No easy answers for addressing mass killings
BY JANET PEARSON Associate Editor
Sunday, December 30, 2012
12/30/12 at 3:23 AM
In fiscal 2012, the local psychiatric emergency service known as COPES received more than 1,000 calls regarding children or teenagers experiencing a mental-health crisis. More than 100 of them were deemed dangerous or homicidal.
One of those calls came "from a parent whose teenage daughter was having hallucinations and heard voices directing her to kill family members and classmates," recalled Gail Lapidus, director of Family & Children's Services, which operates the Community Outreach Psychiatric Emergency Services program.
"In this case, the mother didn't minimize. COPES was called and they came out and immediately connected the family with appropriate inpatient treatment," she continued.
Lapidus added: "This mother could have said, 'Oh, she's said this before, we'll give it a few more days.' " Thankfully, she took the incident seriously, and perhaps averted a major tragedy.
Another call came from someone who "knew about a young college student threatening to kill people on the campus in response to being kicked out of school."
"He did write a letter detailing his plan and did inform someone in the dorm. We got the phone call and we were able to respond, to find the young man, and find an inpatient bed for him."
Lapidus believes, thanks to this 24-hour-a-day emergency service, "two massacres were averted in Tulsa." But while we've been fortunate so far, she also wants the community to know "we aren't any safer here" than places like Aurora, Tucson and Newtown.
"We're just one single gunshot away from being that same community."
COPES will send a trained team of mental-health professionals to the scene of any situation it's alerted to and has a remarkable track record for defusing such incidents. But there are still huge gaps in Oklahoma's array of treatment services, in large part due to significant budget cuts in recent years.
We have to wonder if a large-scale tragedy is in our future as well.
'We've heard this before'
Of the 1,054 calls COPES received about children and teens in fiscal 2012, 252 were demonstrating angry or threatening behavior, 105 were deemed dangerous or homicidal, and 484 were suicidal.
Many will grow into troubled adults: The agency received 5,874 calls about adults in crisis that fiscal year.
Just imagine what the statistics might have been were it not for someone's willingness to call an emergency service that could immediately intervene.
Lapidus is among advocates calling for more intense focus on mental-health issues in the wake of these tragedies, and urging people to speak up and pursue action if they sense someone is dangerous.
"Sometimes people who are hearing voices in a delusional state that can lead to these acts will reach out for help, or will tell someone who then will pick up the phone," she said.
A growing body of research indeed shows that the so-called "rampage" killers often communicate their intentions, but for various reasons, the warnings aren't heeded or taken seriously.
Most people with a mental-health disorder will not turn violent. Lapidus said only a tiny fraction of the more than 12,000 adults her agency treats for serious mental illness in a year might become violent. Usually violence stems from such conditions as delusions, psychosis and paranoia.
"What everybody needs to understand is that most (patients) don't have delusions and psychosis. That's an important point," Lapidus said.
Because the number of mentally ill people who might resort to violence is so small, "they should be easy to identify and get treatment for," Lapidus suggested. "So why can't we do a better job?"
While some people may not realize the warnings are real, Lapidus believes another reason warnings aren't heeded is "people want to close their eyes" to mental illness.
"In a recession we experience drastic slashes in budgets. Families in need of such treatment often find themselves facing barriers to the kind of care they need when they need it," she said.
Sometimes families just give up on trying to find help for a family member in need, concluding - perhaps correctly - that the individual won't be detained against his will or won't receive the kind of treatment needed to keep the problem under control.
"We've heard this before: You can't commit someone, so people shy away from the mental-health system. Detaining people against their will is another conversation we have to have in this country," she said. "Detaining people who are a risk is a huge issue. People are at their wits' end and wanting immediate help, and they don't know where to turn."
Tulsa fortunately has a relatively broad range of services for children with mental disorders. "But all these services hinge on who's going to pay for it," Lapidus said, adding that those without insurance or Medicaid coverage might have trouble getting the help they need.
The inadequacy of state treatment alternatives was starkly laid out in an Oklahoma Department of Mental Health and Substance Abuse Services 2013 budget request: "Service cuts have drastically reduced access to care statewide. They have impacted community services, local hospitals, all aspects of our criminal justice system, children in state custody, our schools, and the overall health and well-being of our state."
Cutbacks have led to the closure of 95 treatment beds statewide, the merging of several programs, and millions of dollars in cuts to 70 private providers.
"Last year we spoke to the negative consequences of cutting behavior health services in Oklahoma and predicted increases in suicides, crime, more children in foster care, needless deaths and untold pain and suffering," the budget proposal noted. "Unfortunately, those predictions have come true."
Lapidus thinks it will take a sustained chorus of advocacy from the public to get our leadership to provide the funding needed for adequate mental-health services. "People have to speak up. There's probably kids like that guy in all of our schools," she said, referring to the Newtown shooter. "Insist on getting help. Scream loud about it."
Exasperated, she wonders why, after all the tragedies the nation has suffered, people still are reluctant to aggressively seek out help, and why Americans from all walks of life aren't demanding change.
"The risks are too high today," she said. "We should have outgrown our hesitancy to seek out help. What should communities do about these kids? What should we do? I think it's a dialogue we need to have. What can we all do a little bit differently?"
Original Print Headline: 'What should we do?'
Janet Pearson 918-581-8328
Therapists Amanda Bradley (left) and Lauren Hereford, with Community Outreach Psychiatric Emergency Services, respond to emergency calls. The COPES hotline is the front line for people in Tulsa County who are thinking about harming themselves or others. Since this photo was taken, Bradley has been with the Broken Arrow police department, where she provides services to victims of crime and violence. Tulsa World file