Weston Case 'Fell Through The Cracks'
Washington Post Staff Writers
Tuesday, July 28, 1998; Page A01
Russell Eugene Weston Jr.'s sudden descent into violence probably could not have been predicted, but it might have been prevented by a mental health system better equipped to monitor patients before they become obvious threats, experts said yesterday.
Weston's psychiatric problems were well known long before he allegedly gunned down two U.S. Capitol Police officers: by his frustrated family, his irritated neighbors, the courts, two state mental health departments and at least three federal agencies. But Weston got caught in a common Catch-22: Because he did not seem to pose a danger to society, he was allowed to languish without care until he did, specialists said.
"Obviously, the system is not perfect," said Jerry Wiener, chairman emeritus of the psychiatry department at George Washington University Medical Center. "But it's impossible to predict dangerousness with complete accuracy, and this man didn't seem to represent a threat. The tragedy here is that he didn't get the treatment he needed, and he became a threat."
Weston's stunning rampage illustrates the difficulties in predicting violent behavior among the mentally ill: He exhibited the classic signs of paranoid schizophrenia, but he raised few of the classic red flags of potential dangerousness, the specialists said. Several recent studies have found that people with schizophrenia and other mental illnesses are no more dangerous than the general population, except for those who abuse drugs or alcohol or have a history of violence. And while Weston was arrested in 1991 on a drug charge that was later dropped, he had no known history of substance abuse or violence.
An estimated 2.5 million Americans suffer from schizophrenia, and about a third of them are paranoid schizophrenics, convinced that they have been targeted for harm. Weston, in the words of a government source, was "just one in a cast of thousands."
"In the absence of a past history of violence or drug or alcohol abuse, I would say it is next to impossible to accurately predict whether someone is going to be violent," said Paul Applebaum, chairman of the psychiatry department at the University of Massachusetts Medical School. "Unless we are willing to confine indefinitely a huge number of people, there is an inevitable risk of violence that we simply will not be able to predict."
Law enforcement officials expect Weston to pursue an insanity defense. His court-appointed attorneys, who met with Weston for about 45 minutes in his room in D.C. General Hospital, would not comment on his mental health, but Weston's relatives in Illinois said they hoped his experience would call attention to the treatment of the mentally ill.
"We don't want this to happen to any other families ever again," said Weston's sister, April Callahan.
By now, most Americans have heard about Weston's bizarre beliefs: that he was cloned at birth, that he invented a machine to reverse time, that the Central Intelligence Agency was spying on him through satellite dishes, that President Clinton had planned the Kennedy assassination out of jealousy over Marilyn Monroe. Before the rampage at the Capitol, local, state and federal officials knew about Weston and his delusions.
The Social Security Administration had classified Weston as a paranoid schizophrenic for disability purposes since 1984. A Montana sheriff has said that his office had several run-ins with Weston -- not violent incidents, "more mental illness types of contact."
In the spring of 1996, the Secret Service, which often consults with mental health professionals for advice about people like Weston, investigated paranoid comments he made about Clinton, but concluded he was a "low-level threat" and did not consult other agencies. That summer, Weston paid a bizarre two-hour visit to the CIA, explaining to a security officer that he received "special presidential programming through interactive television and radio," but the agency just sent a memo to the Secret Service.
Weston managed to avoid confinement until that fall, when a Montana judge committed him to the state mental hospital in Warm Springs after he threatened a Helena resident. But doctors there released him after 52 days, on the condition that he leave Montana and continue his treatments at a clinic near his parents' home in Waterloo, Ill. (He still managed to get an Illinois gun permit earlier this year, although authorities believe the .38 Smith & Wesson he brought to the Capitol was stolen from his father, sources said.)
Those may sound like tepid responses, but America has moved away from the days when schizophrenics like Weston were regularly forced into overcrowded mental institutions. That changed in the early 1960s with the advent of Thorazine, the first of a host of antipsychotic drugs that have changed the culture of mental illness. The drugs, along with revelations about poor conditions at hospitals and concerns about costs, led to a pattern of deinstitutionalization that began in the 1970s and accelerated in the 1980s.
