Sunday, January 13, 2013

It Takes a Village: A Community in Mourning

Photo taken by J. Langley, 2008
It has been one month since the devastating events at Sandy Hook Elementary School.  Knowledge of the horrific details of the shooting shook the residents and families of the community in Newtown, Connecticut and sent reverberations that could be felt throughout the nation.  Traumatic events may lead to changes in our lives for which we cannot truly prepare.  

Who’s to Blame?

When a tragedy occurs we tend to have number of “what if” thoughts about events leading up to the unwelcome change in our lives.   We may find ourselves thinking maybe if I had done this or that, this would not have happened.   

In cases where the individual who committed the act of violence had a documented mental health history, one of the places the community turns for both answers and support is the mental health community.    

In a recent New York Times article, the author references a study published in JAMA Psychiatry indicating that most teens who commit suicide have had therapy prior to planning or committing suicide (Carey, 2013).  

According to Stanton Peele, PhD, J.D.,   “the best interpretation of these data is that therapy -- as it is currently administered and experienced -- is a cultural excuse for not addressing family, social, and life problems that we as individuals, family members, and a society face but cannot deal with (2013).”  This comment, perhaps suggests that it takes all of us, not just those in the mental health community, to address serious mental health issues.


What IS the Responsibility of the Mental Health Community? 

To start, the mental health community is made up of a variety of professionals who provide services to individuals struggling with a wide range of mental health problems (Grohol, 2006).   The general rule is that communication between a mental health professional and her client is confidential. However, the law allows mental health professionals to break confidentiality in cases where an individual is at risk for hurting himself and/or others.  

Specifically, the law requires mental health professionals to assess the dangerousness of the individual and take appropriate action.  One such action may be the involuntary confinement of the individual who has been found to be a danger to himself and/or others, in a process called civil commitment.   

The criteria for determining whether a person may be committed is different in each state (see, Treatment Advocacy Center, 2011)Generally, state laws allow commitment if:
  • The individual is a danger to himself or others and this danger is clear and immediate.
  • The evidence that supports this conclusion is convincing.   
Additional criteria include being unable to care for oneself and lacking the support to care for oneself; being unable to 
make responsible decisions about treatment/hospitalization and being in an unmanageable state. 

Can We Predict Dangerousness?

Predicting dangerousness has proven to be a challenge for mental health professionals and we are seeking ways of improving our accuracy at assessing and predicting dangerousness.   However, addressing mental illness takes a village.  

As parents, immediate or extended family members, teachers, peers, neighbors, and clergy, we can do our part by: ending the stigma associated with mental illness, communicating with others about troubling behaviors we have seen, communicating with our loved one about our concerns, taking steps ourselves to have a loved one civilly committed by calling 911 or try to persuade our loved ones to enter an inpatient or residential facility voluntarily.  

Carey, B. (2013, January 8).  Study questions effectiveness of therapy for suicidal teenagers.  The New York Times.  Retrieved from therapy for-suicidal-teenagers.html

Grohol, J. (2006). Types of Mental Health Professionals. Psych Central.  Retrieved on January 13, 2013, from

Peele, S. (2013, January 10). Therapy as a cultural cop out.  Psychology Today. Retrieved from

Treatment Advocacy Center (2011). State standards for assisted treatment-Civil commitment for inpatient and outpatient psychiatric treatment.  Treatment Advocacy Retrieved on January 13, 2013 from

(c) 2013 Dr. Lori C. Thomas

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