Shooting spree inspires call for mental health overhaul

Friday's stabbing and shooting spree in Santa Barbara, Calif., has renewed the debate over how and whether to require people with serious mental illness to get psychiatric care.

Many families and advocates for people with serious mental illness say the country needs to change its standard for civil commitment, which allows people to be hospitalized against their will.

Changing these laws could help provide treatment for people like Elliot Rodger, 22, who police say stabbed or shot six people to death near the University of California-Santa Barbara, says Doris Fuller, executive director of the Treatment Advocacy Center, a mental health advocacy group. Although his family had asked police to check on him, officers decided he wasn't a threat and made no arrest.

Fuller says states should make it easier for families to petition for involuntary commitment when they are worried about a loved one's health.

"We cannot predict who will be violent, and we will never prevent all violence," Fuller says. "But nobody knows better than family members when a loved one is unstable and dangerous."

Most states allow people to be involuntarily hospitalized only if they present a danger to themselves or others, or if they are "gravely disabled," Fuller says. That often leaves parents with one option: to call police, who aren't trained to make psychiatric diagnoses, Fuller says.

"We use cops as mental health workers," Fuller says. "That makes no sense."

Rep. Tim Murphy, R-Pa., a child psychologist, has introduced legislation that would push states to change these criteria, permitting involuntary hospitalization based on a patient's "need for treatment," a standard now used by only 18 states.

"Once again, our mental health system has failed," Murphy said in a statement after the shootings. "How many more people must lose their lives before we take action?"

Although families are the first ones blamed when something goes wrong, many feel shut out of their loved one's care, says author Pete Earley, author of Crazy: A Father's Search Through America's Mental Health Madness.

Doctors often refuse to talk to the parents of adult patients because of privacy laws, even when family members are their primary care givers. With so few hospital beds for psychiatric patients, many simply can't get care. Earley says he was repeatedly told that his son wasn't sick enough to be hospitalized.

Once, an emergency room doctor told Earley, "Bring your son back after he tries to kill you or someone else."

Studies show that most people with mental illness are no more violent than anyone else, says Ron Honberg, national director of policy and legal affairs at the National Alliance on Mental Illness.

A small portion of people with serious mental illness may need to be committed to a hospital against their will because they don't recognize that they're ill, Honberg says. But Honberg says that states also need to protect patients' rights.

And changing civil commitment laws isn't enough to get people the care they need, Honberg says.

Most people who are committed involuntarily are out of the hospital in a few days, Earley says.

The country should focus on expanding crisis intervention teams, so that trained mental health workers can accompany police officers called to psychiatric emergencies, Honberg says. The country also needs to increase its services for the mentally ill, so that patients can get care when they leave the hospital.