Tucson Shootings and Mental Health System

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Charles Arnold, a mental health attorney and member of the board of directors for Mental Health America of Arizona, provides his assessment of what steps could have been taken to help Jared Loughner, the suspect in the Tucson shootings.

Jose Cardenas: As the investigation into the Tuscon shootings continues, questions are being raised whether or not suspect Jared Loughner could have been helped. Joining me is Charles Arnold, mental attorney -- mental health attorney and also on the board for mental health America of Arizona. Pleasure to have you on the show. Just a little bit about your background. You are the Arnold of Arnold versus -- one of the longest running cases in the state of Arizona. Talk about that and about your background.

Charles Arnold: I am. Thank you and thanks for the opportunity to be here. A mental health lawyer, Formerly in 1979, 1980, '81, was the Maricopa County public fiduciary, the public guardian, now I'm a private lawyer, specializing if you will, in issues of disability. So we work with families of folks with serious mental illness and help them negotiate systems in our community designed to assist in their constant struggle
Jose Cardenas: and just a sentence on the case.

Charles Arnold: As the public guardian in 1981, I filed a lawsuit, I was the named plaintiff in a class action lawsuit against the state and the county for failure to comply with a statute creating a mandatory duty to provide community-based Services to people with serious mental illness. I was the guardian of 600 folks in Maricopa County, those Services weren't available, and so as a lawyer I was able to identify the need to ask the court to require that that statute be met.

Jose Cardenas: Let's talk about Mr. Loughner. Any connection in your opinion between the political rhetoric that sheriff Dupnik talked about on Saturday and his act, Mr. Loughner's acts?

Charles Arnold: As many of us did, I listened to the sheriff and agreed with what he was saying about the nature of our dialogue these days. It's hard for me to link, that however, with a person such as Mr. Loughner. A person with a serious mental illness who within his own head was creating fantasies and paranoid conspiracies upon which he acted. Might he have acted out based upon stimulation from media? Perhaps. But I think it's just as reasonable to assume that his illness is what drove this heinous act, and not media influence.

Jose Cardenas: Without focusing specifically on him as a general matter, it is likely that somebody would commit these kinds of acts based upon that kind of incitement?

Charles Aronld: I think we have to draw a distinction in terms of the level of incapacity. A person such as Mr. Loughner, a person with a serious mental illness, is going to act on his own. A person with less severe illness who might be influence able by stimulations such as media, you bet, could act upon those stimuli being provided. Hearing the kind of things that would get a person worked up might cause them to act.

Jose Cardenas: But at this point in time no reason to believe that that was indeed the case here.

Charles Aronld: You know, that's my view.

Jose Cardenas: We introduced this segment by saying there are questions about whether he could have been helped.

Charles Arnold: You know, one of the ironies of mental health law in our state is that while our systems are often deficient, our statutes, laws passed by our legislature, are among the best in the country. Specifically our statutes relating to involuntary treatment for a person with a mental disorder. What our statutes -- is what's known as the fourth standard of involuntary treatment. A way of providing assistance to someone who might not have insight into their own disability, and provide a means of treatment. And so people who heard what they heard at the college, that resulted in a suggestion that in order for Mr. Loughner to get back into college, he needed to have a mental health evaluation, I don't purport to know what went on and what they heard. But whatever it was, it was sufficient to alarm them and recognize the need for that evaluation.

Jose Cardenas: And we're talking about Pima county community college, where he was enrolled for a period of time. But what could they have done? Based upon that information that they had, what could they have done?

Charles Arnold: The petition for involuntary treatment is a three-step process. The initial step is an application for an involuntary evaluation. That can be done by any responsible party. That's often done by family members of a person with a serious illness. People who know the facts. That starts a process that would have resulted in Mr. Loughner being evaluated, given the opportunity to be a voluntary patient if necessary, and in the event he refused that opportunity, a petition for evaluation would have been filed by a screening agency. A part of the mental health, public mental health system in Pima County. That screening agency would determine whether he met Mr. Loughner, met the criteria for involuntary treatment, and he falls within the category of persistent and acute disability. It's not something that requires a manifestation of dangerousness first, it's something a suggestion that without further treatment, he would be likely to become dangerous to himself or suffer emotional harm. Indeed I believe Mr. Loughner falls within that and so would have been subject to that process.

Jose Cardenas: So this is a process that the college officials could have initiated, do you think they should have done this?

Charles Arnold: Whether they could have or not, I think is clear. I also believe that there's a responsibility to have initiated that process. Mental health law has a common denominator has a balance. A balance of individual rights against community rights. Every one of us has the absolute right to have a mental illness and remain free from involuntary treatment. When the community's rights prevail, when we're dangerous to ourselves or dangerous to others, or according to our statute, persistent and acutely disabled, the community rights trump the individual rights, and we're subject to treatment. Because the stakes are so high in a situation such as this, I believe there was a responsibility, not just a right, but a responsibility to go ahead and file that application for an involuntary evaluation.

Jose Cardenas: Would they have been exposing themselves to legal liability for doing that?

Charles Arnold: Absolutely not. Our statutes are state of the art and they include an immunity clause for people acting in good faith. And presumably the action would have been in good faith.

Jose Cardenas: Now, there's been a lot of discussion about the impact of budget cuts have had and they continue to have the provision of Services for people who need them in circumstances like this. Have you seen that impact, and would it have been manifested here, if he had initiated the process?

Charles Arnold: Without question, that issue couldn't to -- can pop up in two ways. I don't know what if anything the family sought to do for Mr. Loughner, whether they sought treatment. I do know that the regional behavioral health authority in Pima county, CPSA, the community partnership of southern Arizona, is a terrific functional responsive organization who contracts with providers that are open. The fact that the budget has taken such a hit and services have been dramatically reduced for persons with serious mental illness may very well have been an impediment to obtaining Services at that stage. On the other end, there's a problem in people who -- who are providing services to people who are not Title 19 eligible. What that means is people who are not so povertized that they qualify for Medicaid Services. Services have been terminated in many respects for persons who are not eligible for federal reimbursement. Thus, again, I don't know the circumstances of Mr. Loughner, but the problem in the involuntary petitioning process is the outpatient part.

Jose Cardenas: We may be seeing some impact there.

Charles Arnold: Absolutely.

Charles Arnold:Mental Health attorney and member of the Board of Directors for Mental Health America of Arizona;

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