At last night’s candidates forum for the school board candidates, we posed the question of where, if at all, the school district failed in its duties to get help for Daniel Marsh and the rest of the community. While obviously not a venue to solve these problems, we were hoping to at least get the issues on the radar of a school district that all too often seems to avoid such thorny topics.
While the answers were varied and will be covered in a separate article, a few key ideas that emerged were the lack of resources, the fact that we have three school psychologists for a population of 8600 students, and that most school counselors are guidance counselors – much as the one who testified, who was trained to help students academically rather than psychologically.
Following our pointed commentary on Monday, it was suggested that the school system should not be slammed over one kid, who is probably a worst case scenario, when the district on a regular basis deals with students who are in crisis, of whom we will never hear because the district’s work was successful.
That said, we have heard that the problem that we face is not a failure of a system that did not have good people working in it to help students, but rather a case where the district does not have enough people to do that job. The district needs more funding to directly support mental health efforts in the schools and that is something where funding from the state and federal government is completely lacking.
The bottom line: more people working to help these kids could have produced better results. For Daniel Marsh, it seems that people were there. However, they were not communicating the problems between agencies, and also Mr. Marsh himself was less than forthright with the severity and nature of his afflictions – but we have to view that as expected and figure out ways to move beyond that.
One of our readers sent us an article that looks at a program developed in the state of Washington that looks at Adverse Childhood Experiences (ACE) and how they affect the developing brain. The article notes that about a decade ago, the state “embarked on an early social experiment to educate people about the impacts of stress on children.”
There is a growing stream of research investigating how adversity, whether it is trauma or chronic adversity based on stress from a harsh environment, “embarked on an early social experiment to educate people about the impacts of stress on children.”
The article notes, “While most of this research is still fairly theoretical, Washington State is one of the few places where it has been applied, if roughly, on a large scale. About a decade ago, the state embarked on an early, uncontrolled social experiment in disseminating and implementing this set of urgent but still-forming ideas about the mind.”
The article notes that “the single piece of research that has most influenced Washington’s efforts is something called the Adverse Childhood Experiences study, a set of findings published in 1998. The ACE study—as those who cite it religiously refer to it—grew out of research on smoking. In the 1980s, a doctor at the Centers for Disease Control and Prevention named Robert Anda was analyzing why some smokers tended to quit in response to public health messages and why others didn’t. In one study, Anda’s research team found that people with a history of depression were more likely to start smoking, and less likely to stop.”
That finding made Dr. Anda examine whether “researchers were missing other links between emotional and physical health.”
At the same time, another physician and researcher, Vincent Felitti, at Kaiser Permanente found “a similar phenomenon while working on a weight-loss program for obese patients. Many of the patients who dropped out of the program and put weight back on, he found, had a history of sexual abuse.”
The two would team up, to devise an Adverse Childhood Experience survey. The article notes, “If anything, Anda and Felitti expected that respondents would dramatically underreport their histories of childhood trauma. But the results shocked the two doctors. “The information was just mind-boggling,” Anda recalls. Twenty-one percent of respondents said they had experienced sexual abuse; 28 percent had suffered physical abuse; 23 percent had grown up with divorced or separated parents, and 27 percent had lived in a household with an adult who was abusing substances. Respondents were assigned an ACE score from zero to 10, with 10 referring to the most childhood trauma. Barely more than a third had an ACE score of zero. And in most cases, patients had experienced not one but multiple adverse experiences.”
Adding to those findings are two key things. First, the patients “came from a demographic that was not especially at risk for early adversity: Most of them were middle- and upper-class San Diegans, 75 percent white and 93 percent high school graduates.”
The other interesting note was the ACE data’s predictive power. They “were able to correlate patients’ responses to the survey with information about their long-term health. Not surprisingly, they found that childhood trauma casts a long shadow over a person’s happiness: the higher someone’s ACE score, the greater his or her chances of eventually performing poorly in the workplace, taking antidepressants, and committing suicide.”
They add, “But childhood trauma didn’t just affect mental health. As a person’s ACE score increased, so did his or her chances of eventually being diagnosed with cancer, heart disease, liver disease, and emphysema. Sometimes these physical ailments stemmed from the risky behaviors that people with histories of childhood adversity were prone to: injecting drugs, smoking, having sex with many partners. But even absent those bad habits, patients who had been exposed to stress and trauma at an early age were simply far more vulnerable to disease.”
