By Charmayne Schmitz
Day six of the Daniel Marsh trial began with the testimony of the school counselor, Monica O’Brien. She first saw Daniel on January 16, 2013, for 50 minutes. The purpose of the first session was to build rapport. Daniel appeared depressed and did not make eye contact. When asked about family and friends, Daniel said he didn’t like his family. He hadn’t seen his father for some time and his mother did not give him support. He spoke of having a few friends and a girlfriend.
Daniel had no plans for the future. He had daily suicidal thoughts and his brain had stopped producing serotonin. He told Ms. O’Brien he had tried several antidepressants. None of them had worked. His mother was aware of his suicidal thoughts but he felt she didn’t care. Daniel also told the counselor about his homicidal thoughts regarding people at school, telling her he had been bullied and other students were egotistical. He had thoughts of torturing people, standing over them and telling them they are garbage until they believed it. Ms. O’Brien asked him if he had access to weapons. Daniel said yes, but not at home. She asked him if he had used drugs or alcohol. Daniel said he smoked marijuana daily but no longer had a drinking problem.
After the session, Ms. O’Brien informed the school therapist, Jordan Mulder, and called the Davis Police Department. This was not a breach of confidentiality because of the possibility of harming himself and the duty to warn potential victims. Ms. O’Brien wasn’t there when the officer arrived. Also, she did not have the authority to produce a 5150 (Welfare and Institutions section 5150) report, for an involuntary psychiatric hold, as it is a police responsibility.
Ms. O’Brien saw Daniel one other time, on January 29, 2013. At this session, the same topics were revisited. Daniel was upset about her break of confidentiality, but he showed up anyway. He denied plans to hurt anyone but later discussed details about how he could torture people. Daniel said he wouldn’t carry out any of these ideas because he wanted to be there for his friends and girlfriend. Daniel said he had had these feelings for many years. He used to fight them but had given up and was letting his mind take over. Daniel said he tried to tell a former counselor, but she looked scared so he stopped. Ms. O’Brien didn’t report this session because there was no intent or specifics given, only thoughts. She said Daniel seemed coherent and she wasn’t trained to assess if he were delusional.
The school counselor notified Daniel’s mother, who then notified Daniel’s therapist at Kaiser, Timothy Hesgard. The mother allowed Hesgard to discuss Daniel’s situation with Ms. O’Brien. The call between the counselor and the therapist took place on January 30, 2013.
On cross-examination by Deputy Public Defender Ron Johnson, Ms. O’Brien was asked if she had reviewed the notes of the previous counselor, to which she replied “not fully.” She knew Daniel was recently hospitalized but did not know exactly when. She later became aware of a “re-entry” meeting with Daniel’s case manager, teacher and psychologist, which occurred before his return to school. Ms. O’Brien did not see the notes and did not speak to the participants. She was a new employee and didn’t know about these meetings until a while later.
As Johnson continued to question Ms. O’Brien, she kept insisting that her only duties were to treat what affects the student’s education: truancy, difficulty with work production and coping skills. She was hired strictly to perform this function. Mr. Johnson asked if she saw his statements as reaching out and trying to test her. Why did she know his serotonin levels but didn’t pursue that avenue? Why didn’t she explore his homicidal thoughts, toward whom were they directed, where did he have access to weapons? The counselor said she wanted to build rapport and not question Daniel. Rapport building takes several sessions. She didn’t consider asking her colleagues for suggestions about building the relationship quicker. In the second session, she attempted to reach Daniel by suggesting he would soon have options, when he turned 18. Also, perhaps he could write music to cope. When asked why she wasn’t present when the police arrived, Ms. O’Brien said she wasn’t required to be there. Johnson asked, “You never do things outside of your duty?”
Officer Cardini testified next about responding to Ms. O’Brien’s call. He gets about 100 calls a year like this. Cardini spoke to Daniel but he doesn’t remember what was said and believes he mistakenly thought it was concerning an earlier incident.
