04/18/2014

Greg SancierStreet Psychology — Advantage Officer!
with Greg Sancier

The dangerously mentally ill: Spotting the signs to prevent tragedy

Part two of an active killers series explores behavioral cues of the dangerously mentally ill

They’re the once-proud parents of a successful, “straight A” student. Their feelings are incredibly conflicted. They’ve observed their loved one slowly become a “psychological time bomb.” They may feel shame, shock, frustration, guilt, anger, helplessness, depression, and regret. They may even feel fear — even horror — as they realize that they’ve begun to lock their bedroom doors when they go to sleep at night.

The family witnesses mental deterioration of a person they love so much but now fear. They may see their loved one self-medicate with street drugs (exacerbating their condition). They may see a condition called “Anosognosia” — an individual’s inability to realize they are sick (or in this case, mentally ill) — complicate matters further. They may suffer from a form of Anosognosia themselves: some might call it denial. 

The sadness and inner conflict can be overwhelming for families. Ultimately, we sometimes get to the very controversial issue of involuntary commitment. Here, we get into the conflict between an individual’s civil rights and the community’s rights related to public safety. It is at this intersection where police officers come so frequently into the equation. It is a delicate balance but the public’s safety must take precedence in these cases.

Seeking Professional Assistance
Laura’s Law in California and Kendra’s Law in New York State both have to do with involuntary commitment. In a perfect world I would like to think that people left to their own devices would recognize the need for psychological help. Unfortunately many do not. 

It is for this reason that both Laura’s Law and Kendra’s Law can ultimately get people the assistance they need by mandating they get help when certain conditions (such as the potential for violence) are present. We must recognize (and remember) that many mental illnesses — such as Schizophrenia and Bipolar Disorder — are not manifested until the late teens or early to mid-twenties.

This one fact can render moot any argument about “not allowing the mentally ill to purchase firearms.” A seemingly mentally healthy individual may purchase a rifle at 18 years of age, and a handgun at 21 years of age, only to develop mental illness long after they have made the purchase. Furthermore, in Adam Lanza’s case, his mother had numerous firearms around the house — she enjoyed shooting and wanted to share the hobby with her son. 

As we know, this was ultimately disastrous. 

Slowly, people in the community become aware of “that house on the block.” Children are told to keep away, and people take the long way around the block so as to avoid passing by the place. No one wants to live next door, or across from “the wacko” and real estate values are affected. Due to complaints by the citizens who live in the neighborhood, the police eventually become involved. 

This is when it becomes critical that an accurate account of the police responses occurs. 

When it’s clear that someone in the residence has a mental health issue, it’s time to insert the mental health clinician — or the CIT police officer — who can make an on-sight assessment of the individual. Upon contacting the individual at the residence they may or may not answer the door, due to their paranoia. 

Perhaps a family member will answer the door — if the situation is handled professionally and with caring, a relationship can develop with the family to ensure the health and welfare of the loved one afflicted with the mental illness. 

It is possible that the individual may never have been officially diagnosed by a licensed clinician. Regardless, all the information obtained can assist the mental health professionals develop a treatment plan with the assistance of multiple agencies and family (if applicable).

Personality Disorders vs. Mental Illness
This weekend, we will pause to consider the 15-year anniversary of the Columbine Massacre. People will inevitably talk about mental illness and violence. 

Something to be mindful of is this: Unlike Adam Lanza, or James Holmes, or Jared Loughner, Eric Harris and Dylan Klebold did not have discernable psychiatric diagnoses. They weren’t suffering from Bipolar Disorder or Schizophrenia, which are often times accompanied by both delusions and hallucinations of unthinkable violence.  

Many people with personality disorders can function on a daily basis, whereas people with the more severe mental illnesses such as Schizophrenia, Bipolar Disorder, or Clinical Depression may not be able to.

Eric Harris and Dylan Klebold demonstrated certain behaviors which may have indicated problems, but Adam Lanza, James Holmes, and Jared Loughner demonstrated behavioral cues indicative of a mental illness. Whether people chose to address them as potentially violent individuals can only be determined by their actions. 

Why did the gun range owner in Aurora (Colo.) not allow James Holmes to shoot at his gun range? The reason is when he called Holmes’ house and listened to the voicemail message, he felt as though something may be horribly wrong with him. 

Unfortunately it takes a group of people, or the community, to come together to address what may be a potentially huge public safety problem. This can only be accomplished by people in the community who sense that something is wrong with an individual based on some obvious behavior patterns. 

Some indicators may be:

•    Overgrown plants, grass, and shrubs where they live
•    Garbage, junk, broken-down cars, strewn about the yard and the home is in a state of disrepair
•    Rarely seeing anyone in or about the residence, yet being fully aware that people live there
•    People outside the home being menacing, threatening, and/or behaving in a bizarre fashion 
•    People talking to themselves when they’re obviously not on a cell phone or listening device
•    Yelling and/or playing loud music at all hours of the night and morning on a consistent basis
•    Family and friends beginning to speak about a drastic change in a loved one’s behavior

Many of these behavioral cues can only be assessed by a professional Mental Health Clinician from the county mental health department, or a police officer (ideally with Crisis Intervention Training (CIT)) who frequents a particular beat and possibly has been at a residence several times to the point where the address can be “red flagged” for the potential of a mental health crisis occurring. 

These professionals can then contact neighbors, family members, co-workers, colleagues, classmates, etc. to determine if the person is deteriorating mentally. Only then can a “treatment plan” be developed to ensure that the person gets the care they need. It does take a group effort to make this plan a success. 

If the agencies, community, family, and friends can come to an agreement that the person is need of mental health treatment, then (and only then) can a plan be developed that will be in everyone’s best interest and potentially avert another tragedy.

About the author

Dr. Sancier began his law enforcement career at the Atherton (Calif.) Police Department as a Reserve in 1978 and then became a regular in 1980.  While working at APD Greg worked patrol and also worked in a collateral assignment as a Hostage Negotiator. While working full time as a police officer Greg applied and was accepted into the Master’s Degree program in Clinical Psychology at SJSU.  He worked at APD until 1985 when he went to the San Jose Police Department. While at SJPD Greg became a Hostage Negotiator as a collateral assignment as he worked in patrol, the training unit, and then in the Crisis Management Unit (CMU) where he worked the last 7 years of his career.  Upon joining the SJPD Greg earned his Master’s Degree in Clinical Psychology in 1989. During his tenure of nearly five years in the  training unit at SJPD Greg taught in service police officer’s classes such as Psychology of Survival, Officer Safety / Survival, High Risk Car stops, Defensive driving tactics, Fitness and Nutrition, Defensive Tactics, to name a few.  Greg applied and was accepted to the Ph.D. program at the Western Graduate School of Psychology in Palo Alto in 1992 while he worked full-time in the training unit at the police department.

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