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A Word from the President

January 21, 2011

Searching for Rationality in Tragedy

Dennis W. Felty
Dennis W. Felty, President, KHS

The shooting in Tucson has wounded all of us to some degree. Our hearts break for the lives lost and the suffering caused by the senseless violence. As individuals and as a nation, we are searching for answers in our need to understand why such a thing can happen in our society. Each day brings new arguments as to why Jared Lee Loughner ended the lives of six people and wounded fourteen others, including Representative Gabrielle Giffords. In the midst of the flurry of arguments and counterarguments over who or what is to blame, a troubling truth is emerging. There appears to be extensive evidence that 22-year-old Loughner was experiencing symptoms of a serious mental illness.

On the first day of class at Pima Community College where Loughner attended classes, one student wrote to a friend that another student in the class was so disruptive he scared her: “Hopefully he will be out of class very soon, and not come back with an automatic weapon.” Ten days later, she wrote, “…we have a seriously disturbed student in the class, and they are trying to figure out how to get rid of him before he does something bad, but on the other hand, until he does something bad, you can't do anything about him. Needless to say, I sit by the door.”

Eventually, officials at Pima Community College told Loughner's parents he could only return to class if he underwent a mental health evaluation. Classmates sent emails expressing their security concerns. Unfortunately, Loughner did not have a mental health evaluation and did not return to school.

We want to believe that there was a rational cause for the shootings. Perhaps in finding a cause, we think we may find some meaning in the tragedy and ultimately affirm a belief that life is not random. How do you make sense of such devastating pain and suffering when it is the product of a disruptive biological process, a mental illness? Although there is evidence that a constellation of books and movies fed Loughner's delusions, the core issue was a biological process that distorted his perception, his thinking and ultimately, his actions. The human intellect is a fragile balance of chemicals and biological processes and when disrupted or thrown off balance, the world and life experiences can become distorted in unpredictable ways.

Mental illness has been with us since the beginning of time, and it is likely that each of our families will be touched by some form of mental illness at some time in life. In almost all cases when there is effective diagnosis and treatment, the symptoms can be eliminated or at least minimized. Some of our most renowned leaders, artists and scientists have experienced mental illness. This group includes such names as: Isaac Newton, Ludwig van Beethoven, Abraham Lincoln, Vincent Van Gogh, Winston Churchill, Virginia Woolf, Jane Pauley, Judy Collins, Eugene O'Neill, Vivien Leigh, Ruth Graham, Brooke Shields, Howard Hughes and many more. Research is very clear, when looked at as an aggregate, that the occurrence of mental illness does not result in an increased incidence of violence beyond that which occurs in the general population. The circumstances of the shooting were an extremely rare occurrence where a disturbed mental process did result in unspeakable violence.

It can be a formidable task to get treatment for people encountering untreated mental illness, especially if they are not willing to get a voluntarily evaluation. In most states a person cannot be forced into treatment unless they are determined to be an imminent danger to themselves and others. Just because someone acts strangely, talks to themselves, speaks loudly or scares others doesn't mean they're an imminent threat to themselves or others. In Arizona, courts would have required two clinicians to evaluate Loughner and conclude that he was a danger to himself or others in order to begin the process of involuntary commitment to a mental health facility. This dilemma is a fine balance of individual rights and the best interests of society. We certainly do not want to head down the path where any of us who are a little odd are subject to involuntary treatment.

The recent shooting of innocents argues for a more timely and effective assessment and treatment of mental illness. We need to assure that there is ready access to assessment and treatment as soon as symptoms emerge. We know that seventy-five percent of all psychiatric disorders appear by the age of twenty-four and we know that early intervention and treatment is very effective and enduring. When children or adults first encounter symptoms of mental illness, effective treatment can be transformational and can be critical to both a good prognosis and a full recovery. We all share a common interest in assuring that the resources and political commitment is there when access to effective treatment is needed. However the reality is that according to the National Association of State Mental Health Program Directors, at least $2.1 billion has been cut from state mental health budgets over the last three years.

We are left with an understanding of how frail life really is and the very real pain and suffering that is the product of this inherent fragility. In recognizing this fragility, we must be committed to helping each other when that fragility emerges in our own lives or that of our neighbor.

Dennis


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