A registered nurse from Sutter Davis Hospital, Patricia Prentice, testified that she was the psychiatric nurse who evaluated and admitted Daniel on December 12, 2012. Daniel told her when he woke up that day he was really angry. It was a different feeling from before. He had had problems since October of that year with truancy, studying and controlling his anger. He had stopped taking his medications. When his mother was asked, she said Daniel was adamant about not taking his medication. Daniel told Prentice of a volatile relationship with his mother, claimed he was abused by his father since he was a baby, and related the story about giving his father CPR. Recently his mother’s step-brother had died suddenly. Daniel told the nurse he tried three times to kill himself. Daniel appeared very sad and saw little future for himself.
Even though Daniel told Prentice that “if anybody gives him any s__, he will kill them” the nurse didn’t think it warranted notifying the police because it wasn’t specific and he had no weapons. Daniel was involuntarily admitted using a 5150, which allows a 72-hour hold. On cross-examination, the nurse admitted she didn’t know Daniel was already being treated at Kaiser for psychological issues. Daniel’s concern that day was uncontrollable anger.
Dr. David Walters, the Sutter Davis ER doctor who assisted in Daniel’s admittance on December 12, 2012, testified that he doesn’t remember Daniel. He didn’t find any organic brain dysfunctions that would cause hallucinations or delusions – that assessment was from his report. The doctor signed off on the transport authority but had no idea where Daniel was going to be sent.
The remainder of the day was spent on testimony by Dr. Lenore McKnight, a psychiatrist who treated Daniel when he was in an inpatient hospital eating disorder program. Daniel was at the Berkeley hospital from December 29, 2011 to January 25, 2012. The doctor does not remember Daniel by sight. Prosecutor Mike Cabral submitted a 700-page binder that detailed Daniel’s care at the hospital.
Daniel weighed 93 pounds when he was admitted, suffering from anorexia nervosa. It was considered a voluntary admission because Daniel’s parents gave permission. At the time, Daniel was taking Celexa, an anti-depressant. Dr. McKnight switched him to Lexapro because Celexa didn’t seem to be working. Later, she added Abilify, an anti-psychotic. The doctor noted that Daniel was suffering from major depressive disorder with many stressors in his life. Daniel was given psychological tests by another doctor at the hospital, Dr. Pollack. Daniel was found to have PTSD (post-traumatic stress disorder), but wouldn’t answer questions about what may be causing it. He was in denial about his eating disorder. Daniel had been starving himself, but not purging.
On cross-examination of Dr. McKnight, Mr. Johnson pointed out that he didn’t have access to the 700-page binder. His documents show a comment by Dr. Pollack that Daniel “seems to put ideas together in ways that violate reality,” and recommended further monitoring. Dr. McKnight said that is why she prescribed Abilify. Johnson again quoted Dr. Pollack: “Daniel frequently feels frightened even by his own thoughts.” Dr. McKnight responded that Daniel wouldn’t talk about it with her. Another part of Dr. Pollack’s document described nightmares, disturbed memories, and out-of-body experiences noted as feelings of de-realization. Dr. McKnight continued to say Daniel wouldn’t tell her about these feelings.
Daniel was discharged with recommendations for further out-patient care. Dr. McKnight didn’t follow up and has no knowledge of Daniel’s compliance with those recommendations.
There seems to be an utter lack of a primary care person who could manage Daniel’s mental health care. I can’t imagine going to different doctors for a physical condition and having each doctor give a different treatment in isolation of other doctors.
I’m also not impressed with the lack of care from the School Psychologist. A student tells her he is suicidal and has homicidal thoughts. She is concerned enough to call the police, but not concerned enough to be there when the officer responds, which results in confusion by the officer as to the nature of the call. Then she waits 2 weeks to see Daniel again, but only to “build rapport.” Daniel was clearly outside her range of expertise and willingness to handle. Unfortunately, I suspect that this typical of the Davis School District. I wonder how many other students we have in the District who lack parental advocates, are struggling, are known by District teachers and staff, and nothing is being done to help them.
that’s a pretty good observation that there was an utter lack of primary care person managing his mental health. part of my problem in this case is that we’re still talking about a kid, holding him ultimately responsible, as it becomes clear that most of the adults in his life failed him.
