Time for 'If You See Something, Say Something' to Apply to Mental Health, Too

Many years ago before the deinstitutionalization of the nation’s mental hospitals, the Secret Service would visit the psychiatric facilities to find out if patients posed a threat to the President or any other elected officials.

In the mid-1970’s most states responding to court cases by incarcerated patients began the process of closing mental hospitals and returning patients to the communities so they could be in the “least restrictive” alternative. -- The safe haven for both the patients and the community was gone, replaced by “community mental health.” For some patients it has been a wonderful opening for a new life, for others homelessness without care.

Now living in the community, often with aging parents, these mentally ill patients are known to citizens of their community as “disturbed” or “crazy,” but the help needed is often far away.

A few years ago, my friend’s brother, in his thirties, was living with his aging parents. He was diagnosed as both developmentally disabled and schizophrenic. One day, he took a bus from Southern Maryland to Virginia and purchased a gun. Concerned, my friend, who is a school psychologist, called the local mental health center. Their response was they could do nothing about the gun purchase unless he committed a crime.

My friend and I were alarmed at what we saw as increasingly disturbed behavior (playing “monster” with the six-year-old neighbor girl and keeping pornography under his bed) as well as owning a gun. We decided to write a letter to the state’s Commissioner of Mental Health, the local police department and many state and federal elected officials. We provided “the parade of horribles” if something happened after they had been notified of his disturbing behavior as well as the gun purchase and they had continued to do nothing.

Suddenly, action was taken. A commitment paper was drafted to get an in-patient assessment. The assessment considered him a danger and today he resides in a group home where he is both cared for and monitored. There are no more guns, no more playing “monster” and no more collecting of pornography. He even takes his medication. He lives in the community without being a threat to the community.

In the mid- 1970’s a California court interpreted a law saying that mental health professionals had a “duty to warn” people if a patient made threats to a person or persons. The decision, called “The Tarasoff Decision” has put responsibility on professionals to take action when warranted.

No “duty to warn” action was taken with Jared Loughner. In mental health circles his behavior is often called a “leaky faucet,” a constant dripping that needs some attention.

Jared Loughner’s behavior was clear to his teacher, classmates and to the community college he attended. He was kicked out until a mental health professional certified that he was not a threat to himself or others. However, lacking “a duty to report,” nothing was mandated except to not let him attend school until the certification was received by the college.

What more do we need? The nation’s laws, while protecting individual liberty, need to reflect our times. “If you see something, say something” should extend to scary and threatening behavior. Laws to address verifiable reports from members of a community need to be passed so that lives, including those of alleged killer Jared Loughner, can be saved.

Ellen Ratner is an experienced mental health professional. She is currently Washington bureau chief for Talk Radio News Service and a Fox News contributor.