In Arizona, anyone concerned can report odd behavior to mental-health experts

By Brigid Schulte
Washington Post Staff Writer
Monday, January 10, 2011; 10:32 PM

Under Arizona law, any one of Jared Lee Loughner's classmates or teachers at Pima Community College so concerned about his increasingly bizarre behavior could have contacted local officials and asked that he be evaluated for mental illness and potentially committed for psychiatric treatment.

That, according to local mental health and law enforcement officials, never happened.

"To the best of our knowledge, he was never and is currently not enrolled in our system," said Neal Cash, president of the Community Partnership of Southern Arizona, which provides mental health services in Tucson and Pima County for the state. While most of those it serves are on Medicaid, Cash said anyone diagnosed with a serious mental illness would be in its system.

The Saturday shootings that left six dead and gravely injured Rep. Gabrielle Giffords (D-Ariz.) has prompted a wave of questions about whether the attack could have been prevented. Could those who knew Loughner, the alleged shooter, somehow have stepped in as they saw signs of his instability?

Mental health experts say that, unlike many other states - where little can be done to force an unstable person into treatment until he or she becomes violent and poses a danger to themself or others - Arizona is different.

Any person in Arizona can petition the court for a psychiatric evaluation solely because a person appears to be mentally ill and doesn't know it.

"When people appear mentally ill or show some instability, how do you get them to [mental health] resources if the system doesn't know those people are out there?" Cash said. "Our crisis line is manned 24/7. Anyone concerned about his behavior could have called at any time."

Cash added that he had no information on whether Loughner sought out private treatment covered by private insurance. "If he was interfacing with other mental health officials, I don't know about that," Cash said.

As a fuller picture emerges of Loughner, much attention has been focused on his behavior at Pima Community College. Officials there said the school overhauled its student code of conduct to better identify potentially violent students after the Virginia Tech massacre in 2007, when a gunman fatally shot 32 teachers and students before killing himself.

However, citing privacy laws and the investigation, the officials would not say whether Loughner's behavior triggered any action that might have resulted in a referral for treatment at the counseling service on campus or elsewhere.

College officials confirmed that Loughner attended the school from the summer of 2005 through the fall of 2010. They said he was suspended for violating the college's code of conduct after five disruptions in classrooms and libraries on two different campuses and after the discovery of a YouTube video Loughner posted claiming the college was illegal under the U.S. Constitution.

On Sept. 29, two college police officers delivered a letter of suspension to Loughner at the house where he lives with his parents, college officials said. After meeting with administrators Oct. 4, the college sent a second letter Oct. 7 indicating Loughner could return to campus only if he resolved his violations and obtained "mental health clearance indicating, in the opinion of a mental health professional, his presence at the College does not present a danger to himself or others," the college said in a statement.

U.S. Education Secretary Arne Duncan said Monday at a meeting with Washington Post reporters and editors that while he was not familiar with the details of the case, "If I was the chancellor of that community college, I think that would have been my response," he said. "I'm not quite sure what else that community college can do"

But other mental health experts disagree.

"In retrospect, they dropped the ball," said E. Fuller Torrey, a local psychiatrist who researches schizophrenia and bipolar disorder and founded the Treatment Advocacy Center in Arlington. "At least they got him off campus, so they can say, 'We've discharged our responsibility, we're protecting our students.' I suppose they could argue, 'We don't have responsibility for the larger community.' "

Arizona has one of the most expansive mental health laws in the country, allowing any person, concerned about the mental state of another to petition local authorities to have the person evaluated if they are a danger to themselves or others, if they are unable to care for themselves, or if they appear to be mentally ill but may not know it.

In other states, stricter mental health laws require that people must show that they are an imminent danger to themselves or others before they can be involuntarily committed for psychiatric treatment.

"In this case, the law did not prevent treatment," Torrey said.

Some of Loughner's professors said they were concerned about his nonsensical answers on tests, geometric doodles, disruptive outbursts in class and disconnect from reality, that they contacted their superiors. Philosophy professor Kent Slinker told the online magazine Slate that Loughner was "someone whose brains were scrambled." Slinker said that he even discussed getting help for Loughner, but that school policy was for students to go of their own volition.

But Torrey, Cash and others said that is not the case under Arizona law. It's just that people either don't know it or are "reticent" about reporting mental distress, Cash said.

National surveys have ranked Arizona near the bottom for how it provides mental health services. And more recently, like other states, Arizona has seen its mental health budget cut dramatically.

If, as it appears, Loughner was never "adjudicated" mentally ill - the standard that appears on federal firearms forms - then his name would not have been flagged in any background check when he sought to buy the 9mm Glock he allegedly used in the shootings.

Loughner had been arrested on drug-related charges. Federal law prohibits drug abusers from buying firearms, though background checks rarely catch drug abusers, according to FBI statistics.

Pima County Sheriff's Department Capt. Chris Nanos said Monday that local authorities were unaware of specific incidents involving Loughner beyond the disciplinary problems at Pima Community College. "The college is the only incident that I know of that spoke to his mental health,'' Nanos said. "Clearly, anyone who kills someone, who takes a life, their mental health becomes a concern to us. That doesn't mean he's insane.''

Some mental health experts, however, said that while they could not make a diagnosis, the behavior was consistent with a psychotic or "thought" disorder.

Staff writers Nick Anderson, James Grimaldi and Jerry Markon contributed to this report.

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