Unfortunately, too many schools are focused on the students headed for Stanford or Harvard, and not the students who are struggling with one disability or another.
Davis High School’s response to Marsh’s problems is appalling.
It’s fascinating that several of the professional people involved were only concerned with whether Marsh had access to guns — evidently focused on a Sandy Hook problem — and not concerned with access to kitchen knives and scissors and garden tools, poisons, etc. A dangerously narrow focus, oblivious to Marsh’s safety as well as the safety of other people.
My daughter who has above average intelligence, is dyslexic, depressed, introverted, socially awkward and on the autism spectrum with a profoundly serious heart condition went to Emmerson Jr High. We learned she had talked to a boy at school who said he could sell her his father’s handgun for $20 and arranged to meet her a a specified place and time on the school grounds. Daughter was admitted to hospital. We informed the school more than once. They did nothing. Didn’t seem to take it seriously. Maybe because daughter was hospitalized. That seemed strange. On the day of the meet, I called the Davis police. Really had to convince them someone should at least be at the meeting place in front of the school and check it out. They did but…the kid could have been walking around the school with a gun. He could have sold it to someone else. We never learned his identity. This was 15 years ago so guess they would take it more seriously now.
My experience with the school system and the mental health system is that it is spotty, ineffective, uncoordinated and trying to get people to take the time to consult with someone else rarely works; they can overreact and under react but all you can count on is funding for programs not for the student and the staff reassuring you that the program will fit your kid, even when research says it doesn’t come close. The principals’ job, the special ed teachers, the school psychologist, and the Special Education Local Area Plan (SELPA) board are all mandated with keeping the percentage of kids receiving services at or below 10%. Because funding is for programs and does not follow the child, you get this mess we have now. They are all doing the jobs they were hired to do and doing it In the required manner.
Once upon a time, kindergarten and first grade teachers referred the kids needing extra help to the school psychologist who interviewed and tested and with parents developed a plan to provide the support necessary for the child to succeed in school. Because early intervention was the norm and the funding followed the child, the child was the focus and not the programs available. The goal of the team was to provide as many services as necessary as early as possible to REMEDIATE the problems because failure in school creates depression, diminished self worth, anger and resentment. The system we have now requires the child to fail before the very slow process of evaluation begins. I referred my daughter for evaluation in September of 2nd grade and she received services in late March of that school year. I checked on the number of kids attending. North Davis Elementary school and the number receiving services (I had to attend a SELPA meeting to get the number receiving services) and big surprise, they were at their limit so they just delayed as long as possible.
While no system will help everyone, it is well documented that early intervention is the most successful and actually less expensive in the long run. When we wait until they are pre-teens to try to help and the help is just like what Marsh got, the success rate plummets and the outcomes are often tragic even when they don’t go out and murder people.
With funding that followed the child, Marsh would have received help sooner because it is unlikely he was a happy, social, well adjusted kid prior to age 11. And the help would have been for Daniel Marsh, not for ‘kids who seem depressed and withdrawn’.
You wonder how many other students we have in the District who lack parental advocates …and nothing is being done to help them. You should wonder how many have both parents in the home, provide private therapy, and are committed advocates and still the district does nothing to help them. Although they rarely do nothing. They do as little as possible OR what they are required to do.
The system doesn’t work. Or it does work for about 80% and that’s all we care about until people get killed. Maybe 80% is a solid B and we should celebrate. Only two gruesome murders not 28 as in Sandy Hook or 12 in Columbine.
San Francisco Unified School District had a similar “cap” because of a consent decree 20 years ago. Because more African American male students were referred out of the standard school system than average, they were prohibited from doing this any more (I don’t know if you call it a transfer, or a referral to a continuation program). Therefore, teachers had to deal with unruly, aggressive, and disruptive students as they knew there was no alternative. The students and parents were also aware of this, so had no motivation to correct their children’s behavior … as if every group behaves to or at “the norm”.
