Thursday, August 2, 2012

James Holmes' Psychiatrist Knew He Was Dangerous

We have been discussing whether or not James Holmes’ psychiatrist could have or should have known how dangerous he was and what she could or should have done about it.

Yesterday, ABC News reported that the psychiatrist, Dr. Lynne Fenton was, in fact, very concerned about the threat that Holmes posed and reported him to her colleagues on the University of Colorado threat assessment committee.

This committee had been organized by the university to identify and help students who were presumed to be dangerous.

Dr. Fenton reported on Holmes in early June, but, before the committee could meet, Holmes dropped out of school.

Whatever the legal issues now swirling around this case—and there are many—the question we should now address is this: if the problem was sufficiently severe to be reported to a threat assessment committee, why was it not reported to competent law enforcement authorities?

Holmes was just as much of a threat after he dropped out of school. He might have been more of a threat.

We do not know whether Holmes saw Dr. Fenton after he dropped out of school, so, we will not speculate on that matter.

The larger question is: should academic institutions should take on law enforcement functions, and is it sufficient for a physician to report concerns to university authorities and not to the police.

Take another example: members of the coaching staff at Penn State were aware that Jerry Sandusky was a sexual predator. Was it sufficient for them to report to university authorities or should they have informed the police?


Anonymous said...

The criteria to report a patient to the police, a Tarasoff trigger, if you will, is very high, as it should be. If the patient does not make a direct threat against an identifiable person, that the therpaist believes is a credible threat, not just blowing off steam, they cannot violate confidentiality.

Patients, millions of them, see therapists in an environment of trust, to get help, not to give up their rights to remain silent, as in going to the police.

They need a safe place to get well and be treated.

MOST patients NEVER harm anyone, but rather are victims of violence because of the ignorance and stigma of society.

The standard to raise concerns about students, a student with an eating disorder could be reported to such a committee, for example, at a university is far different.

It is beyond sad, what happened. But it is also rare, and if you do not allow therapy to stay private and confidential unless there is a direct threat to an individual's life, then people will simply not seek help and there will be far greater harm to society.

It is so sad what happened, but knee jerk reactions can only result in more harm.

Stuart Schneiderman said...

In fact, Dr. Fenton did report Holmes to the campus police. Clearly, she thought that his behavior was sufficiently threatening to be examined by law enforcement authorities and forensic psychiatrists.

Anonymous said...

Reporting to a committee like that does not mean anyone will be examined by law enforcement or a forensic psychiatrist. It means that the committee with determine what is in the best interest of the student and the student body. For Fenton to keep her license and "report" a patient to law enforcement there would have had to be an identifiable threat. There clearly was NOT, or she would have called the Aurora police. I was even wondering if there wasn't a sort of blurring of the boundaries with her on that committee and seeing students for therapy, because of confidentiality. And, it sounds to me like she abandoned her patient.

I don't have the answers, but I do know that in years past, many people were held in psychiatric facilities against their will for no reason. They posed no danger. Laws were changed at that time and now we seem to be suggesting going back to that.

We need better mental health care, and that costs money. We need a society that is tolerant. There are no easy answers.

I think Holmes was a victim of mental illness, I wish in his desperation he had received help. I feel for all the victims, Holmes included. My heart aches for everyone who was killed.

Stuart Schneiderman said...

I suspect, as you do, that she abandoned her patient. My understanding is that she did report him to the campus police. We know now that they canceled his student ID so that he was not allowed on campus. I do not know what, if anything happened between the campus police and the local police.