Forced Commitment Might Have Stopped School Shooting, AP reports. Also, A Father Inside View Of A Backward System

(3-19-18)  During the weekend, the Associated Press reported that authorities in Parkland, Florida,  sought to involuntarily commit the alleged school shooter there several times more than a year before he opened fire, killing 17 with an assault rifle and wounding 17 more . A commitment under the law would have made it more difficult, if not impossible, for Nikolas Cruz to obtain a gun legally. 

A New York Times OP ED by advocate Normal J. Ornstein, whom I greatly admire, specifically discusses what happened in his family in Florida after Ornstein used the Baker Act to hospitalize his son. 

Meanwhile, The Washington Post published a front page story entitled, “I’m constantly asking: Why? When mass shootings end, the painful wait for answers begins. Earlier in that same week, D. J. Jaffe, author of Insane Consequences, and no stranger to causing controversy, published an Op Ed in the Post under the title: “Don’t deny the link between serious mental illness and violence.”  Jaffe wrote that untreated Americans with serious mental illnesses are, in fact, more dangerous, an unpopular view that others have challenged. He also repeated his call for six changes: 1. more hospital beds, 2. not using dangerousness as the primary criteria for involuntary commitment, 3. adoption and better funding for Assisted Outpatient Treatment, 4. modifying HIPAA so that parents and other caregivers are kept informed by medical providers, 5. using “red flag” orders to remove firearms from persons with mental illnesses, and 6. reining in the federally funded, state administered Protection and Advocacy groups (PAIMI), that often fight to get individuals out of hospitals arguably before they are ready. 

Ever since the school shooting in Parkland, Fla., law enforcement and other officials have been calling for changes in the Baker Act, a Florida law that allows involuntary commitment for 72 hours of people who are an imminent danger to themselves or others. If the Baker Act had been easier to deploy, they think, Nikolas Cruz, the accused shooter, would have been taken and treated before his horrible act.

However this law may be reformed, it will never be able to get people with serious mental illness the treatment they need.

I know something about the Baker Act. About halfway through my son Matthew’s decade-long struggle with serious mental illness, my wife and I invoked the Baker Act against him.

This kind, brilliant, thoughtful young man, who experienced the sudden onset of mental illness at age 24, was living in a small condominium we owned near Sarasota, Fla. One day the manager called us with alarming allegations about his behavior and insisted that Matthew was in immediate danger.

In a panic, we flew to Sarasota, went to the courthouse and filled out the forms to invoke the Baker Act. It was surprisingly easy.

When we got to the condo, Matthew was already gone.

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John Oliver Uses Humor To Focus Attention On The Need For Mental Health Reform

(3-16-18) From My Files Friday: I posted this segment about the need for mental health reform by John Oliver three years ago and it remains one of the best. 

“Anosognosia Is Clearly Biological In Origin” Dr. E. Fuller Torrey Argues That Science Proves It


(3-13-18) An article entitled The Perplexing Semantics of Anosognosia: Why an obvious phenomena has sparked controversy, written by Dr. Dinah Miller, co-author of COMMITTED: The Battle Over Involuntary Psychiatric Care,  drew strong reactions yesterday after I posted it.  Among them was this reply from Dr. E. Fuller Torrey, who has been described by The Washington Post as “perhaps the most famous psychiatrist in America.”

By E. Fuller Torrey, M.D.

Dear Pete,

Dr. Miller questions the appropriateness of using the term “anosognosia” to describe the lack of awareness of illness in individuals with schizophrenia or other psychosis.  In The Study of Anosognosia (G.P. Prigatano, ed., Oxford University Press, 2010) anosognosia is defined as “a complete or partial lack of awareness of different neurological…and/or cognitive dysfunctions” which would appear to cover psychoses. She contacted the late Dr. Oliver Sacks who in fact had given an eloquent description of anosognosia in The Man Who Mistook His Wife for a Hat: 

“It is not only difficult, it is impossible for patients with certain right-hemisphere syndromes to know their own problems – a peculiar and specific ‘anosognosia,’ as Babinski called it. And it is singularly difficult, for even the most sensitive observer, to picture the inner state; the ‘situation’ of such patients, for this is almost unimaginably remote from anything he himself has ever known.”

Dr. Miller is also incorrect in saying that “we know nothing of the fundamental neural dysfunction” for individuals with anosognosia.  Studies of stroke patients have demonstrated that the inferior parietal lobule plays a critical role, especially on the right side. Since 1992, there have been 25 studies comparing the brains of individuals with schizophrenia with and without anosognosia. In all but three studies, significant differences are reported in one or more anatomical structures. Since anosognosia involves a broad brain network concerned with self-awareness, a variety of anatomical structures are involved, especially the anterior insula, anterior cingulate cortex, medial frontal cortex, and inferior parietal cortex. Three of the positive studies included individuals with schizophrenia who had never been treated with medications, discounting the likelihood that the observed brain changes resulted from treatment.