A friend had a child who was identified as an “at risk” child in middle school in the Bay Area, and she was thoroughly impressed with how the school did everything within their power to see that child graduated. High test scores, ADHD, some depression and social issues… they started by having her attend summer school to get ahead of the curve to have better odds of graduating high school. In this case, I think community health groups and the school did a good job, but the parents sometimes sabotaged the system / enabled poor behavior / choices.
Every SELPA district in California has the same cap however if you are in a poor, underprivileged , blighted area or have a high percentage of English as a second language students then the district can get a waiver. For all other districts, when you top 10% you have to reduce numbers or explain why and the exceptions they like are listed above.
‘It wasn’t in the job description’. Ugh.
And I am telling you their response to him is exactly what they offer anyone. He may have actually gotten more attention than most. The system doesn’t work.
Here is a young person who was in mental agony, he was shuffled form doc to doc with no one looking to create continuity or address the real issues. Symptoms were treated with DRUGS and more DRUGS but problems were ignored such as family issues and bullying and health. This is the medical system we have in place, it’s a travesty and a tragedy. And I doubt anything will change even as it stares us in the face.
Donna, since we have only recently decided our brains are part of our bodies and mental health coverage should be covered as a medical expense what other outcome can we expect? In spite of the fact that mental health services are now covered by medical insurance, try to find a list of providers here in Davis who will take your medical insurance. Actually, that is too difficult. What is easy is to find those who accept private payment.
As far as drugs for psychiatric problems, that is what they are trained to do. I think helping troubled children would be an expensive time consuming effort for which we have no foundation laid.
I remember I once had to go to the school to try and resolve an issue conserning my daughter with a high school counselor. I walked into the office with my daughter and noticed that her counselor wasn’t busy at the time and asked if we could talk to her and she seemed all put out that we needed 5 minutes of her time. It came across as very unprofessional.
My experience with the Davis school system and the medical community was much like what is described here. Daniel got more attention from the school psychologist than most. I don’t really see that she needed to be present when the police arrived. If the police listened to her initial call, they should not have been confused. While it would be nice if we hired and paid for mental health services in the schools, they are spread thin and spend most of their time doing assessments for special education and attending IEP meetings.
It is standard operating procedure for doctors to ignore reports from other doctors ( they may glance at records but they don’t really seem interested in anything more than a previous diagnosis. It is sad and discouraging but not uncommon.
I think it’s important to understand who these counselors and psychologists are and what they do. A school psychologist is not, in my experience in Davis and elsewhere, a mental health professional. They deal in placements, IEPs, etc. They don’t do therapy and are not licensed to do so. They may have only a certificate. The counselor in this situation may be a mental health professional – probably a master’s level therapist.
It’s also hard for me (and maybe others) to know really what the level of treatment was based on the snippets of testimony we are getting. I found the article to be a bit confusing, but I guess that’s the order of witnesses in the trial – so it was hard for me to have a sense of the chronology of events.
I have had two children who have had mental health problems while in school. My experience is that the mix of mental health providers and school routines is a hard one to pull off well. Within the last few years, the school districts in Yolo ended their contract with Yolo ADMH for mental health services when a child has an IEP. They hired an outside firm (I think it was mentioned in an earlier article) and that is who comes in when an IEP includes mental health services. There have been some good programs in DJUSD schools and some not so good programs for kids with mental health problems. One of the biggest hurdles I see is that mental health treatment, to have lasting effect, is not cheap and the school district (and DJUSD is probably not alone on this) is loath to spend the resources in this area. And the law says it is the district’s responsibility to provide the services necessary for the child to succeed. But school districts are not mental health providers, and when the district is dictating what services they are willing to pay for, then the kids get short shrift – IMHO.
Regarding suicide and the high school, for a number of years the high school had a suicide prevention coordinator who was trained in assessment and referrals for kids who are suicidal. I don’t know if they still have that person.
Hi Robert!
My understanding is that Suicide Prevention of Yolo County has a presence and is available to the schools and gives outreach presentations. Someone more directly involved may want to comment.
Hi Diane, yes, I think I have heard that also. They are a great resource for anyone who is feeling like taking their life. And it is ironic we are talking about this this week – it is Suicide Prevention Week and today is World Suicide Prevention Day.