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Shootings expose cracks in U.S. mental-health system

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POSTED: October 4, 2012 4:00 p.m.

MINNEAPOLIS — Andrew Engeldinger’s parents pushed him for two years to seek treatment for what they suspected was mental illness, but even though he became increasingly paranoid and experienced delusions, there was nothing more they could do.

Minnesota law doesn’t allow people to be forced into treatment without proof that they are a threat to themselves or others. Engeldinger’s parents were horrified last week, when their 36-year-old son went on a workplace shooting spree that led to the deaths of a Minneapolis sign company’s owner, several of his employees and a UPS driver. Engeldinger then killed himself.

“They wanted him to get treatment. They wanted him to get help,” said Sue Abderholden, the executive director of the Minnesota chapter of the National Alliance on Mental Illness, who has acted as a family spokeswoman.

She added: “You’re not going to convince someone they’re ill if they don’t want to believe it.”

This is a problem faced by many friends and relatives of people suffering from mental illness, along with the police officers and health-care providers to whom they turn for help. While a small number of people with mental illness commit acts of violence, the difficulty of securing treatment and ensuring it is successful — and the catastrophic consequences of failure — are common threads that often link such outbursts.

“These are not random acts of violence,” said Dr. E. Fuller Torrey, a psychiatrist at the nonprofit Stanley Medical Research Institute in Maryland. “It is my personal belief that these episodes will increase in number and severity and will continue until we figure out what to do about it.”

A successful patients’ rights movement in the 1970s made it difficult — and illegal in some states — to force a person into treatment unless he or she was homicidal or suicidal. Dr. Darold Treffert, a Wisconsin psychiatrist, coined the phrase “dying with their rights on” in 1974, after collecting stories of people who didn’t qualify for involuntary commitment and later killed themselves.

In the years since, 41 states have added “need for treatment” standards to their laws that allow more individuals to be placed into court-ordered treatment programs. Minnesota is not among them.

“The pendulum is slowly returning to a reasonable balance,” Treffert said. “I have comforted myself on this long mission with the realization that some things can be learned and can’t be taught. We do seem to be learning slowly from tragedies.”

 

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