Shipyard Shooter: Could Treatment Have Prevented Tragedy?

Thursday, 19 Sep 2013 02:31 PM

By Nick Tate

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The Washington Navy Shipyard shooting that left 13 dead, including the gunman, is prompting thorny questions about shooter Aaron Alexis's mental health and whether the nation is doing enough to get treatment for unstable individuals with violent tendencies. 

Mental-health experts — including specialists who treat patients with schizophrenia, PTSD, and bipolar disorder — say media reports about Alexis's state of mind leading to Monday's shooting reflects what appear to be classic symptoms of psychiatric problems and raise important questions about the mental-health safety nets in the U.S..
 
Michael C. Miller, M.D., former editor of the Harvard Mental Health Letter, tells Newsmax Health incidents like the Navy Shipyard rampage are difficult to explain and understand. But they clearly spotlight the need to expand access to mental healthcare in general — an effort he said could have the net effect of reducing violent incidents overall in the U.S.
 
"When a bad thing happens because an individual did something violent we tend to focus on prediction on individuals, but an approach that is more likely to yield better results and reduction of harm are actions that target large populations," said Dr. Miller, who like other medical specialists, declined to comment directly on Alexis's specific mental health status

"If you reduce the incidence of certain kinds of illness, you're going to see fewer of the bad outcomes that come from that illness," he adds. "And that's as true for mental illness as it is of heart disease."

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David Reiss, M.D., a San Diego post traumatic stress disorder specialist, also says more needs to be done to close gaps in the nation's healthcare system that not only leave the mentally ill vulnerable, but also others.
 
"Our mental health system is on the back burner," he told the Everyday Health website, "and that's not in the best interest of anyone."
 
Dr. Reiss also notes individuals who suffer from PTSD — a condition Alexis reportedly suffered after participating in rescue efforts following the 9/11 attacks in New York City — can be living in state of "intense fight of flight response."
 
He adds: "If you look at the number of people who have PTSD, it overwhelms the system."
 
Prakash Masand, M.D., president of Global Medical Education, says the shooting spotlights the need for more screening for mental healthcare problems before individuals are cleared to enter the military.
 
"Individuals who are at high risk for psychiatric illness do not belong in the military," he said.
 
In the wake of Monday's shooting, numerous reports have indicated Alexis was suffering from symptoms that are the hallmarks of serious mental illness for which he was apparently not treated.
  • His father told investigators that his son had suffered from PTSD following the 9/11 attacks. Alexis was in New York City and actively involved in search and rescue attempts.
  • Alexis later moved to Seattle where the first documented outburst of violence occurred, when police reports indicated he shot at a construction company's vehicle, because a worker had disrespected him.
  • Alexis joined the Navy in 2007, but was discharged after a 2010 incident during which he reportedly shot a gun into a neighbor's apartment. He told police, the weapon accidentally discharged while he was cleaning it, but the neighbor said it may have been an attack.
  • Alexis reportedly called the Newport Police Department in 2010 and said he was being stalked by three people who were keeping him awake by sending vibrations from a "microwave machine" to his body through the floor, The New York Times reported. Alexis also told the police he was hearing voices, but because he had no prior record of mental illness, nothing was done.
Mental health experts note that hearing voices and complaining about the use of devices to transmit signals into a person's body are classic symptoms of schizophrenia.
 
"It sounds like a fairly typical case of paranoid schizophrenia," E. Fuller Torrey, M.D., a professor of psychiatry at the Uniformed Services University of the Health Sciences, told PBS Newshour.
 
"He clearly thought people were following him. He thought people were using machines to cause vibrations in his body. This is a brain disease — it's a brain disease like Parkinson's disease or Alzheimer's disease."
 
According to the National Institutes of Health, schizophrenia affects about 1 percent of Americans and can cause hallucinations, delusions, and disorganized thought patterns.
 
While it's impossible to say whether psychiatric help could have headed off Monday's rampage, experts say improving mental healthcare in the United States could reduce the risks of violence that may be at least partly fueled by such conditions.
 
"There never easy explanations for why somebody does something as violent as this kind of act," Dr. Miller notes. As a result, it is difficult to identify individuals ahead of time who might commit such crimes, even when there’s been a history of violence or mental illness. Consequently, restricting gun access or apprehending individuals who appear to have the potential to commit violent acts is problematic, he says.
 
"The reality is it's always a balance. We in this country are very careful about denying people their basic rights," he says. "We have rules in place to prevent people from being picked up and put into mental hospitals and being denied [gun ownership]. The truth is there is no way we have any tools to be able to predict who's going to do a violent thing, and it's unfortunate, but it is the truth.”
 

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