Disgraced Officer Pushed For Cruz Psych Eval in 2016

[Nithavela]

Officials were so concerned about the mental stability of the student accused of last month's Florida school massacre that they decided he should be forcibly committed. But the recommendation was never acted upon. A commitment under the law would have made it more difficult if not impossible for Cruz to obtain a gun legally.

Disgraced Officer Pushed For Cruz Psych Eval in 2016

 

[Ana the Ist]

Disgraced Officer Pushed For Cruz Psych Eval in 2016

Involuntary commitment is difficult to legally achieve. It's unfortunate that laws make it so that the subject has to nearly be on the cusp of harming themselves or others before they can be required to seek help.

I think it's partly because the Reagan administration gutted the mental health infrastructure, so sadly many people have nowhere to turn and end up only receiving treatment once they're incarcerated.

 

[LaSorcia]

It's unfortunate that laws make it so that the subject has to nearly be on the cusp of harming themselves or others before they can be required to seek help.

I find that quite a frightening statement. At what point would you rather that people be required to seek help?

 

[Ana the Ist]

I find that quite a frightening statement. At what point would you rather that people be required to seek help?

It's a tough call...and I don't claim to be a professional. I guess my main concern is for those suffering from paranoid schizophrenia. The very nature of that illness prevents those suffering from it from being able to self analyze their situation. Their family and friends are essentially left helpless and have little choice other than watching them slide further into their delusions until they're in imminent danger to themselves or others...and often it's too late then.

I think if perhaps two close family members request professional help for the subject, and have documented delusional behavior for a period of time (perhaps over a couple of weeks, or a month) then they should be able to commit the person involuntarily for at least a professional evaluation (say 48 hours).

That's my opinion anyway.

 

[LaSorcia]

It's a tough call...and I don't claim to be a professional. I guess my main concern is for those suffering from paranoid schizophrenia. The very nature of that illness prevents those suffering from it from being able to self analyze their situation. Their family and friends are essentially left helpless and have little choice other than watching them slide further into their delusions until they're in imminent danger to themselves or others...and often it's too late then.

I think if perhaps two close family members request professional help for the subject, and have documented delusional behavior for a period of time (perhaps over a couple of weeks, or a month) then they should be able to commit the person involuntarily for at least a professional evaluation (say 48 hours).

That's my opinion anyway.

Thank you for your honest answer. I am a professional in this area, and I'm also a libertarian. It's sometimes a tough call to make between the help needed and the help consented to.
There are several diagnoses that make it difficult for a care provider to decide what sort of help is ethically called for, and schizophrenia, paranoid type, is one of those.
I did have a client whom I had to involuntarily commit. Thank God, I had built enough rapport with this person that he decided to phone me just before he attempted suicide. I had to have him 302'ed, but it turned out well in the end.
I have ethical quandaries about to do in situations where a person is a potential danger to themself or others. On one hand, the law says that I am a mandated reporter. That part is easy enough to figure out (even though there are far too many health care professionals who don't disclose this to their clients); these are mandatory ethics. On the other hand, we have 'aspirational' ethics. How do I decide, without full disclosure from a client, when the or others are in danger? Codification of these internal processes are, in my mind, possibly helpful for an internal reference, but more potentially dangerous to both the practitioner and the client if misused.
Any professional who is required to follow a codified set of rules to the exclusion of their skilled judgment is just an automaton who memorizes a set of rules and doesn't know how to utilize their thinking skills like a human being should. The key here is 'skilled judgement', which, in my experience, universities don't want to invest the time or financial resources to teach, and after receiving professional qualifications, employers don't bother to.
In general, I ethically feel bound to err on the side of freedom for the the client and professional, even if it means some tragic results, rather than having a stringent set of rules that helping professionals must follow at the expense of giving real and genuine, if sometimes faulty, help.

 

[Ana the Ist]

Thank you for your honest answer. I am a professional in this area, and I'm also a libertarian. It's sometimes a tough call to make between the help needed and the help consented to.
There are several diagnoses that make it difficult for a care provider to decide what sort of help is ethically called for, and schizophrenia, paranoid type, is one of those.
I did have a client whom I had to involuntarily commit. Thank God, I had built enough rapport with this person that he decided to phone me just before he attempted suicide. I had to have him 302'ed, but it turned out well in the end.
I have ethical quandaries about to do in situations where a person is a potential danger to themself or others. On one hand, the law says that I am a mandated reporter. That part is easy enough to figure out (even though there are far too many health care professionals who don't disclose this to their clients); these are mandatory ethics. On the other hand, we have 'aspirational' ethics. How do I decide, without full disclosure from a client, when the or others are in danger? Codification of these internal processes are, in my mind, possibly helpful for an internal reference, but more potentially dangerous to both the practitioner and the client if misused.
Any professional who is required to follow a codified set of rules to the exclusion of their skilled judgment is just an automaton who memorizes a set of rules and doesn't know how to utilize their thinking skills like a human being should. The key here is 'skilled judgement', which, in my experience, universities don't want to invest the time or financial resources to teach, and after receiving professional qualifications, employers don't bother to.
In general, I ethically feel bound to err on the side of freedom for the the client and professional, even if it means some tragic results, rather than having a stringent set of rules that helping professionals must follow at the expense of giving real and genuine, if sometimes faulty, help.

I totally agree with you... it's a bit of a minefield to navigate. It's not for those who blindly follow guidelines laid down by others. I'm not a libertarian, but my personal politics have always had a heavy emphasis on personal freedoms. That said...

The issue here isn't one of the dangers of such a system as I proposed being abused. I've no doubt that in time, there would be cases where people were involuntarily committed for less than altruistic reasons. No system is perfect when it's run by people.

The problem we currently have is one where it's near impossible to get someone the help they desperately need if they don't want it. Paranoid schizophrenia, some of the more extreme levels of bipolar disorder, and some other conditions like anorexia can not only be dangerous to the person experiencing them....they can be dangerous to others. It's not just the case of the shooter in the OP....there have been others who clearly needed help and if it were possible to get them help, tragedy could have been avoided. Off the top of my head, the movie theater shooter in Colorado and the guy who shot the congresswoman in Arizona are also examples. Both of those subjects had to be heavily medicated for weeks if not months before they could even stand trial. Yet for some reason, it's not until they're headed somewhere with a gun to kill people that we can get them treatment against their will. It seems backwards to me. Perhaps the only way to change public opinion on tis would be to expand the legal definition of "not guilty by insanity"....And when more of these guys are found not guilty, the public will take notice.

Thank you, from the bottom of my heart, for the work you do. I've had personal experiences with friends and family who dealt with very serious mental disorders. I think people in your line of work don't always get the credit they deserve. You deal with the most vulnerable people in society...and they're often overlooked as helpless or hopeless, even though they need both. Thank you.

 

[LaSorcia]

The issue here isn't one of the dangers of such a system as I proposed being abused. I've no doubt that in time, there would be cases where people were involuntarily committed for less than altruistic reasons. No system is perfect when it's run by people.

The problem we currently have is one where it's near impossible to get someone the help they desperately need if they don't want it.

Potential system abuses and lack of access to care are definitely both problems.

Thank you, from the bottom of my heart, for the work you do. I've had personal experiences with friends and family who dealt with very serious mental disorders. I think people in your line of work don't always get the credit they deserve. You deal with the most vulnerable people in society...and they're often overlooked as helpless or hopeless, even though they need both. Thank you.

Thank you. I'm not working in the field at the moment. Sadly, I did see far too many instances of sloppy or inadequate care when I was counseling. One woman I worked with was on no less than 25 medications. All psychotropic meds! This is bad bad mental health care on so many levels.