Tragedy – A Reminder That We Need More Proactive Attention to Mental Illness –
Unfortunately, the sad episode of Linnea Lomax, a 19-year-old UC Davis student, has come to an end, probably in the worst and most excruciating way one could possibly imagine, with her mother finding her body hanging from a tree next to the American River on Friday.
The story hits painfully home for all parents, for I’m sure it’s one of many worst nightmares. That this one might have been prevented only makes it all the worse.
When the news hit yesterday, I posted to my Facebook page the news and it triggered an unusual amount of responses. But I think a lot of us got this wrong.
Suicide of any sort is often deemed a selfish act as the individual deals with their own pain and misery in a way that profoundly impacts all of those who care about them the very most. This one was worse than most, as she literally disappeared for weeks, and so the parents and loved ones had the anguish of the unknown.
But reading the account in the Sacramento Bee this morning, I realized that my first thought was completely wrong. What became clear reading the interview with the parents is that the illness that Ms. Lomax suffered overwhelmed all capacity for reasoned thought.
As he parents described, “Her delusional fears overcame her. It was an illness that overcame her ability to think.”
And it appears to have happened very quickly, with her parents describing her as “a bright, happy young woman until her third quarter in college, when she began losing weight and obsessing over small things. While studying for finals, they said, she had a breakdown and appeared to be contemplating suicide.”
She then spent a week in a mental health facility before she was released. During lunch break of her first day of outpatient therapy she simply walked away and was never heard from again.
As much as this is a personal tragedy, however, I believe her parents are correct – this is a failure by our system to save the life of a young girl, just entering college who apparently never had a chance.
The Bee reports, “Even before Linnea was found, the Lomaxes talked about trying to change a system they think did not offer a safety net for their daughter.” Adding to that, Mr. Lomax “believes his daughter’s judgment was clouded when she insisted she didn’t need help – a common frustration expressed by loved ones of mentally ill people – but that because of her age, she was able to walk away from therapy.”
“We feel the loss was unnecessary and avoidable,” Craig Lomax said. “No one should have to suffer what Linnea did, or what we are suffering.”
And so today with heavy hearts, we need to understand that, as much as this is a personal tragedy, this is a community tragedy.
We need to figure out what went wrong here, what we could have done, and how we can prevent the next young student from suffering the same fate.
It is difficult in times like these to avoid flailing around blindly for the easiest answers. The first layer has to come at the university – figuring out ways to allow students to handle stress and to distinguish between the normal stresses of college and the overwhelming challenges of mental illness.
Some of the biggest challenges seem to lie in the very nature of mental illness itself – the inability for the individual inflicted with the disease to recognize the disease. And the inability of our society, even family, to compel treatment on an unwilling patient.
The other challenge has been the stigma attached to mental illness. Hopefully, old attitudes will change, however. It was remarkable sitting in a seminar last spring, where a researcher showed MRI images of the normal brain compared with someone who was schizophrenic and someone who was bipolar. There are notable and obvious difference in the physiology of the brain. These are not mental illnesses so much as brain abnormalities. Some of this can be treated with medication, but again that requires that the individual – who is not of sound mind – consent to the treatment.
These are all questions that, hopefully, will get raised in light of this tragedy. Even more tragically, it will likely be on the grieving parents to push for some of these changes. We can only hope to do our parts to avoid this tragedy from being revisited on others in our community and elsewhere.
—David M. Greenwald reporting
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Linnea’s story is so sad. My heart goes out to her family and friends, who I believe did all that they could for her – even to keep searching until they found her body and give her a dignified burial. You are right that this is a community tragedy.
We need to stop the public employee union raid of our state and local dollars that should be used to provide better help for people like this young woman. We have allowed the money that should be directed to people in absolute need of help, to be transfered to union employees to provide them a luxurious life and retirement. Shame on us.
