By Allison, Ronald A.
Behavioral Healthcare , Vol. 27, No. 8
Virginia Tech Shootings, 2007--Influence
Community Mental Health Services--Evaluation
Mental Health Personnel--Training
Mental Health Personnel--Evaluation
Psychiatric Facilities--Human Resource Management
The Virginia Tech tragedy has placed the nation's mental healthcare system under the microscope--with Virginia's public system being examined under high magnification. After the shootings, the American public was justifiably upset. People who normally don't think about mental healthcare wondered, "How can something like this happen in rural America?" "Could someone have stopped this from happening?" "Is the mental healthcare system broken?"
Responsibility for the Virginia Tech tragedy is being placed squarely on Virginia's public mental healthcare system. The general public's reaction is understandable, but from a realistic point of view, this condemnation is totally unjustified. After all, the public mental healthcare system lacks adequate funding and the necessary resources to be able to prevent incidences like the Virginia Tech tragedy.
What We Know So Far
Yet there's no doubt about it: Seung-Hui Cho definitely slipped through the system's cracks. As early as a year and a half before the incident, Virginia Tech officials and students became aware of Cho's delusional and disturbing behavior. His writings depicted graphic and macabre violence. Virginia Tech Professor Lucinda Roy, former chairwoman of Virginia Tech's English Department, was so concerned that she pulled Cho from another instructor's class and taught him one-on-one. In December 2005, campus police met with Cho, acting on two female students' complaints that he had left graphic messages on their doors. Later that evening, Cho sent an e-mail to his roommate threatening suicide. The roommate relayed the message to his father, who called the campus police.
Following the campus police's intervention, Cho was taken to their campus headquarters, where the emergency staff from New River Valley Community Services Board, the local mental health agency in Blacksburg, prescreened Cho. The prescreening staff determined that Cho met commitment criteria and recommended hospitalization. A temporary detention order was issued, and Cho was taken to Carilion Saint Albans Behavioral Health clinic, a few miles from the Virginia Tech campus. New River Valley staff recommended that Cho receive medication management and outpatient counseling services upon his release.
The next day the actual commitment hearing was held by Special Justice Paul M. Barnett to determine whether to continue hospitalization or to release Cho back to the community. Although Cho was judged to be an "imminent danger to self or others as a result of mental illness," Barnett released Cho under an involuntary outpatient treatment order with a recommendation that he seek professional counseling. Cho did make an appointment at that time with the Cook Counseling Center on the Virginia Tech campus.
Records obtained from the University Counseling Center failed to clarify whether Cho ever received counseling. Gerald Massengill, chairman of the panel appointed by Gov. Tim Kaine to investigate the event, stated, "I think the absence of documentation might tell you something within itself." He added, "If in fact there was never any sign of violence, any indication of violence on his part, how would you anticipate anything like this?" He also said, "It's unfair to point a finger and blame the mental health community for something that may not have been detectable."
Until the investigation began immediately following the shootings, New River Valley CSB was never aware that an involuntary outpatient commitment order had been issued, according to Les Saltzberg, the former executive director of New River Valley CSB. No further information was available at press time.
The History of Virginia's Community-Based System
The Virginia Tech tragedy has brought to light the fragmented and poorly funded mental healthcare system in Virginia--and the entire nation. Understanding the history of the commonwealth's system will help decision makers take steps to prevent future tragedies across the state and country. …