It is a fascinating line of research but, in the case of Daniel Marsh, it might guide us to understand the interaction between traumatic childhood events and depression. It might not get us to criminal insanity, but it gives us a better understanding of what may have happened, how we might prevent it in the future, and why some people are able to overcome adversity, but not others.
It is also important to understand the linkage between mental illness and violence. While mental illness increases the likelihood of violence, it does not mean that mentally ill people are necessarily violent.
Dr. Jeffrey Swanson, a professor in psychiatry and behavioral sciences at the Duke University School of Medicine, is one of the leading researchers on mental health and violence.
In a recent interview with ProPublica, he was responding to the issue of mass shooters and he noted, “The risk factors for a mass shooting are shared by a lot of people who aren’t going to do it. If you paint the picture of a young, isolated, delusional young man ― that probably describes thousands of other young men.”
This is an important point as it pertains to Daniel Marsh, because, while Daniel Marsh had warning signs, his warning sides were probably not atypical of many students who would not turn into killers.
Dr. Swanson notes, “People with serious mental illness are 3 to 4 times more likely to be violent than those who aren’t. But the vast majority of people with mental illness are not violent and never will be.” Therefore, he argues, “Most violence in society is caused by other things.”
At the same time, he warns us, “We need to think of violence itself as a communicable disease. We have kids growing up exposed to terrible trauma. We did a study some years ago, looking at [violence risk] among people with serious mental illness. The three risk factors we found were most important: first, a history of violent victimization early in life, second, substance abuse, and the third is exposure to violence in the environment around you. People who had none of those risk factors ― even with bipolar disorder and schizophrenia ― had very low rates of violent behavior.”
He adds, “Abuse, violence in the environment around you ― those are the kinds of things you’re not going to solve by having someone take a mood stabilizer.”
Clearly, we have a long way to go to even understand these factors, but as we move forward we need a school system that works with our mental health system and that has the resources to be able to identify kids at risk – not just for violence, but also for more run-of-the-mill responses to trauma and mental illness.
—David M. Greenwald reporting
A compelling, if mildly deceptive headline, David. It seems that just about everyone has failed Mr. Marsh at virtually every turn and only the coarsest of souls could fail to be moved to concern for other “at risk” kids. Putting much of the weight on the schools may also be appropriate, in consideration of how much time they are responsible for our children and the amount of information that they “input” into students. Davis public schools, as is so often noted, have an exceptional and deserved reputation for academics and safety. Their areas of outreach are well beyond the scope of many, if not most, districts in the US.
None the less, I believe that family role modelling (as well as genetics) has at least as much, and perhaps more, influence on actual outcomes.By accounts I’ve read, Daniel’s parents’ involvement in his life was more traumatising than nurturing. Finding a way to get primary medical providers engaged and involved in “family mental health” would go a long way to identifying the “most at risk” kids. That would involve all of the “professionals” listening to all the parties involved, communicating with one another and constructing a diagnosis and plan of treatment. That listening, objectively, also extends to the community. Lots of folks knew this family and knew that they had issues. They either discounted the severity or, more often, simply did not follow through, to see that something was actually done to help.
;>)/
“By accounts I’ve read, Daniel’s parents’ involvement in his life was more traumatising than nurturing.”
While that may or may not be true, the person suggesting that has been Daniel Marsh, and based on all he has said and done, I think there is good reason to doubt his veracity with regard to his family situation.
Obviously, he did not come from an intact family. But otherwise, it’s possible his parents were as supportive and loving as they could to him, and he just turned out to be a psychopath. As far as I know, his sister, who has the same parents, is a normal, well-adjusted person.
The bottom line for me: I don’t think it is certain, if he has a psychopathic brain, that was due to things his parents did. I don’t know exactly what causes such outcomes.
