Jared Loughner: An Example of Our Broken Mental Health System?Jared Loughner, the accused shooter in the Tuscon, Arizona murders of 6 people and dozens of others wounded — including Congresswoman Gabrielle Giffords — apparently had some issues. What exactly those “issues” were, we may not know until he is properly examined by a mental health professional. But his YouTube videos, combined with descriptions of the last few months of his life, suggests something serious was going on.

I won’t play armchair psychologist here and make a diagnosis from afar. I think it’s a bit irresponsible when Kate Pickert and John Cloud writing over at TIME, suggest that among the 6 warning signs of mental illness, it includes things like smoking marijuana (sorry, this is not a sign of mental illness!), had five contacts with campus police (again, not a sign of mental illness), and he started scaring his friends (not included in any of the mental disorders symptom criteria I’m aware of).

The other signs of psychosis or schizophrenia — disorganized thoughts, paranoia — may indeed be signs of a mental illness. But we simply don’t know in Loughner’s case, because he was never seen by a mental health professional. They could also be signs of heavy drug or alcohol use… or something else altogether (like an undiagnosed brain tumor).

But I will point out that someone who repeatedly gets in trouble with others — teachers, school professionals, friends, and the law — because of erratic behavior suggests someone who is grappling with issues not well-understood by anyone. The problem is one we’ve seen before — nobody has the complete picture of the man. Everyone has these small interactions with him that suggest something is amiss, but how badly amiss? You can’t make a valid or reliable threat assessment if you only have 10% of the picture.

At some point, a mental health interview or intervention may have not only been warranted, but ultimately benefited Loughner, had one been ordered. But he hadn’t been ordered into treatment. It’s not clear if that was something strongly suggested. Given some of the reports of his alleged behavior at school, it seems like there may have been grounds to have him checked out by a mental health professional even without his consent (based on allegations he threatened others).

Many are pointing out that Loughner suffered at the hands of the broken Arizona state mental health system. That’s wrong, though. He would have had actually had to have interacted with that system in order for this argument to make sense. To date, we’ve had no evidence he ever came in contact with the public (or even private) mental health system.

Is it society’s responsibility to proactively seek to identify, single out, and treat — by force, if need be — anyone who might have a mental illness? I’d suggest no, that’s going too far. We live in a free society where treatment is not something forced upon us, with one notable exception — unless we present a clear and present danger to ourselves or others. Otherwise, I don’t want the government interfering so directly into my healthcare and life — “Sorry, mister, you’re not dealing with stress in a mentally healthy manner. Forced treatment for you!”

A Comprehensive Social Safety Net

Jared Loughner is not an example of our broken mental health system. What he may be an example of is our broken lack of communication amongst numerous parties who are all involved with the same individual in different ways — a comprehensive social safety net. Pima Community College apparently knew (or at least had strong suspicions) that this individual was of concern; so much so they apparently kicked him out. But that’s where their communication seems to have ended — “Thank goodness he’s not our problem anymore!”

What we need is a more systematic way to communicate amongst organizations and agencies to collaborate on individuals who may be at risk for something, like a mental health concern. This seems more likely to be a public social work function rather than a strictly mental health function, because it means someone should be coordinating with all of these different organizations and law enforcement to get a holistic and clear picture of the individual.

Schools are often the place where young people demonstrate erratic or concerning behavior when they’re experiencing troubles in their life. Most schools don’t have any policies in place in order to do anything more than deal with the student in the context of the school. In fact, due to privacy regulations, it may be difficult for them to share information about a student of concern with others.

This has to change so that colleges and universities start to understand that their students are a part of a larger community, a community that deserves to be treated with mutual respect and care. Colleges and universities must setup ways to communicate concerning information with other agencies within the community to ensure students like Loughner don’t slip through the cracks of society in the future.

And here’s a radical idea — let’s require an Emotions & Stress Regulation 101 course for all students at all schools. Let’s teach students to recognize their own emotional reactions and reactions to stress early on and give them the basic tools to help better deal with these things sooner. Let’s de-stigmatize mental health concerns even more, so that other students feel free to question when one student seems to be acting in an erratic and concerning fashion in and outside of the classroom.

Sure, let’s find a way to fully fund the public mental health and social work systems. But this is a pipe dream for state governments that are facing bankruptcy and huge deficits, and state agencies that are forever underfunded. Because when it comes right down to it, society cares only so much for the poor and indigent who have mental health concerns. We only care when a Congressperson or a bunch of people get shot at, and then, within weeks, the nation’s attention turns elsewhere. When taxpayers are asked to pay even more into their taxes to fund such programs, they rebel, leaving us with the same broken system we started with.

Read the Dr. Pies article on the Tuscon shooting: The Arizona Shootings: A Recurrent American Tragedy

Read the transcript from yesterday’s PBS Newshour: In Loughner Case, Missed Signals and a Troubled Mental Past