Reading the comments on this Gawker thread about Jared Loughner’s family, a few thoughts:
It is far harder than you probably think to get an adult with paranoid schizophrenia help—professional treatment or otherwise. And I know this from painful direct experience. Paranoid schizophrenia runs in my family on my dad’s side and we’ve had to deal with it in the worst possible ways. (I was adopted, so I’m lucky to have dodged that bullet, but it’s a concern for the rest of the family.) It’s not simply a matter of recognizing signs and getting someone into therapy. It’s also a matter of convincing that person to consent to treatment or legally compelling them to do so if they won’t. And if the person in question happens to be an adult when his or her psychotic break occurs and does not think he or she has a problem, it’s nearly impossible. (Not surprisingly, many schizophrenic people don’t believe they’re schizophrenic. And if they’re paranoid, too, they may in fact believe that they’re the only people whose perceptions are actually accurate. They’re not crazy; you are. And so is everyone else.)
Unless someone becomes violent, getting a reasonably high-functioning adult into treatment—or even into a clinic for a diagnosis—without their consent is exceedingly difficult. And not because it requires effort, though it does, and quite a lot of it, but because the threshold for compulsion is extremely high and most patients won’t meet it. (And reading about Loughner, he would fall into the high-functioning category. And I don’t see anything obvious—even the junior college expulsion—that would have resulted in compulsory institutionalization.)
Someone in the Gawker thread mentioned a 72-hour hold for people who present a danger to themselves or others. But what constitutes danger to self or others is, in most jurisdictions, predicated upon whether the person in question has actually attempted something violent. Verbal threats are almost never enough. At best, you can file a harassment charge—and that usually won’t get you a court-ordered hospital visit. In my family’s case, we were lucky enough to know and be in a position to figure all of this out via talking to law enforcement, consulting lawyers and so on. Not everyone is. And we were also (in a twisted way) fortunate that the family member in question had sent threatening letters to both of my parents (and when I say threatening, I mean threatening to kill them), which allowed for some documentation when he was brought before a judge on a completely unrelated charge—also a lucky coincidence. But all that got was 72 hours with a shrink to make a diagnosis. And just barely. If we didn’t have the death threats on physical paper, the outcome would have probably been different. There would have been no diagnosis at all, even though we all knew something was wrong.
And that was better than nothing—a lot of mental illness goes undiagnosed because you can’t get the patient in to see a shrink in the first place—but it’s almost useless when the patient refuses meds, refuses therapy, can’t be compelled to take meds by the court, can’t be forced to by family members to do so because he’s legally an adult (and a large physically fit one at that, which makes confrontation potentially dangerous). And there’s no reasoning with the patient because, well, when’s the last time you tried to reason with a paranoid schizophrenic? Logic and facts are no longer relevant.
It is nearly impossible to force a mentally ill person into institutionalized treatment in that scenario. And not without reason; No one wants a system that allows people to be institutionalized simply for behaving erratically or saying crazy things. We live in a country where those things are allowed, as long as they’re not hurting other people. But we also have a system where what constitutes hurting other people is very literal and physical in its criteria. (Ask anyone who’s had a stalker problem about how far someone has to go before law enforcement can really do anything about it.)
So I actually feel some sympathy for the Loughner family. When they say they don’t know how this happened, I don’t think they necessarily mean that literally. I think they mean it in the way that anyone who’s had a child with serious mental issues means it: as a genuine way of asking why. Because no one deserves to have to deal with something like this. And schizophrenia is not a matter of bad parenting—unless you consider having defective genes bad parenting, which I don’t. Breaks often occur in early adulthood, after the patient may have had a completely normal and happy childhood, in which case it’s even more difficult for the parents to process because they can’t believe that their child—who was totally fine just a few years ago—isn’t simply going through a phase.
And for those of you who have kids, ask yourself what you would do if your beautiful, angelic children—no doubt raised lovingly and perfectly by you—were happy and productive and loving people the entire time you raised them. And then one day they weren’t. Because it happens all the time. And if you think it couldn’t happen to you, you’re wrong.