From Psychology Today: “The causes of psychopathy remain a mystery. We don’t even have a satisfactory answer to the question of whether psychopathy is a product of Mother Nature or a feature of upbringing.”
http://www.psychologytoday.com/blog/the-superhuman-mind/201212/the-making-serial-killer
I think we often go too far looking for excuses for people that commit the most heinous of crimes. There is this disturbing tendency to look at people on trial as victims and in need of empathy for their struggles and pains. I have a less muddled view that separates the crime from the mental state of the criminal. Because even most people with mental health problems are aware of the wrongness of certain criminal acts they may be compelled to commit. There is the crime and there is a need for punishment for the crime… and in most cased mental health should be the consideration before the crime… not after. Unless there is absolute proof that the mental status of the criminal is such that he/she absolutely could not understand the wrongness of his/her actions.
I think we take it too far.
But we do need to fix our mental health system in this country. It is a mess.
The ISIS terrorist that cut off the two journalist heads was the product of a failed system and bad parenting. It’s not his fault.
“I think we often go too far looking for excuses for people that commit the most heinous of crimes.”
Maybe you can elaborate on this comment. I don’t see any problem at all trying to figure out why a person did something (his motive, if any) or what biology, life events, upbringing, etc. caused a person to turn out as the way he did.
But merely investigating cause or motive is not in any sense excusing behavior or removing consequences from behavior. Most importantly, these sorts of investigations might reveal what we as a society can or should do to protect ourselves or change a person’s motivations. In the case of a psychopath, there is probably very little we can do. (Some psychologists believe, if they get ahold of a psychopath when he is very young, they can teach him to emulate normal behavior, even if his brain never operates normally.) But in other cases, maybe we can figure out how to prevent such crimes. A good example of such prevention, in my opinion, would be stepping up Laura’s Law, where psychotics (note psychotics are not the same as psychopaths) have some history of violence or threats of violence.
It seems like a mixed bag. His parents supported him in some of his medical / mental needs, yet then both apparently refused to do group counseling. That tells us a lot.
What you have pointed out is the big problem with charging the schools with providing the mental health services for kids with IEPs. Why we rely on the schools to provide these services has always puzzled me. The schools are mental health institutions and there should be more reliance on mental health experts – particularly pediatric and developmental experts to assist the schools.
Above response got posted here instead of below Robin W’s comment below. Sorry about that.
David wrote:
> At last night’s candidates forum for the school board candidates, we
> posed the question of where, if at all, the school district failed in its
> duties to get help for Daniel Marsh and the rest of the community.
We will never have enough money for the “system” or “school district” to take over as parents for every kid like Daniel who’s parents split up and don’t spend much time or attention raising their kid(s).
The only way to fix this is to “force” the parents to take care of their kids and punish them if they don’t do it. If we don’t do something soon we will end up with more killers like Daniel and more people like this guy (who has 30 kids with 11 women):
http://www.dailymail.co.uk/news/article-2146545/Man-fathered-30-kids-11-different-women-says-needs-break–child-support.html
But Marsh’s problems go deeper and the research I site shows the critical nexus between typical problem (parents split, bad divorce) and crisis. Intervening variables are critical. This isn’t about the district taking over as parents, its about the district identifying potential troubled youth and intervening when needed.
“This isn’t about the district taking over as parents, its about the district identifying potential troubled youth and intervening when needed.”
Built into your prescription is the assumption that something could have changed Daniel Marsh. It’s entirely possible, even likely, if he has psychopathy, no “needed intervention” would have altered his course at all, short of locking him up a priori, something no one would ever consider.
I think you might not grasp the biological nature of psychopathy, and how impossible it is to treat. Here is a brief description of the brain of a psychopath:
“Brain scans revealed that psychopathy in criminals was associated with decreased connectivity between the amygdala, a subcortical structure of the brain that processes negative stimuli, and the ventromedial prefrontal cortex (vmPFC), a cortical region in the front of the brain that interprets the response from the amygdala. When the connectivity between these two regions is low, processing of negative stimuli in the amygdala does not translate into any strongly felt negative emotions. This fits well into the picture we have of psychopaths. They do not feel nervous or embarrassed when they are caught doing something bad. They do not feel sad when other people suffer. Though they feel physical pain, they are not themselves in a position to suffer from emotions hurts.”
