Thursday, April 19, 2007

Should the Judge Have Jailed Cho When He Had Him?

The news of the Virginia Tech shooting took me back to the days when I was an active leader in the National Association for the Mentally Ill (NAMI). That organization has made a great contribution by convincing decision makers that psychosis is a treatable disorder of the brain.

The success of that campaign however, created an unanticipated dilemma. If psychosis is a brain disorder, what is societies’responsibility(see the debate) for someone like Cho Seung-Hui, the shooter, who shows up in the mental health system.

Advocates for the mentally ill, using similar rationale, ended up in two opposing camps. One side, fought against forcefully locking people up. They argued that it was inhumane to treat someone as a common criminal because that person had been unlucky enough to have been born with a damaged brain. No other type of illness is treated in that manner.

The other side argued that mental illness is a special case in that, unlike other illnesses which create discomfort, the mentally ill often cannot know they are sick. The part of the brain which informs them that something is wrong, is damaged. The forced treatment group argued that it was inhumane to the psychotic person, not to forcefully treat him.

One of the psychiatrists that I had speak to our state meeting, gave a dramatic and chilling demonstration of what it is like to be mentally ill and not know it. Turning to our director, he asked: “Mr. Johnson, what do you do?”

“I am the director of the mental health association.” Mr. Johnson replied.

“No, Mr. Johnson, I am sorry you are not. You just think you are. Actually, you are suffering from a mental illness and your parents are here with the police to take you away.”

A gasp went through the crowd as the psychiatrist had made his point.

As I watched the tapes of Cho, I was thrown back into that debate. Cho was psychotic. As he looked into the camera, he totally believed he was making sense. He would be completely unaware that he was talking nonsense out of a deranged mind.

Cho is the argument for forced treatment. Had the judge had that option, and taken it, a lot of people would be alive today.


Rich Tatum said...

There's a debate raging on my blog right now about homosexuality and Christianity (essentially, the dialog is over whether the Bible explicitly forbids homosexual acts or whether the disputed Greek terms imply something else, such as forcible male rape, etc.). A key plank to the pro-gay argument is that homosexual orientation (as well as gender identity orientation) is innate, possibly genetic, and immaleable. The argument goes that since it is innate, the loving, Christian thing to do is to accept the behavior as within the Biblical norms.

On the surface, this has little to do with your post here. But this is what occurred to me as I read your anecdote: Is it possible for innate mental deviancy — which seems perfectly rational to the sufferer, to be communicable?

By that, I do not mean is it possible to induce mental illness by exposure. I'm simply wondering if one's altered sense of what is right can be so persuasive as to generate a "meme" that others not so mentally inclined might eventually accept and pass on themselves?

I'm thinking of this in light of the GLBT debate, of course. But I suspect there is evidence that an individual's psychosis can become mass psychosis when a cultural "tipping" point is reached. For example, what happens when a psychotic megalomaniac rules a country? Perhaps you get Nazi Germany, or North Korea, or Iraq. One leader's delusions fuel and inform a cultural delusion.

The seed may be biological but its flowering and fruit can be sociological and cultural.

In the example you cited, it would have been theoretically possible that your director, compelled by the rationality of his "reality" could have persuaded everybody else in the room to accept his role and position by fiat. In short, his native psychosis induced a belief in his peers, family, and friends indistinguishable from his own break from reality save for the fact that his was rooted and biology and everyone else's rooted in belief.

I don't know. I feel like I'm rambling here, but it is good food for thought.

One last aside: I've been hearing reports today of a high-school boy arrested for writing too creatively when given a therapeutic creative writing assignment by his teacher. The goal was to deal with the emotional aftermath of Virginia Tech by having the students confront their emotions through writing. Unfortunately, one boy's writing proved to be too violent for comfort. The teacher called the police, and the boy was arrested and charged with disorderly conduct.

Seems that if forcible treatment is to be actionable at all, there should definitely be experienced and expert mental health professionals involved, not merely lay-people.


Father Don said...

Thanks Rich. I am thinking about what you wrote.

Rich Tatum said...

Regarding the incident I mentioned, from the Chicago Tribune today:

'STAB, STAB, STAB, STAB, STAB, S . . . T . . . A . . . B . . ., PUKE.' That's an excerpt from a school essay written in response to the assignment, "Write whatever comes to your mind. Do not judge or censor what you are writing" -- the essay that led to a student's arrest.

See more here.