Psychologist lawmaker: Congress should study shooting, then act

Rep. Tim Murphy (R-Pa.) is calling on Congress to throughly review the circumstances behind last weekend’s shooting of Rep. Gabrielle Giffords (D-Ariz.) and 18 others before taking any legislative action.

Murphy, a psychologist and co-chairman of the Congressional Mental Health Caucus, said the tragedy hit close to home for lawmakers but that it’s important for them to have all the answers before taking action.

{mosads}”Right now you have a number of members of Congress who really want to do something, and they don’t know what they’re going to do so they are reaching out in the areas that they know something about — gun control, security systems, Internet control,” Murphy told The Hill.

“What I want to do is use the resources and talent of the Mental Health Caucus and sit down and review this with professionals once we have more data and then ask the questions: Were there gaps in care or in the process here that can be remedied by congressional action?” he said.

The debate over mental healthcare in the U.S. has resurfaced in the wake of last weekend’s shooting because the suspect, Jared Lee Loughner, is widely believed to have been mentally ill. He was removed from Pima Community College and his parents were told he wouldn’t be allowed back until a mental health expert had assessed him, but it appears he was never evaluated or treated.

Murphy said a congressional review could uncover multiple possible breakdowns that could then be effectively addressed: “What was the school aware of? Did they make referrals for counseling, for therapy? Did someone follow through? What were the parents aware of? What were the law enforcement agencies aware of? Was there any involuntary commitment for psychiatric care? Was there any drug and alcohol treatment?”

“We haven’t even taken the history on a patient that people are trying to diagnose,” Murphy told The Hill.

Murphy’s co-chair on the bipartisan caucus, Rep. Grace Napolitano (D-Calif.), told The Hill this week that she wants the caucus to educate lawmakers and staffers about mental health danger signs they should be aware of. The two lawmakers are scheduled to discuss the topic of mental healthcare in the U.S. Sunday morning on CNN’s “State of the Union.”

The shooting has also rekindled debate over whether the pendulum has swung too far toward protecting the rights of individuals who display disturbing behavior. Most states over the past few decades have shuttered their mental hospitals where the mentally ill used to be locked up, and more people with mental illnesses than ever now live in the community.

Since the shooting, the National Alliance on Mental Illness has been actively reminding people that millions of people suffer from mental illnesses — as many as one in five Americans will suffer from some form or another in their lifetime — and the overwhelming majority are no more violent than the norm in society.

“But if you put someone in a situation where they’re very ill, and there’s substance abuse involved, people are isolated and can’t find their way to treatment and evaluation, sometimes we run into these situations,” Michael Fitzpatrick, NAMI’s executive director, told The Hill.

He pointed out that under Arizona law school officials could have demanded that Loughner be evaluated even if he didn’t appear to pose a threat to anyone — the standard in many states — so curtailing people’s civil liberties isn’t the answer.

“The whole tragedy in Arizona was not an issue of the law in place,” Fitzpatrick said. “It was really a breakdown in the process. We should train, for example, university and college staff on what the steps are and what the process is to get people into treatment or in evaluation…Anything that would provide more training, provide more resources, allow people to get into treatment faster and allow for really early intervention — that’s really the key to this.”

He called on Congress to hold states accountable, since the mental healthcare system is largely a local and state responsibility.

“At some point what we need is a standard expectation by the federal government in terms of what the mental health system should look like,” he said.

Murphy agreed that the situation today is a great improvement over how things used to be done.

“We are much better off,” he said, “because what we now know is that people who previously were locked up for prolonged periods of time, we know now that many of them with proper treatment and medication are well-functioning people in the community.”

He acknowledged, however, that Giffords’ shooting raises difficult questions about freedom and security for lawmakers.

Privacy laws are one area of concern. After the Virginia Tech shooting in 2007 Murphy introduced legislation to hold schools harmless if they shared their concerns about a student’s mental health with the student’s family, which did not happen in the case of Seung Hui Cho. The bill did not pass but Murphy got an amendment in an education bill requiring the Department of Education to review the privacy policy and make recommendations.

“Now is the time to ask, what recommendations were made?” Murphy said. “What was put in place?”

In Loughner’s case the other part of the confidentiality law, Murphy said, is did he get treatment, and did anybody know whether he did?

“That’s another place where, in our goal to be more compassionate, did we not protect society?” Murphy said.

And while he echoed Fitzpatrick’s message that most people with a mental illness are not dangerous, Murphy predicted Congress will face a tough debate over what to do with people who, like Loughner, display signs of mental illness but haven’t been deemed to be a threat.

“It will require the wisdom of Solomon as a society to say, do we reach farther beyond that, if people have hints then they are involuntarily committed? Or do we say, people still have their freedom and we will not have them involuntarily committed unless we’re absolutely sure? That’s the dilemma we’re going to have to deal with and that’s the difficult question,” Murphy said.

“That’s the one that will require much more thoughtful input than just to say, let’s pay for government programs, let’s outlaw guns, let’s filter the Internet or let’s barricade ourselves behind armed police officers.”