Despite their messed up brains, many biological psychopaths don’t become criminals. Some are just manipulative, impulsive and exceedingly aggressive. Those traits, not too surprisingly, can lead to success in some businesses. But they also cause problems in social interactions which can not, AFAIK, be corrected by medications or psychotherapy.
This is only one, and only one, viewpoint about psychopathy. The field of personality study is not satisfied that a person with a psychpathic disorder is not able to change. The use of brain scanning is controversial and the studies of those identified as psychopaths have few good control groups and may have other biases.
And anyway, the standard definition of a psychopath – a person who scores high on the Psychopathy Checklist-Revised (PCL-R) is controversial. There has been a lot of push back by professionals who evaluate for violence risk and do court-ordered evaluations about what a psychopathic personality is and what happens when we call someone a psychopath. The main argument is that what psychologists measure with the PCL-R is not psychopathy, but how people score on the PCL-R. The confusion is that the test may not measure “true” psychopathy and has a lot of “noise” in it.
Another problem with talking about Marsh and psychopathy in the same breath, is that none of the professionals who evaluated him have either given him testing for those characteristics or have opined about it on the stand. Before we all jump to the conclusion that he is a psychopath why don’t we stand back and learn a little.
For one, Rich, I’m not sure what you are basing your assertion that psychopaths are “impossible to treat.” The current literature on treatment of these folks is almost completely nonexistent. The myth that psychopaths are not treatable is based on a 1960’s study that was not meant to treat them, did not measure their psychopathy the way we do today, and was completely uncontrolled.
Another important point is that few professionals in the field would venture to say that Marsh is a psychopath because it is considered an adult disorder and not one found among children his age (15 when he committed his crime). One cannot make a diagnosis of antisocial personality disorder of a youth – conduct disorder, yes, but not antisocial personality disorder. There is a Youth Psychopathy Checklist by the same author as the adult measure, but it is more of a screening measure for antisocial and criminal characteristics.
There is no settled theory about how someone “becomes” a psychopath. There may be genetic components (they have less emotional excitability than those who score lower on the PCL).
Quoting from the popular press about psychopathy is useful to a point. We are talking about a young man here who will probably spend many, many years in either a mental hospital or state prison. Talking about him as if he has irreversible problems is, IMO, doing him a disservice, and not helpful. Labeling someone a psychopath has been shown to be prejudicial in court proceedings and has been called into question in the literature as confusing and biased.
And in case you wonder, I do have a license to practice and I am qualified to give the PCL-R and opine about it.
Should we assume that more money for the DJUSD is a higher priority than a new 50-meter swimming pool? The answer always seems to be more money, but another issue is where the current monies are spent.
TBD wrote:
> Should we assume that more money for the DJUSD is a higher priority
> than a new 50-meter swimming pool?
If we give the schools more money they will probably want to get their own MRAP (like the LA schools):
http://foxtrotalpha.jalopnik.com/la-school-district-gives-back-its-grenade-launchers-but-1635861334/+travis
Psuedoshrink Rifkin brings up an important point: “Obviously, he did not come from an intact family. But otherwise, it’s possible his parents were as supportive and loving as they could to him, and he just turned out to be a psychopath. As far as I know, his sister, who has the same parents, is a normal, well-adjusted person. ”
The fact is that most psychopaths do not act out. They learn that there are consequences for acting impulsively and develop mechanisms for maintaining social contact without overt violence toward others.
“… his parents were as supportive and loving as they could (be) to him,..”
The depth of that “support” seems limited, to say the least.
;>)/
This personal attack on me is a clear violation of terms of service.
Rich wrote:
> This personal attack on me is a clear violation of terms of service.
I would not call it an “attack” (unless you actually are a licensed “shrink”).
I never met the kid or the family, but I heard nothing but bad things about “both” the kid and his parents,
Today the Sacramento Bee writes:
“retired FBI profiler Chris Campion in hours of questioning of his struggles to fit in at school; a volatile home life with parents he detested that Campion described in the interview as a “family train wreck”; his depression and medications he took to fight it; and the hospitalizations.”