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Anosognosia: Is It An Accurate Description Of Individuals Who Don’t Believe They Have A Mental Illness?

There’s no controversy here.  People with psychotic disorders sometimes don’t know they are suffering from a mental illness, and there really is nothing to argue about.  And yet, the word “anosognosia”—meaning the patient is unable to see that he is ill—is a charged word.

Why is that?  Let me talk a little about the history of this word and the political meaning it has taken on.

Anosognosia is a term that was coined in 1914 by a Hungarian neurologist named Joseph Babinsky.  Babinsky noticed that sometimes after a stroke, people are unaware of their deficits.  This is presumed to be a result of pathophysiologic changes in the brain, and not the psychological defense mechanism of denial.  There is not a precise anatomical finding that predicts anosognosia: you can’t look a patient with anosognosia and say, “ah, the MRI will show a lesion in X area of the brain.” Though certainly, some deficits are more likely to include anosognosia than others.

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Desperate Mother Pleads For Help In Florida: Mentally Ill Son Charged With Attempted Murder Using A Comb While in Hospital

REARRESTED…again…same crime new charge. MY SON IS MENTALLY ILL AND WAS BAKER ACTED AND LEFT UNSUPERVISED BY STAFF! #FreeElliott : March 5 Elliott is being held without bail. I feel sick, Michelle is crying, my son could be in jail for YEARS before even getting a trial. Gemma’s son sat there for four years before his trial even began. Right now my mind is gone, yesterday the SWAT team learned AFTER they executed the warrant that my son is seriously mentally ill…they learned his “weapon” was a plastic comb…THIS IS WHY PEOPLE WITH MENTAL ILLNESS GET KILLED BY THE POLICE. They have charged Elliott with 1st Degree Attempted Murder AND Attempted Murder with a weapon – FOR THE SAME INCIDENT SAME MAN.Elliott Longworth

Posted by Tamara Lee on Monday, March 5, 2018

To hear her video plea from Facebook, you must turn on the volume in the right corner facing you.

(3-7-18) I receive pleas for help every week from desperate parents, but few are as gut-wrenching as the email that I received from Tamara Lee, telling me about her son.


A SWAT team entered my son’s grandmother’s house in Port St. Lucie, Florida this week and executed a warrant for “Attempted Murder With A Weapon.”

This sounds horrific right? Truth be told, this nightmare began on Dec. 6 2017 “officially.” That’s when our family made the decision to call the police because my 21 year-old son’s mental health had deteriorated to a point that he was self harming himself.

Elliott was also trying to clean out the refrigerator to bury it in the back yard to use as a shelter so he could survive an upcoming purge. The police came. They saw he was in mental health crisis back then and took him to a hospital where he was sedated, admitted and shoved in a room with another mentally ill person.

Early in the hours of December 8, my son hurt the man in the room with him.

My son doesn’t even recall the incident he was blacked out.

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New York Times Writer Puts Human Face On Mental Illness & Homelessness

 (3-7-18) My former colleague from the Washington Post, Benjamin Weiser, has written a beautifully told story that is all too familiar for too many of us. Thank you Benjamin Weiser and The New York Times for putting a human face on homelessness and how difficult it is to help someone who has a mental disorder if that individuals doesn’t want it. 

Published by The New York Times, March 3rd, 2018

They met on a rainy morning several years ago, at the base of the Helmsley Building in Midtown Manhattan. As others hurried to work, Pamela J. Dearden, an executive with JPMorgan Chase, noticed a woman, unperturbed by the rain or her surroundings, standing on a 36-square-foot sidewalk grate she had chosen as her home.

Ms. Dearden, known to everyone as P.J., offered her umbrella to the woman, who took it and thanked her.

A friendship blossomed. P.J. would often stop to talk with the woman, who sat amid shopping bags, books, food containers and a metal utility cart. P.J. admired her hardiness, but also her smile, her soft features and her humor. If the woman was sleeping or talking loudly to herself, P.J. held back, but other times she engaged her in short conversations, which could go into unexpected places.

The woman’s name was Nakesha Williams. She said she loved novels, and they discussed the authors she was reading, from Jane Austen to Jodi Picoult. She and P.J. chatted as time allowed, or until Nakesha veered into topics that hinted at paranoia: plots and lies against her. Yet, P.J. realized she knew little about Nakesha, and she wondered about her past.

Nearly three decades earlier, another woman took notice of Nakesha, then an 18-year-old college freshman, and considered her seemingly boundless future.

Sandra Burton, director of the dance program at Williams College in Massachusetts, was struck immediately by Nakesha’s vibrancy and talent as a dancer. She became Nakesha’s teacher and mentor, and she began to closely track her development. Nakesha, she recalled, stood out no matter the setting: the stage, the classroom, even across a kitchen table.

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