It’s a rights issue. Despite their illness, they have rights and can be forced into treatment and to take medications only under very specific circumstances. An individual, despite suffering from serious mental illness, can’t simply be locked up somewhere and have treatment and medication forced upon them because the family believes he/she should. Clearly, this is problematic as the individual suffering mental illness often lacks the capacity and insight to decide for him or herself.
David, what do you think must be done in the community to prevent similar incidents?
JB,
[i]We need to stop the public employee union raid of our state and local dollars that should be used to provide better help for people like this young woman. We have allowed the money that should be directed to people in absolute need of help, to be transfered to union employees to provide them a luxurious life and retirement. [/i]
I feel like this is a bit much. The article doesn’t even fix its mark on where the system failed, yet you’re suggesting somehow the public employees’ wages/retirement and unions are somehow taking money away from the services to the mentally ill? Your response is strange to me.
[i]”Some of this can be treated with medication, but again that requires that the individual – who is not of sound mind – consent to the treatment.”[/i]
It sounds like her illness was very severe. Yet, like so many people with serious psychiatric pathologies, she was probably no danger to anyone other than herself.
My opinion about forced psychiatric treatment is this: If the person is not getting treatment on his own and is a danger to others due to his illness and his parents or legal guardian believes he would be helped by psychiatric intervention, and a court authorizes it, treatment should be forced. That is essentially Laura’s Law ([url]http://lauras-law.org/states/lauraslawindex.html[/url]). Yet in no counties but Nevada County is Laura’s Law funded. It’s a shame.
However, in cases of severe depression, I don’t think Laura’s Law would apply no matter what, unless the patient showed a violent tendency, which probably was not the case here.
SM: [i]”you’re suggesting somehow the public employees’ wages/retirement and unions are somehow taking money away from the services to the mentally ill? Your response is strange to me.”[/i]
Look at this Super. In the 2003-04 budget for Yolo County mental health, 14.66% of the dollars went to Mental Health Admin.:
Mental Health Access 505-3 146 $4,701,692
Mental Health Admin. 505-2 148 [b]$2,598,928[/b]
Mental Health Adult SOC 505-4 150 $5,794,093
[u]Mental Health Children’s SOC 505-5 152 $4,632,005[/u]
Mental Health Total Budget $17,726,718
By contrast, in the 2011-12 budget for Yolo County mental health, 59.63% of the dollars went to Mental Health Admin.:
Mental Health Administration 505‐1 32 [b]$11,254,631[/b]
[u]Mental Health Services Act (MHSA) 505‐7 33 $7,618,667[/u]
Mental Health Total Budget $18,873,298
Based on those numbers, it sure looks to me like the higher costs of employee administrative salaries and benefits and pensions are eating into the money which could be going to help those poor residents who suffer mental illness problems.
FWIW, all of the county’s budget numbers are on its website. Just Google “yolo county budget” and look under the health & human services sections. They have every year going back to 2003-04, and they have estimated numbers for 2012-13.
If I’m understanding the law, one can be involuntarily committed if the individual is a danger to others or him or herself. That said, once committed, the patient may refuse treatment.
I don’t quite understand how this, as tragic as it is, was the fault of the system. Unless, the contention is that the system needs to be changed to make involuntary commitment and medication easier. The legislature would need to make the changes to permit, as Rich puts forth, someone else the authorization to force medication upon the patient. In terms of involuntary commitment, we have a system, but it seems others believe it is not sufficient. It’s a tough issue, rights versus the patience mental health and safety.
I don’t get much from this article in terms of the services she was receiving or the type of facility she was in, but it sounds like her involvement in it was voluntary and the facility had no legal right to stop her from leaving. But it’s tough to say based on what I’ve read.
Thanks for the information, Rich. That is interesting. Maybe this is something that can be looked into further.
[i]”If I’m understanding the law, one can be involuntarily committed if the individual is a danger to others or him or herself.”[/i]
Here is my understanding, not expert, but informed by long-time dealings with a relative who has severe paranoid schizophrenia and does not “want” treatment. (He was once a very successful businessman and is now, AFAIK, back and forth from living in gutters and going to jail.)
