Sunday, January 09, 2011

Jared Loughner, Mental Health and the Criminal Justice System

I just read an article in the Arizona Daily Star about Jared Loughner, the Tucson shooter.

The article indicates that Loughner completed "diversion programs" after minor criminal charges. This is just another example of how our so-called criminal justice system fails to deal with mental health problems.

We have a relevant case pending right now. We applied for the new Judicial Diversion program for drug felonies in New York. The normal approach is that the Court orders an evaluation.

We like to go a step ahead of that, and apparently a step beyond. Before seeking diversion we have our client get a thorough mental health evaluation from a trusted professional. The psychologist we send people to is a respected professor. He does a complete evaluation and provides us with a detailed report, addressing the total mental health picture as well as the specific legal questions we ask him.

In our pending case, the Court did not accept our psychologist's report as sufficient and ordered an evaluation from the court's own staff. I have that evaluation. While I agree with its ultimate conclusion (that our client should be admitted to the diversion program), I find the overall quality of the report disturbing.

The evaluator is a social worker with far less education and training than a psychologist. He filled out a boilerplate questionnaire with very short handwritten answers - rarely full sentences and often one word. There was no discussion, no analysis of our client, his life, the incident that led to his arrest, etc.

Relevant to Jared Loughner, what stands out is that the court evaluation only addressed the substance use/abuse issues and did not address other mental health concerns. Our psychologist identified a number of other DSM-IV diagnostic codes, and the major concern was not substance abuse but rather a severe form of a fairly common mental health problem. According to our psychologist this is the underlying cause of most of our client's other problems (including the recently developed substance abuse, a collapse in school grades and family issues).

Did that happen with Loughner in Tucson? Did the diversion programs ignore other mental health problems and address only substance abuse? I'm not sure if we'll ever know, but I know it happens here.

Mental health problems are one of the biggest causes of crime. We see it a lot in our DWI cases and petit larceny (shoplifting) too. The criminal justice system should pay more attention to overall mental health problems. Let's hope the Jared Loughner story pushes in that direction.


Chad Polenz said...

I agree, but up to a point.

There still needs to be some due process. Psychology has always been inherently leftist and pro-conformity. Many shrinks have written papers along the lines of being a "conspiracy theorist" is a sign of schizophernia. But then they define that term so vaguely that anyone who questions or criticizes the government could be considered legally insane. Hell, that's what Stalin and Mao did "you don't like communism? - to the reeducation camps for you!"

But yes, the average social worker with a degree in basket weaving isn't really qualified to determine who's sane or insane. There definitely needs to be a more professional level of involvement. Trying to find that level, and keeping it politically neutral is extremely difficult to determine.

Unknown said...

Thanks for your comment Chad. I don't know enough about the broad world of psychology but in my experience most are pragmatic in trying to help those who seek them out.

This isn't about sane or insane. The world of mental health is not black and white. Most people have some level of mental health issues, often very brief but still real. It's part of the human condition.

Mental health issues become "problems" requiring treatment when they interfere with life. A good example of that is when someone gets arrested.

The problem with some drug court evaluators is how they came into the field - some (but certainly not all) are former drug abusers themselves. From what I hear, that is becoming less of a concern and the area is becoming more professional. But I've still seen major deficiencies.

eoin said...

I'd love to get a peek at the Pima county diversion file on Loughner. Every one who has dealt with him since 2006 says he's "certifible".....but they didn't address it. Wonder if the file isn't shredded by now.

Your commentary is "dead on"

Anonymous said...

All due respect to those in the field of social work, but in no way should they be qualified to provide that for the court.

It strikes me as odd because a court would not call a nurse to testify and diagnose a physical ailment or illness, yet the equivalent is done for mental health without the bat of an eye. It speaks not only of the inability for the court system to accurately address mental health concerns, but also their attitude towards mental health as a whole.

A questionnaire is not a diagnosis, it's bureaucracy masquerading as treatment.

For all the great inroads made over the last several decades, this just goes to show how much further we have to go as a society when it comes to treating mental health issues with due diligence and respect.

Anonymous said...

I think any reasonable discussion of the role the mental health system might have played in Jared Loughner's case should reference Monahan's classic monograph 'Clinical Prediction of Violent Behavior.' Monohan points out three current major criticisms of violence prediction by mental health professionals: that "violence cannot be predicted with any satisfactory level of accuracy, that any attempt to do so violates the civil liberties of the subjects, and that the societal protection function is at variance with the traditional helping role of the mental health professions." Put simply, I think it is nearly impossible for the mental health system to prevent someone from being violent, other than to offer aggressive treatment to mentally ill people. Predicting human behavior is very tricky. Most psychologists, psychiatrists, and social workers--and lawyers--are trying to help people. The criminal justice system is not well prepared to deal with drug and mental health issues. It's nice to see that you have found a rare profession who understands both systems. Those professionals are quite rare and often poorly compensated. I too hope that higher quality mental health evaluations are included as part of our diversion programs.

Sarah said...

I have a 27 year old son who has been in RSS hosuing in Albany and at ClearView Center's day treatment for 6 long years. My son's mental health is in the worst condition possible. He has not had adequet basic mental health care and his "group home" has mistreated him and ignored his condition. I need a lawyer to help us. There is no reason after 6 years that my son is in such bad health. He is in Ellis Hospital right now. Please help us. Mentally ill people are human beings too. With the proper psychiatric care and therapy they can live well.
Sarah Field