Shooting shows gaps in US mental health safety net

UNITED STATES: Mental health professionals complain their hands are tied in two ways when they try to help people like Virginia Tech gunman Cho Seung-Hui a lack of funding for mental health services in general, and laws that makes it tough to treat people against their will.

They say the 23-year-old student's shooting rampage sheds new light on flaws in the U.S. mental health system.

"Our mental health system failed this young man," said Jill Bolte Taylor, a brain researcher at Indiana University School of Medicine in Bloomington, Indiana.

Cho drew the attention of campus police in late 2005 amid complaints that he was annoying women students. He spent some time in a psychiatric hospital because of worries he was suicidal. "Funding for mental health services in the United States has dropped in half over the past 25 years," Dr. Christopher Flynn, director of Virginia Tech's Thomas Cook Counseling Center, told a news conference.

"We have seen, every time there's a cut in public health funding, the first people that are cut are mental health providers, and we do our entire system a disservice by continuing to do that."

Dr. Steven Sharfstein, past president of the American Psychiatric Association, said the problems are both financial and legal.

"What was a red flag for me is that he was seen in a mental health facility and held for one day. That is a symptom of the dysfunction of our mental health system," said Sharfstein, who is president of Sheppard Pratt Health System in Baltimore.

"If someone isn't readily seen as imminently dangerous, there is no time and money set aside to do a more in-depth and effective diagnosis. He may have been hiding a paranoid psychosis that with a few days of observation might have come out."

The National Alliance on Mental Illness in a 2006 report gave the U.S. mental health system the below-average grade of "D".

"Untreated mental health is the nation's No. 1 public health crisis," Michael Fitzpatrick, the group's executive director, said in a telephone interview.

"In recent years, states like the Commonwealth of Virginia have systematically reduced their funding for mental health services," he added.

"The reality is that in many communities, it is impossible to get mental health services unless you have been arrested," Fitzpatrick said.

Even if treatment is available, patients often are too sick to believe they need treatment. And unless a patient presents an imminent threat, many states prohibit involuntary treatment.

"Unfortunately, we live in a society that says as long as you are not a danger to yourself or someone else you can be as psychotic as you want to be," Taylor said.

Exceptions include states such as New York, which allow court-ordered treatment called assisted outpatient treatment for patients who cannot recognize their own need for care.

New York's law is named in memory of Kendra Webdale, a 32-year-old Buffalo woman pushed to her death in front of a subway train in 1999 by a man with severe mental illness who had a history of avoiding treatment.

Mental health advocates fear the shooting might produce a backlash against people with mental illness.

"Studies have shown that it is incredibly rare for someone with a mental illness to commit gross acts of violence, especially on such a scale as the Virginia Tech shootings," the U.S. Psychiatric Rehabilitation Association said in a statement.

Chicago, Friday, Reuters