Posted by: L | April 25, 2007

Oddities in Cho’s Psychiatric Confinement

Here is a Salon piece by Bonnie Goldstein with the relevant documents. I had posted it last night, with detailed commentary and then deleted it this morning – darn!

So – here goes again:

First, the Salon piece:

In December 2005, two undergraduate women at Virginia Tech complained about inappropriate messages they’d received from fellow student Cho Seung-Hui. A licensed social worker, Kathy Godbey, assessed Cho’s behavior and petitioned a Virginia magistrate for Cho’s “involuntary admission” to a mental-health facility (see below). The magistrate found “probable cause” to believe the young man was “mentally ill and in need of hospitalization” and issued a temporary detention order.

Cho was taken to the Carilion Saint Albans Behavioral Health facility in New River Valley, Va. Using the four-page involuntary admission form provided by Virginia’s Department of Mental Health, Mental Retardation and Substance Abuse Services, psychologist Roy Crouse observed that, although the patient’s affect was “flat” and his mood “depressed,” he “denie[d] suicidal ideations” (see Page 3). Crouse (a Ph.D., though not a physician as state law requires) wrote that Cho did not “acknowledge symptoms of a thought disorder.” Cho’s “insight and judgment [were] normal.” Also noted in the exam: Cho had no previous psychiatric care and was not on medication.

The patient exercised his right to counsel by court-appointed attorney Terry W. Teel (see Page 2), and his case was considered and decided by Special Justice and Guardian Ad Litem Paul M. Barnett. Justice Barnett found that although Cho presented “an imminent danger to himself as a result of mental illness,” there were suitable “alternatives to involuntary hospitalization” available. Cho was ordered instead to get outpatient treatments (see Page 5). No record has been found to confirm whether Cho, who killed 32 people and himself on April 16, ever sought or received the court-ordered treatment.

Also, in this regard, here is what we know about the possibility that he was taking drugs:

“Some news accounts have suggested that Cho had a history of antidepressant use, but senior federal officials tell ABC News that they can find no record of him in the governments files on controlled substances. This does not completely rule out prescription drug use, including samples from a physician, drugs obtained through illegal Internet sources, or a gap in computer databases, but the sources say theirs is a reasonably complete search. (NOTE: Some readers may have inferred from an earlier edition of this story that the federal government keeps a comprehensive record of all prescriptions. The Drug Enforcement Agency says it does track prescriptions of so-called controlled substances — including some mood-altering medications — but not all prescriptions made in the United States.)”

My Analysis:

1. It looks like Cho was never seen at any point in all this by a medical MD.

2. He was assessed by a licensed social worker, a magistrate, a special justice and guardian ad litem, and a PhD psychologist whose evaluation of his mental state ranged from finding him mentally ill and a threat to society and finding him largely normal and just depressed.

3. He clearly was not evaluated for any extended length of time – hardly a day at best.

4. No records were retained (perhaps not even kept) of his subsequent treatment.

5. No one followed up or monitored his treatment, or if they did, we have no records of it now.

6. No one informed the university or his parents. The argument is that privacy laws prevented the health system from doing so.
7. Cho went voluntarily to the police, and they referred him which posed a problem under Virginia law, since, as I said the Chris Wallace post, the form that Virginia courts use to notify the state police about a mental health disqualification only addresses the state criteria, which lists two potential categories that would warrant notification to the state police – someone who was “involuntarily committed” or ruled mentally “incapacitated,” neither of which ended up applying to Cho.

So, the problem was that Cho went “voluntarily” and wasn’t ruled incapacitated. From my earlier post:
“But didn’t anyone realize the potential danger here. OK. the two V-Tech students didn’t press stalking charges, but what happened to the arson charge? How does that not pose a threat to anyone else? Didn’t any of the teachers, like Nikki Giovanni, who found him so intimidating in class, want to find out where he was with his treatment?

Here’s a comment from one of the students (I think he was in Edward Falco’s class):

Before Cho got to class that day, we students were talking to each other with serious worry about whether he could be a school shooter. I was even thinking of scenarios of what I would do in case he did come in with a gun, I was that freaked out about him. When the students gave reviews of his play in class, we were very careful with our words in case he decided to snap. Even the professor didn’t pressure him to give closing comments.

After hearing about the mass shootings, I sent one of my friends a Facebook message asking him if he knew anything about Seung Cho and if he could have been involved. He replied: “dude that’s EXACTLY what I was thinking! No, I haven’t heard anything, but seriously, that was the first thing I thought when I heard he was Asian.”

While I “knew” Cho, I always wished there was something I could do for him, but I couldn’t think of anything. As far as notifying authorities, there isn’t (to my knowledge) any system set up that lets people say “Hey! This guy has some issues! Maybe you should look into this guy!” If there were, I definitely would have tried to get the kid some help. I think that could have had a good chance of averting yesterday’s tragedy more than anything.”

So, as I argued from the beginning, there is a clear case of negligence here, and indeed that is what experts are saying now:

“So here was a man who was actively intimidating other students and who had inappropriately and repeatedly photographed and contacted female students. His own suite mates say he was a stalker. That the university did not suspend Cho for such violations makes a solid case for negligence.

In a rational legal system, the school would be held accountable for its errors. But Virginia Tech is a state institution, and Virginia is a state where the doctrine of sovereign immunity remains quite robust. That doctrine, a relic of English common law, essentially says the state can do no wrong because the state creates the law and thus cannot be subject to it. Many states have relaxed sovereign immunity and made it possible for victims of, say, botched operations to sue state hospitals. But Krauss of George Mason University says the Virginia Tech victims’ families would probably have to seek an exception to sovereign immunity from the Supreme Court of Virginia in order to sue the school.

There’s a simpler way: Steger, the university president, should stop withholding documents on how the university mishandled Cho and take responsibility for his school’s lax approach. And then he should resign.”

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