A former FBI agent does not usually use the terms “volatile” or “train wreck” when describing parents doing a good job…
Read more here: http://www.sacbee.com/2014/09/17/6715266/investigator-david-marsh-posted.html#storylink=cpy
The Father seemed to have some rules and consequences, while his Mother sounds to have been very permissive. In my youth, my parents would never have allowed me or my siblings to stay out all night, and come home high / drunk. Yes, I think I had a somewhat normal high school experience, but knew if I drank, I had to do it within certain limits. (Home on time, not drink so much as to be unable to get past my parents in a coherent state, etc.) I had to “handle it”. And I can’t imagine a girlfriend coming to live with us. Did the girlfriend have some kind of traumatic home life, or did she just want to party like Daniel?
I’ve always been taught that children need structure and security and routine, and it looks like he had anything but these.
And who provided or paid for his drug habit? I have my hunch.
I’m sorry, are you a real shrink?
;>)/
Are you a real [edit], or do you just present yourself as one?
That seems quite over the top. If you were a real psychotherapist and took offense at the jocular term”psuedoshrink” or even “shrink,” I would feel a bit more sincere in my apology, but since, as far as I can tell, you are a, sometimes paid, writer and raconteur, I would think you’d take offense at terms like “hack” or “wheeze,” but to put it to rest I’d be happy to settle on non-psychiatric professional, if it’ll settle your liver. Oddly enough, I’d have never guessed you’d be so thin-skinned.
;>)/
I get it. You act like an [edit], but then pretend that my taking offense at your personal attack is a character flaw of mine, now lobbying a “thin-skinned” bromide my way. All the while, you hide behind a fake name, so not even your acquaintances know you behave so badly.
David, this is an interesting concept (ACE), thank you.
How much money do we think DJUSD need to add a therapist or two? Can’t it be taken from current sources? Yes, there are 8600 students, but maybe 90 percent will never need these services, and another chunk have more garden-variety issues. How do we handle the extreme cases, or potentially extreme cases?
I wonder how an Outward Bound program like this would have helped Daniel Marsh. I’ve read reports were some are quite effective: no drugs, no booze, structure, consequences, therapy, nature, and hard work and learning, which build self confidence.
It seems as if a high percentage of these teenage killings involve prescription drugs, and we’ve also heard that his drug use (including marijuana) likely played some role.
With a classification of Seriously Emotionally Disturbed (SED), Daniel could have been placed in a group home where he would have gotten all you described except maybe hard work. The physical component is important and it’s not there–and should be. Nevertheless, had he failed some more, they would have considered a level 12 or 14 group home placement. The current system is built on FAILURE. Seems really wrong headed to me and in dire need of change but that is what we have. Every service is built on failure.
Reading the reports, Marsh was/is classified as SED.
David, thank you for the article. So much of the discussion on this site has been about the spotty care Marsh received but I believe he got as much or more attention than many students who have emotional problems. I would like the focus on the school system and the mental health system as a result of the Marsh trial to result in efforts to coordinate and improve the services at the high school and our county mental health services. Marsh had Kaiser insurance which actually provided him with better mental health services than most. If a person has to rely on Yolo County Mental Health, they will find the services are really bare bones–one meeting with a psychiatrist every three months for 30 minutes!
If an ounce of prevention is worth a pound of cure, we should be looking at the delivery of services at the elementary level because that is when they have a better chance of being helped and our pennies spent there are worth hundreds of dollars spent in high school.
Currently, as we see with Marsh, the district’s resources are spent to prop up the students so they can function in school. Given the resources they have and how thin they are spread, this may be the best they can do BUT is it good enough? Could they use their resources more effectively? Is it time to demand a re-allocation of funds so these services aren’t at the bottom of the funding priorities? It seems like a good question for the school board candidates. Also, perhaps there are there grants for implementing additional services in the schools and the community.
I think, for Marsh, and according to the ACE study, the third element of violence in his environment was the key to his behavior. Without the violent video games and gore and horror movies would he have become homicidal. The Southern Poverty Law Center tracks hate groups and they, too, find immersion in violence to be a key component in the lives of people they track.
