Wed January 12, 2011
Shots - Health News Blog

Psychiatrist Weighs In On Attitudes Toward Mental Illness After Loughner

In an opinion piece in today's Baltimore Sun, Johns Hopkins psychiatrist Larry Wissow argues that there are still real barriers to getting care for people with apparent mental health concerns like the alleged Tucson shooter Jared Loughner.

Wissow can't, of course, definitively diagnose Loughner, whom he's never met. But Wissow writes, "accounts of Jared Loughner's prior behavior strongly suggest that he was psychotic — not just 'wacky,' but having a definable, treatable mental illness."

In Arizona, the law makes it easier than in some places to have someone involuntarily evaluated for mental health problems.

Many people like Loughner as well as the non-violent mentally ill often don't get treated, Wissow notes, in part due to the stigma surrounding mental illness. Shots caught up with Wissow today to learn more. Here are highlights from our conversation, edited for length and clarity.

Q: What's the first step if you come across someone who might be mentally ill?

A:  Consider the symptoms: Is this somebody who's kind of cranky or someone who's really behaving out of the ordinary? A lot of it is trust your gut. Our brains are wired to detect this sort of thing. Even little kids are good at picking up on someone who is mentally ill.

The second piece of this is helping people to respond. Some people who might want to help get caught up in rules about whether they're allowed to get involved. Or they may just ignore it and think it's none of their business.

Q: So how do you approach somebody and tell them, "I think you need some help?"

A: The questions that may not get the right answer right away but need to be asked are, "Who else cares about you? Is it okay if I get them involved to try to support you in getting some help?" One of worst things is the cone of silence that descends over the situation. But the easiest way to get around this is to ask someone, "Who would be willing to help you?"

Q: And who is the best person to do that?

A: The best person is often the person in the institutional or educational setting that person is interacting with. Because that's the one they have a bond with.

Q: So it's the teachers' or coworkers' responsibility to reach out first?

A: Well, these kinds of things are easier said than done in big, busy places where you have big classes, and teachers who feel stressed. Often we see that extra step of becoming attuned to students' emotional needs is voluntary and not an obligatory part of the job.

Q: In the wake of tragedies like the Virginia Tech massacre, do you think we're getting better at this?

A: There's definitely more of a movement on college campuses around early detection of mental illness and response. But it's still very dicey because colleges don't want to make the problem seem common.

Q: Is there anything that concerns you about the way cases like Jared Loughman's affect discussions of mental health?

A: The thing I fear is now this case will get a lot of attention, but it may or may not be a typical or clear-cut case of mental illness. There could be lots of other complications. What you don't want is for that case to become the poster child because the vast majority of people who are psychotic don't go out and get guns. They say weird things, quit their jobs, and stay at home. But they ultimate don't hurt anyone but themselves. That's the thing that's sad. You don’t want this to be the face of mental illness. Copyright 2011 National Public Radio. To see more, visit http://www.npr.org/.