Question of the Week

April 23, 2007


This past Friday (April 20, 2007), the family of the Virginia Tech shooter issued a statement.

" 'We are humbled by this darkness. We feel hopeless, helpless and lost. This is someone that I grew up with and loved. Now I feel like I didn't know this person,' Cho's sister said. 'We have always been a close, peaceful and loving family. My brother was quiet and reserved, yet struggled to fit in. We never could have envisioned that he was capable of so much violence.' "

His family knew that he was struggling. They didn't know how much. They loved him. They wanted to help him. Over the years, they had tried to do what they could. Many people who encountered Cho were concerned. Many people saw the need and tried to help.

"In December 2005, [Andy Koch, who was Cho's suitemate last year] called police to say that his suitemate seemed suicidal. Officers went to speak with Cho. He was referred to the local mental health center, and then sent to a psychiatric care hospital. Here was Cho, safely away from campus, in the arms of the mental health system. ... A day or two later, he was released and returned to campus. Virginia Tech officials say his care was out of their hands, and they could not know that he needed more help.

How could anyone know how much help he needed? We can only see into the minds of others as much as they allow. It can be difficult to tell when "thinking outside the box" crosses a line and becomes a threat. What should be considered a cry for help, and what can/ should be done to answer that cry?

"The massacre at Virginia Tech has sparked an intense debate over how to deal with mental illness and how best to protect society from people with violent tendencies. ... [W]hile some are calling for a reform of the mental health system and the expulsion of disturbed students, experts say the solution is not that simple. Strange behavior is not sufficient to force a student into counseling, and even the best practitioners cannot always predict when a patient has become a danger to themselves or to others, experts said. 'There can be signs, but it's not a crime to be odd.' "
France 24

"Strange behavior is not sufficient to force a student into counseling..."

"It's not a crime to be odd."

Where is the line that marks when "strange" and "odd" behavior should be considered "threatening" or "dangerous"?

" 'I don't think at the time you could have said he's definitely going to shoot someone. But we had talked about he was likely to do that if there was someone that was going to do it,' says Andy Koch ... 'The first thing I thought of Monday was Seung ... and if that's the first thing you think about, there were definitely some things that we should have done,' he says. But 'I don't know what we could have done.'

"But 'I don't know what we could have done."

What can be done? What should be done?

"When George Washington University and New York's Hunter College expelled students who appeared suicidal, the students sued. Schools have to 'balance the rights of students with the rights of the communities and with what parents want, and its not an easy thing to do,' says Dr. Joanna Locke of the Jed Foundation, which works to prevent suicide and promote mental health among college students."

It is a fine line to walk, and a difficult balance to find. Not all students who are mentally ill pose a threat, and some say that not all students who pose a threat are mentally ill.

"Despite media reports, Cho Seung Hui, the shooter in the tragedy, may not actually have had a serious mental illness relative to other diagnoses. But the possibility opens the door for reflection on the nature of mental illnesses--what they are and what they are not--with regard to symptoms, treatment and risks of violence. The U.S. Surgeon General has reported that the likelihood of violence by people with mental illness is low. In fact, 'the overall contribution of mental disorders to the total level of violence in society is exceptionally small.' More often, people living with mental illness are the victims of violence. Severe mental illnesses are medical illnesses. They are different from episodic conditions.  They are different from sociopathic disorders. Acts of violence are exceptional. Treatment works, but only if a person gets it."
National Alliance on Mental Illness

There are those who consider anything outside the norm to be some sort of mental illness. Then there are those who consider mental illnesses to be only the most severe chemical imbalances.

"Mental illness is a term rooted in history that refers collectively to all of the diagnosable mental disorders. Mental disorders are characterized by abnormalities in cognition, emotion or mood, or the highest integrative aspects of behavior, such as social interactions or planning of future activities. These mental functions are all mediated by the brain. It is, in fact, a core tenet of modern science that behavior and our subjective mental lives reflect the overall workings of the brain. Thus, symptoms related to behavior or our mental lives clearly reflect variations or abnormalities in brain function. On the more difficult side of the ledger are the terms disorder, disease, or illness. ... Moreover, the manifestations of mental disorders vary with age, gender, race, and culture. The thresholds of mental illness or disorder have, indeed, been set by convention, but the fact is that this gray zone is no different from any other area of medicine.

Once again, there are questions. There is a gray area. There are many questions people have about what should have been done, and what can be done to prevent such a tragedy from happening again.

As was the case in many universities across the country last week, students and teachers at Colorado University spent class time discussing the events at Virginia Tech.

"On Tuesday [April 17, 2007], a student at Colorado University was arrested on charges of interference with faculty, staff and students when others felt threatend after he reportedly made sympathetic remarks about Virginia Tech shooter during a class discussion of the rampage and said there were things at Colorado University that made him angry enough to kill people. Max Karson was arraigned, his father posted $1,000 bond and was barred from campus and could face up to six months in jail if convicted on the misdemeanor charge. Is this a call for help? A danger to society. Or is it, as Karson's father put it, simply a bit of free speech. 'If a major university means anything, it means free exchange of ideas,' Michael Karson told the campus newspaper, 'Max was arrested for making intellectual comments to an academic discussion. I don't think you should be able to arrest a kid for expressing his views.' "

Where is the line? If all students who at one point were frustrated with their fellow classmates and/ or were struggling with a mental health issue were to be removed from school, the schools would be significantly less crowded.

"While mass shootings are rare, a large number of students have mental health problems and practitioners say there are not enough resources to help them all. Nearly 18 percent of college students say they suffer from depression and 12 percent say they suffer from anxiety, according to a recent study by the American College Health Association. Even more disturbing is that nine percent of college students said they had seriously considered suicide and one percent had tried to kill themselves in the past year. In addition to safety concerns, administrators have to worry about liability. More universities have begun forcing suicidal students to withdraw following a 2003 lawsuit by the parents of an MIT student who committed suicide. But that can also lead to lawsuits: George Washington University recently paid a settlement to a student it suspended after he sought help for depression when he claimed the school violated federal disability laws.
France 24

The goal is not (or should not be) to discourage those who need help from seeking it. The goal is not (or should not be) to discourage free speech.

Where is the line between free speech and a threat? It seems as though it used to be much more clear than it is today.

Few will argue that the goal is to have safe schools -- schools where students feel safe expressing their insights and needs, and schools where others still feel safe after hearing what these students have shared.

Questions of the Week:
How can schools "'balance the rights of students with the rights of the communities and with what parents want"? Is it possible? What can be done to help schools do a better job of balancing the rights and needs of those they serve? How can students determine what role they play in helping their school be a safe place that balances their rights and needs with the rights and needs of all students?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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