On Wednesday, March 7, 2012, one of my mother’s worst nightmares came true.
At Western Psychiatric Institute and Clinic (WPIC) in Pittsburgh, Penn. — one of the state’s best psychiatric hospitals — a shooting spree left two dead and seven injured.
WPIC helps educate future psychiatrists, psychologists, and masters-level mental health therapists. Medical doctors of other specialties, including surgeons, anesthesiologists and radiologists, and other health care professionals also receive training there. It is an institution where education, science, and practice merge together.
I remember the day I spoke to my mother about potential danger at mental health hospitals and the possibility of violent occurrences becoming my reality as a therapist providing treatment to various populations. Her eyes said it all; I could see the terror across her face. Many — primarily professors, professional speakers, and coworkers — reassured me that such incidents were rare because most institutions were highly secure and provided their employees with emergency protocols and trainings. WPIC trains their employees on issues relating to mental health policies, emergencies, and “unusual occurrences” — that is, patient violence.
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this incident is a big issue for mental health providers and true patients. I can only speak for psychiatry, and with this specific incident, I know next to nothing on the details, but I know this as a general issue for outpatient psychiatrists both in community mental health and private practice settings for the past 10 years or so: antisocial personality disorder is not amenable to treatment options we can offer, and it is time to put forensic psychiatry on the mat for trying to make us pick up the messes they create in courts, prisons, and other state systems that deal with this group. Face it colleagues, some people are just criminals and have no regard for the public, and specifically use our efforts at empathy and caring as weapons against us. And these forensic people who argue there are Axis One diagnoses for these alleged patients is just not fair to dump on unsuspecting and naive colleagues.
Sorry, some people are destined for why we have prisons and graveyards! And I am not talking about legitimate patients and hard working mental health care providers. You all figure out the space between the lines!
Hi Joel, thank you for your post.
This is a very costly situation and it can turn out to be a replicated situation if we do not think of ways to put a stop to this. This young man, John Shick, had a laundry list of diagnoses and problems. He may even have had a criminal record. Nevertheless, it is important that we learn to decipher whether individuals like John are strict “criminals,” mental health patients with “criminal” tendencies, sociopaths, or simply victims of circumstance. It can get very complicated, but we cannot just point a finger and say “he’s a criminal” because he committed a criminal act.
Despite these specifics, there are many changes that need to be made to the mental health system and we ought to get started on preventing future deaths and rampages from individuals who are severely disturbed and unmonitored. Shick was clearly in need of psychiatric attention, he did not get that attention and this is the result. Very, very unfortunate for all of us.
More specific to your point Joel, forensic psychology has indeed made a BIG mess out of mental health issues. I agree. However, we must keep in mind that forensic psychology serves a good purpose (or at least it attempted to), which is the fact that they are there for us when we need to prove that a severely mentally disturbed individual, who has committed a violent act, is indeed incapable of comprehending right vs. wrong. In many cases, we are looking for culpability and the criterion for this is wayward too! We need to seriously fix our mental health and legal systems, if we EVER can!
I have no issue with people who have true diagnosible mental illness issues and are at least somewhat amenable to treatment. It is the pure antisocial/sociopathic population that is just trying to game the judicial system to avoid punitive consequences. These people are getting more sophisticated in feigning illness, and too many colleagues are foolishly naive, or just looking to move the patient along and not trying to establish malingering or pure manipulation.
No one really makes an effort to get collateral information about a person when doing an assessment/evaluation anymore. Talking to spouses, family members, recent employers as applicable, can really give a good picture of who is struggling with mental illness, and who is just a criminal.
However, in the end, narcissistic injury or just plain antisocial outrage cannot be negotiated in a provider’s office. Which is why you as a provider need to go with your gut when someone is giving you negative vibes.
I don’t know Shick’s issues or history, but I know this, if we don’t learn something of value to maximize an incident like this not happening again as we can control, there will be more Shicks in community mental health offices, that I can say with fair certainty. And if they happen again, less motivated and invested providers will work in such clinics.
I agree Joel with most of what you said.
The antisocial/sociopathic population is not only trying to scheme the judicial system, but the mental health system as well. They are indeed very good at appearing “innocent” and needy. We do need to be more aware of the sociopathic population and become more serious about assessment and evaluation of sociopathic features. If not, we will help to further along a potentially violent and “heartless” population that can become a detriment to society.
Perhaps Shick was a sociopath, perhaps he was not. We’re still not sure. But what is sure is that he had a serious problem that went overlooked or was undermined. There may not have been anything that we could have done to prevent the dangerous act at WPIC, but we can use Shick as an example and motivation to create systemic change. Much needed change.
OMG!!!!! I was hospitalized at this very place back in ’07!!!!!!!! Whoaaaaaaaaaaaa……