<p>@Cardinal Fang,
When your son was living away, how did you handle his day to day financial needs?</p>
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<p>I wasn’t saying accessing public wi-fi hotspots wasn’t easy though even there, YMMV depending on area of county being driven through. </p>
<p>The issue, however, is the ease of access often means lack of security because one doesn’t need to sign on and there’s no encryption of data between the wi-fi hotspot and the computer accessing as a consequence unless the police/institution/individual has a decent secure VPN tunnel to counteract that. And that VPN tunnel adds to the bandwidth overhead. </p>
<p>There’s also the issue most have bandwidth constraints imposed by the owner of the hotspot, many users accessing that particular spot at the same time, environmental/electromagnetic interference, etc. </p>
<p>You’re correct that it’s not really an issue if one’s googling name/info. However, if we’re talking the need to view a series of youtube videos for evidence in a police car, those bandwidth constraints may seriously impede their efforts even if they tried viewing them en route to the scene. </p>
<p>Bay, I can’t believe you’re suggesting that this is in any way similar to Nancy Lanza buying guns. </p>
<p>Families get criticized for failing to financially support their mentally ill adult offspring, who often become homeless wanderers, abused and victimized by all those who prey on the homeless mentally ill. Families get criticized for failing to intervene when the mental health system actively prevents them from doing so. </p>
<p>If you haven’t walked in the shoes of a parent/family member who’s had to deal with another adult family member with severe mental illness and delusions, you have no idea what the realities are, and how little the family actually controls anything.</p>
<p>Diane Ravitch spoke about being careful not to assume that the people of the historical past were stupid because, in retrospect, their decisions were incorrect. Is this any different? </p>
<p>If they knew he was at risk for suicide, they should have also known he was at risk for mass murder? I don’t buy it. There were 38,364 suicides in the US last year, and presumably there were other failed suicide attempts, and people who were suicidal but who didn’t attempt suicide. How many mass murders were there? Two? Three? Five? </p>
<p>The parents knew or suspected he was suicidal. And that means he had, say, a one in a hundred thousand chance of being a mass murderer. I’m not seeing the legal responsibility there. </p>
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<p>He had a bank account and a credit card. For him, the issue was not overspending but remembering to pay his legitimate bills. </p>
<p>Bay says:
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<p>When they have no ability to stop him from any action, since he is adult? Way too many causal interventions and lack of duty problems. If his mother still owned the car, the insurance and potential liability for those run over may possibly exist, i am not sure about that. </p>
<p>Re potential liability for Adam Lanza’s mother, I thought he physically overpowered her to get the guns, though, and that could happen as you put them in a gun safe. I didn’t really get into the weeds of that case the way I have into this one however. I’m interested in Santa Barbara as an alumnus and I have become interested in this discussion of mental health. </p>
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But privacy is the most important thing, and that was more important than getting important information from the patient’s family. So wrong! I understand there is a lawsuit now involving malpractice against some MH practioners in a nationally publicized case because they refused to take the family’s information into account, with a tragic result. It will be interesting to see what happens with that. </p>
<p>Adam Lanza shot his mother in her bed.</p>
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<p>Parents might be absolved of any liability if they follow professional protocols.</p>
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<p>Then I had the facts wrong. As I said, I wasn’t really following that.</p>
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<p>The liability doesn’t exist to be absolved of. There has to be an initial duty to act for negligence to attach.</p>
<p>^Right. That is what I was proposing. New precedent.</p>
<p>On the one hand, people claim we can’t predict these tragedies, and by extension, they can’t be prevented. On the other hand, people scream for new gun laws every time this happens, as though there <em>is</em> a way to predict/prevent them.</p>
<p>In my mind, the most logical place to start for prevention is with the people who know the perpetrator best. No one else is going to be better at taking preventive action than the parents of mentally ill children. If we don’t want to do that, then I guess we just throw up our hands and hope our loved ones aren’t the next victims.</p>
<p>It is worth noting that hospitals worry about lawsuits. I knew someone who was released from the ER of a major medical center after a suicide attempt because she said she was no longer feeling suicidal. I knew someone else who entered a hospital (voluntarily) acutely suicidal and checked out the next day AMA and they didn’t hold her because she told them she was no longer suicidal. Whether or not she was, the fact that she said those words meant they could not hold her (I called and asked) because you can’t put someone on an involuntary hold who says they are no longer a danger. Similarly, if someone says they are not a danger to others, even if they felt that way hours before, a hospital is most likely going to release them. </p>
<p>@Bay the law is developed. You are not going to get that from a court, as precedent, because they would be overturned based on well settled law - law that is well settled for very good reason in my opinion. Adults are adults and making parents responsible for their actions just for being parents and doing something total strangers would be allowed to do opens up cans of worms in every area of life.</p>
<p>and I think the place to look is at places where he was in the system, such as coordinating the contacts with police into a profile and accessing that and the existing gun records and the reason for the concern where he had a welfare check, as a new procedure. </p>
<p>But there are things that can’t be stopped without turning the nation into a police state, and saying you don’t want that or unreasonable liability for innocent people is not ‘throwing up your hands’, it is just disagreement.</p>
<p>I’m also not calling for gun laws. In my mind if there was ever someone aiming at the result, not the particular means, it was this guy.</p>
<p>And California has most of the laws being sought by gun control advocates across the nation. They didn’t prevent this.</p>
