Everyone failed Cho: VA Tech panel calls for better commitment law

[David Baxter PhD]

Everyone failed Cho: VA Tech panel calls for better commitment law
Thursday, August 30, 2007
Treatment Advocacy Center

What happened to keep Seung Hui Cho from getting needed treatment and at what point could the Virginia Tech massacre have been prevented? The state-appointed panel charged with answering those questions released its report today, stating in part that ?The Virginia standard for involuntary commitment is one of the most restrictive in the nation and is not uniformly applied.?

The report details Cho's mental health history and the many lost opportunities to help him, and makes recommendations to improve Virginia?s restrictive mental health treatment law.

The scope and extent of how Cho was ultimately failed by every facet of the system is stunning. Read TAC's press release on the report.

 

[David Baxter PhD]

VA Tech: The HIPAA Excuse?
August 31, 2007
Treatment Advocacy Center

The HIPAA privacy rules (see summary ) were never intended to block people from getting needed medical attention. Yet, yesterday we learned from Governor Kaine?s Panel on the Virginia Tech shootings that school officials and mental health professionals claimed the law prevented them from communicating with each other and getting Cho the treatment that he so obviously needed.

That?s simply not true. As the Virginia Tech report and its authors explained, the HIPAA law doesn?t bar all communications about a person?s medical history. In fact, there are specific provisions for medical emergencies, for sharing information with family members and caregivers, and for communicating the presence of a person in the hospital acrobat: about page 4).

Another important fact is that the privacy law does not prohibit mental health professionals from LISTENING to information about a patient.

For a more detailed look at releasing health information to the families of people with severe mental illnesses, read this Catalyst article.

 

[Mari]

Many people (including myself) are sadly misinformed about health issues. Since my son died I have been told over and over by friends, family, police, doctors, counsellors, (in fact almost everyone I talk with) that even if I had known my son was suicidal there is nothing I could have done since he was an adult. Many people actually think it is illegal to do anything!

I would like to give a simple example of how easy it can be to help. My friend was concerned about her mother's physical and mental well being but she was afraid to call the doctor because people told her that privacy laws prevented her from intervening. I asked for the doctor's name and number and called the office. I very briefly explained my friend's concerns about her mother to the receptionist who asked me to hold. When she came back on the phone she said that the mother was overdue for a check-up, said that she had set up an appointment and would call the mother to make sure the date and time were convenient for her.

It is very very very difficult for me to come to terms with the fact that the people who knew my son was suicidal and could have intervened did absolutely nothing.

 

[healthbound]

Va. Tech report says privacy laws misinterpreted

Va. Tech report says privacy laws misinterpreted

Media reports that say privacy laws stop Canadian universities from protecting students "inaccurate, unhelpful": BC privacy commissioner

Source: Macleans.ca

Erin Millar, Macleans.ca | Aug 31, 2007 |

Virginia Tech officials should have acted on indications of campus shooter Seung-Hui Cho's mental health problems, said a state report released yesterday that investigated the school rampage that left 33 people dead four months ago. The report said that privacy laws were misinterpreted and that information about Cho's bizarre behavior and hospital stays could have been exchanged between university officials and police.

However, just what the university could have done in response to this knowledge is far from clear. U.S. universities are quite limited by privacy and discrimination laws in what they can do to deal with students with mental health problems. It is widely believed that, except in emergency situations, universities cannot tell parents about problems and a student cannot be kicked out of school for mental health reasons.

BC information and privacy commissioner David Loukidelis said today that Canadian privacy laws do not prevent university officials from protecting students. He called media that has reported otherwise "inaccurate and unhelpful."

"B.C.'s universities can share students' personal information to protect students from harming themselves or to protect others from being harmed. To suggest otherwise is plainly wrong," Loukidelis said.

But how to deal with knowledge of mental health issues is a very difficult topic for universities. Of course, cases as extreme as Seung-Hui's are extremely rare. But depression and other mental health problems among students are not uncommon.

For example, the National College Health Assessment found that 14 per cent of female UBC undergrads and 11 per cent of male undergrads seriously considered suicide at least one time during that year. Eleven per cent of women and 12.7 per cent of men had been diagnosed with depression and 83 per cent of women and 70 per cent of men felt overwhelmed at least three times during the school year.

In B.C., health care providers cannot tell next of kin about an individual's health situation without consent. That means that parents may not be told if their son or daughter is going through problems while away at university. Although health care law is legislated provincially, other provinces are in a similar situation.

"It's a really serious problem," said Dr. Patricia Mirwaldt, director of health services at the University of British Columbia. "What are the rights of the individual versus the rights of the family versus the rights of the community? The whole health care system is struggling with those problems."

The only exception is when a person is deemed to be unable to make decisions. "If you are too incompetent to take care of yourself, I can tell next of kin in emergency cases," Mirwaldt said.

Canadian health care providers are closely watching a number of lawsuits in the States. "It is a topic of vigorous conversation among health care professionals," explained Mirwaldt.

Recent cases include a US$27.7 million lawsuit against the Massachusetts Institute of Technology, filed by parents after their daughter committed suicide while at the school. The parents had not been told about a number of suicide notes and that their daughter had used the university's counseling services, the New York Times reported. The case was settled for an undisclosed amount.

Universities struggle with the other side of the problem as well. A student at the City University of New York was paid US$65,000 after being barred from her dorm room because she was hospitalized after a suicide attempt.

At UBC there have been cases of students being refused residence because of mental health problems, Mirwaldt said. "These are usually voluntary, negotiated agreements that are part of a treatment plan. ? The residence advisor would ask the student to prove that they are well enough to live with others."

In most cases of campus depression, students pursue help themselves. However, Mirwaldt receives calls from residence advisors, professors, fellow students, and other members of the campus community who are worried about another person. In extreme cases, such as suicide threats, an ambulance is immediately called. Other situations can be more challenging to deal with.

If a person refuses treatment, a doctor can issue a warrant to get an assessment done in hospital. Most of the time, when a person is asked to go to the hospital, they do. If the person still refuses, police can get involved at this point. According to Mirwaldt, this happens approximately every couple of months on UBC's campus.

Being admitted to hospital does not, however, guarantee that the person will receive treatment. If the individual maintains that they are well or cannot be diagnosed with a treatable illness, they will be released, even if they still intend to commit suicide.

"It is very hard to be a student," Mirdwaldt said. "I think people underestimate how stressful it can be." She went on to describe academic, social, and financial pressures that are unique to student life.

Common symptoms of depression are losing interest in class, a change in sleeping habits, and marked deterioration in health. Mirwaldt advises students to keep an eye out for a change in demeanor. "If your roommate would usually say hi to you or stop and talk for five minutes and it stops. ? If you just follow your instinct about asking, 'are you ok?' you are usually right."