mental-health system aren’t “engaged,” meaning they haven’t been identified as mentally ill or, if they have been identified, aren’t getting treatment, Margiotta said.

Most of them also enter treatment voluntarily.

“Forty-five times a day in the Phoenix-metro area a cop is handing someone off to one of those three or four behavioral crisis centers,” Margiotta said. “What happens in that intervention, I don’t know. We’ve done the cop job, we’ve given them the chance to figure it out and hopefully they do.”