<p>That might have been part of why only 100 people turned up for a gun control walk and rally yesterday in Isla Vista (put on by the Brady gun control group, not by students) despite the fact that 20,000 students live in a square half mile there.</p>
<p>18000 to 20000 were estimated to be at the memorial service at Harder Stadium last week.</p>
<p>New legislation then.</p>
<p>Parents and friends are unable to clearly and honestly evaluate their loved ones. They exist in a vortex of emotions and behaviors and expectations that blur the reality of the situation. It is not until one steps out of this vortex that you can see situations more clearly.</p>
<p>My first career was crisis intervention and suicide prevention. I was responsible for all involuntary commitments in a county of half a million people. I went out to homes, hospitals, police stations, and more than a number of bridges and water towers to attempt to help people in crisis.I was part of training our local police municipalities on how to deal with people in crisis. I have been closely involved with at least one nationally known event in which someone walked into a mall and started shooting.</p>
<p>I will repeat what I said earlier. Everybody does their best. Everyone strives to do better. It is impossible to Monday morning quarter back these situations in order to place blame. We will never really know the tone people used in describing a situation. Communication is based on such nuance that what one thinks they said and what was actually communicated can be very different.</p>
<p>The best we can do is to refine the laws we have in place at the time and continue to educate people on mental illness. </p>
<p>Sometimes we will be lucky and stop these things from happening. Sometimes we will not.</p>
<p>CF,
xanax can be taken up to 3 times a day. Its often taken daily.</p>
<p>Sax – but are we likely to be successful at stopping situations like this one when their are such walls built between the mental health system and the patients’ families? </p>
<p>Our family only knew what happened with the hospital because they decided that sitting down with us and sharing the information after the suicide was the right thing to do, and I am grateful for that. It was an awkward meeting, with the top two hospital administrators, director of the psych unit, hospital attorney, and attending psychiatrist sitting around the table with us. They were clearly very sorry, and shocked. They’d never seen her before, had no history, and did no investigation, and that was the norm. That’s the key – this wasn’t one institution practicing outside the norms, this was standard practice to not solicit information from third parties.</p>
<p>One phone call to a family member could have elicited important information, one conversation with the officer who had brought her to the ER would have revealed that they’d been called in because she was wandering up and down the street giving away her belongings (including her computer) to random clerks, freaking the clerks out. One look at that computer would have revealed a facebook posting (hidden from family) that clearly indicated her despair. </p>
<p>She’d told them that she’d been released from another psychiatric unit several days earlier, but they didn’t reach out to that hospital because it was a weekend, and apparently records are shared only on weekdays.</p>
<p>I get fairly irked when it is suggested that families should have, “done something.” Sometimes there were clear things that the family should have done. But it many cases, family has done virtually everything they have been allowed to do, with minimal useful feedback. The system is not set up to involve families unless it is the express wish of the patient that they be involved. </p>
<pre><code> arabrab. I went back and read your posts. My condolences to all of you.I certainly can see areas where she may have fallen through the cracks in their system.
I have not been active in this field for years and I am sure some laws are different.
I think the worst part of your situation was that the young lady was admitted on a weekend. Sadly the weekend staff is often times part timers and the weekday routine is not in place. Often times psychiatric residents are the Dr.'s on the floor on the weekends. So you have part time staff and an inexperienced psychiatrist in training. As you noted it only took being alone for 15 minutes for this woman to take her life. I am not sure if having had more information from many people in her life would have changed their determination that it was okay to leave her alone for 15 minutes on the second day. Obviously it was a judgement call and it was wrong. I can say that when someone is absolutely determined to take their own life they will find an opportunity to do so.
If the ER staff and Dr were the admitting group I am sure that vital information could have been left off the intake form or commitment form. ER Dr.'s are often in a hurry and just eager to get the patient on their way to the psych unit. The ER staff are not professionals in talking psych intakes. Having the police bring her in was also a spot where communication could have been compromised. They may have been in a hurry to drop her off and on to another call. They may have made many assumptions as to the ER figuring everything out on their own. One officer may have thought the other explained the situation.Who knows.
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<p>Anyway…I would absolutely call the family if this was an involuntary commitment and I had identifying information. I would do everything I could to involve the family.</p>
<pre><code>If she signed in voluntarily then it was entirely up to the patient if anyone can be called. We would do our very best and use any magic that we had up our sleeves to get the patient to give us permission to talk with family. Sometimes it would take a few days.
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<p>Sometimes Dr’s would allow an involuntary patient to change to voluntary status and sign in. I always dreaded this as it gave much too much control to the patient at a time when you need to take control .</p>
<p>Anyway I am so sorry for your family.</p>
<p>If this hospital had no interest in involving the family and this is the system where you are then it is, in a word, wrong.</p>
<p>Families are vital in giving information about a MH patient. I did not mean to imply their information was not valuable. I meant that their information was filtered through their love, frustration, anger etc for the patient. Professionals should be able to piece it together.</p>
<p>In our county we ended up having a crisis center where the patient was brought. The commitment statement was always taken by an experienced MH person who knew what was important. Often times they were more experienced than the psychiatric resident on call.</p>