With due respect to DavisBurns, I’d like to dispel a couple misconceptions. Marsh had private insurance and got care from Kaiser. In the DJUSD, kids with Individual Educational Plans that indicate that they are SED get services in the school from the school’s contracted mental health providers – and these are not the County Dept. of Alcohol, Drugs, and Mental Health. Until a few years ago he would have had services through the county but three years ago (I may be off a little) the county Special Education committee let their contract lapse with the County and chose to find alternative providers for the mental health aspect of IEPs. The problem as I see it, and I have personal experience with this aspect of DJUSD, is that the schools are charged with providing services needed to help the child succeed in school. And they are penny-pinchers when it comes to non-education-related expenses associated with IEPs. They fight tooth-and-nail to provide the lowest level of services and when challenged they get petulant and stubborn. (This is my opinion only.)
Good mental health treatment is expensive to provide. But when it is provided it can be very helpful and provide the needed assistance a child needs. If parents are not very vigorous advocates for their child the school district (and DJUSD is probably not alone in this) will skimp. I have heard very little in the reporting of this trial about how the parents were involved with his school-based treatment and IEP. Certainly they were involved with his care at Kaiser but that care seemed disjointed and poorly coordinated with the school, if we can believe all the testimony.
DavisBurns is correct that too often the level of services for kids in the school system is not ramped up until they fail. That’s backwards. Good prevention should provide intensive treatment right off the bat (in home visits, school-based services, outside care, maybe residential). This sort of “wrap around” services can make a difference. And the schools can play a big part.
Robert Canning, you are correct. Marsh had private insurance and did not rely on Yolo County Mental Health. While my comments about the districts operation are accurate, the inclusion about the current access to YCMH was mixing apples and oranges. YCHM offers bare bones services to those they serve and they are the only mental health services many in the county have but that isn’t relevant in the Marsh case. Thank you for pointing out the misdirection. I would maintain the district still has limited mental health services.
DJUSD is more than stingy in approving needed services however if he had gone to a group home, it is my understanding that doesn’t come out of their budget. It’s been a while since I was involved but I believe a placement in a group home comes out of another pot of money.
The primary responsibility of a school system is to provide education. In Marsh’s case, it looks like DJUSD did an exemplary job of identifying the fact that this particular child had emotional/psychological issues. He had an IEP and was seen by district mental health professionals. In addition, he had health insurance and was seen by private mental health providers, including having been hospitalized twice for mental health issues.
How much more can we realistically expect a school district to provide to a single child? How much would it cost for the school district to provide more mental health services to a single child? How many other children would lose educational opportunities if district money were shifted to provide more extensive mental health services?
Yes, there were some serious system failures here, particularly a lack of communication and coordination between the multitude of mental health providers and counselors who had contact with this child over the years. It is unclear whether better coordination and communication between these mental health providers would have made any difference. But, either way, it is not realistic to expect a school system to be responsible for the failures of our mental health care system.
So many “trusted adults” who would not be or could not be trustworthy.
“they are penny-pinchers when it comes to non-education-related expenses associated with IEPs. They fight tooth-and-nail to provide the lowest level of services and when challenged they get petulant and stubborn. (This is my opinion only”
IN my experience, they were much worse than that. Their offerings are consistently too little, too late. And it is inaccurate to characterize necessary services as non-education related. Schools are charged with educating mentally handicapped, learning disabled, autistic, physically disabled…this is the on-going argument the parents of children with special needs face.
Are sports education related? Art? Music? Speech therapy? Physical education?
As to how much a district can spend on one child, the answers is they are charged with giving each child a free and appropriate education. When there are obstacles that prevent them from learning, they are charged with support, remediation and accommodations. They are not allowed to accept and educated only the children who will cost them the least to educate. This is the basis of special education and parents of children with special needs are faced with this attitude all the time. We have laws that say we have to create the infrastructure for people in wheel chairs to use the sidewalks and restaurants and bathrooms even though it adds considerably to building costs. It is the law and we seem to have accepted it for the most part. The school identified marsh as being seriously emotionally disturbed, this means his emotional disturbance was an impediment to his education. The outcome for most kids who get too little too late is usually a lack of access to higher education, limited job choices, depression and shame that is very private.
I repeat myself but had Marsh postponed becoming homicidal but continued to fail, DJUSD could have foregone the daily stipend they got from various sources for each day he actually attended school and placed him in a group home which is funded by other sources and he would have had the supervision, structure and services that would more likely met his needs.