Temporary commitment (called a 5150 or a 72-hour hold) depends on a few factors: First, they need to have psychiatric bed space. That is very often unavailable. When it is not, they will usually “hold” patients in ERs, such as at the UC Davis Med Center in Sacramento or County General in SF. If that does not work out, some are held in regular jail cells.
Second, the time limit is 72 hours. In that time, they cannot force treatment, but they can (I think) force “tranquilization” if needed.
After 72 hours, they normally have to release them untreated. The exception is if they are clearly a present danger to themselves or others. But “present danger” is impossible to know in most cases. Most psychiatrists seem to err on the side of “he is unlikely to kill anyone today” and let him go. I think our lack of bed space for pyschiatric cases plays into that.
[i]”That said, once committed, the patient may refuse treatment.”[/i]
Yes. That is the heart of the long-term problem for those who “choose” to not take anti-psychotic meds and whose health condition keeps getting worse.
Rich,
I think the 72 hour hold can be followed by a 14 day hold, which uses the same criteria, “danger to self or others.” You may be right, that in practice, psychiatrists take the “he’s likely not going to kill anyone today.” I don’t know.
Forced treatment is a sensitive issue. Until that right is taken away, which I assume would require some legal process, the patient may decide for him or her self. Even if forced treatment were allowed while the patient was committed, he or she would eventually be released into the public. Then, it’s a matter of either relying on the patient to continue taking medication or, and I’m not sure to what extent this is available, having mental health personnel follow up. The other alternative is sending the patient to a facility in which they are monitored and/or medication is forced upon them.
Rich–wow, very phantasmagorical numbers on the changes in administrative costs. This appears worse than UC Davis, where the administrative costs have double to tripled since the mid 1990s, if I remember correctly (though I think over the last 2-3 years they may have stabilized.)
Are you sure this isn’t some accounting artifact; where the classification of who is or is not and administrator has changed over the years?
Are we evolving into a nation of button-pushing data relayers?
One of the Davis sanctuaries for a portion of the population is Cesar Chavez Plaza. We accomodate about 20 individuals who are receive one type of County service or another relating to mental health needs.
The County does provide funding towards an on site service professional providor.
One of the additional elements that helps many of the population are the activites that occur on site in support of mental health.
We probably save the County a lot of money in being able to meet mental health needs on site.
NAMI-Yolo holds many of its meetings there and many of its services.
NAMI Canvas holds its programs there as well as many local mental health professionals offer their services.
Students from UCD host a communal meal there every month as do some other groups.
We have a pantry were we can add food to someone’s diet who may be on hard times that month.
Neighborhood Partners was able to get this built even though staff tried in various ways to stop us. We are partners with Davis Community Meals in the services.
While the service professional is there to serve the 18 people in the categories she serves, she extends her services to many of the other residents who are in need of guidance and help in their lives.
Many people see the program as quite low key but very effective.
It probably could not have helped that young lady but on a daily basis it helps many people obtain a stable life. A number of adult children of Davis residents live there with the nearby support of their parents.
David Thompson, Neighborhood Partners, LLC.
[i]”Are you sure this isn’t some accounting artifact; where the classification of who is or is not and administrator has changed over the years?”[/i]
Good question. I am honestly not sure. It’s possible the numbers are an accounting illusion. I just don’t know. But on the surface it appears to me that administrative costs have gone up tremendously as a share of the budget for mental health.
Before I looked at those numbers (some 6 or 7 monts ago), I was ready to assume that the County’s mental health budget, due to falling revenues had been cut. But, while the budget has not completely kept up with the general pace of inflation*, the total budget has in fact gone up nominally. It is just that the share, on paper, is far, far higher for administration expenses now.
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*I think the CPI over the period has averaged around 2.50% per year. The total mental health budget has inflated at just 0.79% per year. As such, that is a nominal dollar increase but a real dollar reduction.