In the 1990s, most schizophrenics live much more normal lives in the community. And authorities are now much more reluctant to seek involuntary commitments, which usually require evidence that the patient poses a danger to himself or others, or is incapable of caring for himself.
To the federal agencies that encountered Weston's delusional behavior, he didn't seem to qualify. Paranoia is not a crime. Fantasies are not the same as threats.
"Look, the guy seemed like a garden-variety nut," one government source said. "In the United States of America, you're allowed to be a garden-variety nut."
The idea of the mental health system, of course, is to treat people with psychiatric problems -- not just to prevent them from storming the Capitol or committing other acts of violence, but to help them lead productive lives. That system broke down in its tracking of Weston, who was forced out of Montana and soon quit treatment and stopped taking his medications in Illinois.
In Montana, one of just three states that does not recognize the insanity defense, officials have declined to discuss the specifics of Weston's case, citing privacy concerns. But Wesley Alcorn, an advocate for the mentally ill in Montana, described his state's decision to release Weston to the Illinois system as "Greyhound therapy: Put him on the bus and your problem disappears." He said it was typical of a state that has few mental health resources for anyone who is not ill enough to require hospitalization.
"This system is in a state of Third World collapse, and no one wants to pay to fix it, man," said Alcorn. "That's why this tragedy happened."
Robert Singer, clinical coordinator of Human Support Services, the community mental health center in Waterloo, Ill., declined to comment on Weston's treatment there. But he did point out that there is not much his clinic can do to make sure patients show up for counseling and take their medications. The clinic makes several attempts to contact patients by telephone and mail, then sends them letters terminating their cases, he said.
Illinois and Montana are among a growing number of states with laws allowing judges to force the mentally ill to comply with treatment outside a hospital, a sentence known as outpatient commitment. However, it is rarely used in either state.
"In the 10 years I've been at this agency, we've had one case like that and it wasn't Weston," Singer said. "It's not illegal to stop taking your meds. A lot of this becomes a question of individual rights, a legal issue. It's a delicate balance."
Illinois mental health advocates do not argue that Weston should have been committed, or even forced to take his medications. But they do question whether he received the oversight he needed, a problem they say is common in their state -- especially for poorly functioning patients who are more likely to miss appointments and ignore prescriptions.
"It's gotten a little better, but we still need to provide better services to people early, so we don't need to commit them later," said Zena Naiditch, president of Equipped for Equality, a disability rights group in Illinois. "I don't know if this tragedy could have been prevented. But I do know that it helps to make services available."
The ability of psychiatrists to predict dangerousness -- and the discretion of judges to commit people to hospitals against their will -- have been a frequent source of debate and litigation. Civil libertarians who oppose involuntary commitment often cite studies from the 1960s and 1970s arguing that predictions are about as reliable as coin tosses. But some mental health advocacy groups have argued that the pendulum has swung too far away from civil commitment, and have urged lawmakers to make it easier to force people into treatment.
In any case, violence by the mentally ill is a smaller problem than high-profile cases like the Capitol shooting would suggest. Studies suggest that at most, 3 percent of the violence in U.S. society can be attributed to people with serious mental illnesses. And when the mentally ill do turn violent, their victims are rarely strangers or public figures. The most comprehensive survey, a MacArthur Foundation study released in May, found that 86 percent of the violent acts by the mentally ill were directed at friends and relatives.
In the end, no one seems to think there is any one person, any one agency, any one misstep to blame for the handling of Weston's case. But to advocates, it is a clear example of cracks in a system that loses track of "low-level threats" at its peril.
"Here's a guy that didn't appear to be inherently violent, but the system let him down," said Ronald Honberg, legal director for the National Alliance for the Mentally Ill. "He fell out of sight. He fell out of mind. And he fell through the cracks."
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