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April 19, 2007

Media madness: The Virginia Tech story

Clarice Feldman
There seems to be  just one template for the media in covering tragedies like that which just occurred at Virginia Tech: Discussion of further regulation of guns and so much coverage of the perpetrator that copycats are sure to be impressed. Living in some deluded state, sure that the world has mistreated him, seeing the glorification (at least in his demented condition) of the latest mass murderer, the next Cho may be already getting some ideas about how to take follow in his footsteps

On the other hand, the media might want to consider whether it's time to undo the attitude they've taken in the past few decade -- that mental illness is just a social construct or that it is best treated outside hospital settings. Bedazzled by Thomas Szasz and his theories which poo-poohed the very concept of mental illness, influenced by the film industry's sympathetic treatment of institutionalized mentally ill (One Flew Over the Cuckoo's Nest), horrified by documentaries of the worst of those institutions, oversold on the efficacy of drugs to treat mental illness, and lured by the notion that we could save a lot of tax money by treating patients outside , we made it exceedingly hard to institutionalize psychotics against their will.

Rael Jean Isaac and Virginia Armat documented this in their powerful book, Madness in the Streets:How Psychiatry and the Law Abandoned the Mentally Ill.

But we didn't stop there, as the New York Times explains today:
Federal privacy and antidiscrimination laws restrict how universities can deal with students who have mental health problems.

For the most part, universities cannot tell parents about their children's problems without the student's consent. They cannot release any information in a student's medical record without consent. And they cannot put students on involuntary medical leave, just because they develop a serious mental illness.[snip]

College officials say that a growing number of students arrive on campus with a history of mental-health problems and a prescription for psychotropic drugs. But screening for such problems would be illegal, admissions officers say.

"We're restricted by the disabilities act from asking," said Rick Shaw, Stanford's admissions director.  [snip]

Federal laws also restrict what universities can reveal. Generally, the Family Educational Rights and Privacy Act, Ferpa, passed in 1974, makes it illegal to disclose a student's records to family members without the student's authorization.

"Colleges can disclose a student's private records if they believe there's a health and safety emergency, but that health and safety exception hasn't been much tested in the courts, so it's left to be figured out case by case," Ms. Fleming said.

And the Health Insurance Portability and Accountability Act prohibits the release of medical records. "The interaction of all these laws does not make things easy," she said.
Some concerted examination of existing laws concerning the mentally ill among us is a great deal more complicated than booking pro- and anti- gun proponents yelling at each other between commercial breaks. But, frankly, I see no better way to protect students than to make some very substantial changes in the law. And to do that, we need a public far better informed than they are about what we've done and why we have to change that.

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