121219 Two Stories: Sandy Hook Shooting
I Am Adam Lanza's Mother - Liza Long
Three days before 20-year-old Adam Lanza killed his mother, then opened fire on a classroom full of Connecticut kindergartners, my 13-year-old son Michael (name changed) missed his bus because he was wearing the wrong color pants.
"I can wear these pants," he said, his tone increasingly belligerent, the black-hole pupils of his eyes swallowing the blue irises.
"They are navy blue," I told him. "Your school's dress code says black or khaki pants only."
"They told me I could wear these," he insisted. "You're a stupid bitch. I can wear whatever pants I want to. This is America. I have rights!"
"You can't wear whatever pants you want to," I said, my tone affable, reasonable. "And you definitely cannot call me a stupid bitch. You're grounded from electronics for the rest of the day. Now get in the car, and I will take you to school."
I live with a son who is mentally ill. I love my son. But he terrifies me.
A few weeks ago, Michael pulled a knife and threatened to kill me and then himself after I asked him to return his overdue library books. His 7- and 9-year-old siblings knew the safety plan - they ran to the car and locked the doors before I even asked them to. I managed to get the knife from Michael, then methodically collected all the sharp objects in the house into a single Tupperware container that now travels with me. Through it all, he continued to scream insults at me and threaten to kill or hurt me.
That conflict ended with three burly police officers and a paramedic wrestling my son onto a gurney for an expensive ambulance ride to the local emergency room. The mental hospital didn't have any beds that day, and Michael calmed down nicely in the ER, so they sent us home with a prescription for Zyprexa and a follow-up visit with a local pediatric psychiatrist.
We still don't know what's wrong with Michael. Autism spectrum, ADHD, Oppositional Defiant or Intermittent Explosive Disorder have all been tossed around at various meetings with probation officers and social workers and counselors and teachers and school administrators. He's been on a slew of antipsychotic and mood-altering pharmaceuticals, a Russian novel of behavioral plans. Nothing seems to work.
At the start of seventh grade, Michael was accepted to an accelerated program for highly gifted math and science students. His IQ is off the charts. When he's in a good mood, he will gladly bend your ear on subjects ranging from Greek mythology to the differences between Einsteinian and Newtonian physics to Doctor Who. He's in a good mood most of the time. But when he's not, watch out. And it's impossible to predict what will set him off.
Several weeks into his new junior high school, Michael began exhibiting increasingly odd and threatening behaviors at school. We decided to transfer him to the district's most restrictive behavioral program, a contained school environment where children who can't function in normal classrooms can access their right to free public babysitting from 7:30 to 1:50 Monday through Friday until they turn 18.
The morning of the pants incident, Michael continued to argue with me on the drive. He would occasionally apologize and seem remorseful. Right before we turned into his school parking lot, he said, "Look, Mom, I'm really sorry. Can I have video games back today?"
"No way," I told him. "You cannot act the way you acted this morning and think you can get your electronic privileges back that quickly."
His face turned cold, and his eyes were full of calculated rage. "Then I'm going to kill myself," he said. "I'm going to jump out of this car right now and kill myself."
That was it. After the knife incident, I told him that if he ever said those words again, I would take him straight to the mental hospital, no ifs, ands, or buts. I did not respond, except to pull the car into the opposite lane, turning left instead of right.
"Where are you taking me?" he said, suddenly worried. "Where are we going?"
"You know where we are going," I replied.
"No! You can't do that to me! You're sending me to hell! You're sending me straight to hell!"
I pulled up in front of the hospital, frantically waving for one of the clinicians who happened to be standing outside. "Call the police," I said. "Hurry."
Michael was in a full-blown fit by then, screaming and hitting. I hugged him close so he couldn't escape from the car. He bit me several times and repeatedly jabbed his elbows into my rib cage. I'm still stronger than he is, but I won't be for much longer.
The police came quickly and carried my son screaming and kicking into the bowels of the hospital. I started to shake, and tears filled my eyes as I filled out the paperwork - "Were there any difficulties with... at what age did your child... were there any problems with... has your child ever experienced... does your child have..."
At least we have health insurance now. I recently accepted a position with a local college, giving up my freelance career because when you have a kid like this, you need benefits. You'll do anything for benefits. No individual insurance plan will cover this kind of thing.
For days, my son insisted that I was lying - that I made the whole thing up so that I could get rid of him. The first day, when I called to check up on him, he said, I hate you. And I'm going to get my revenge as soon as I get out of here."
By day three, he was my calm, sweet boy again, all apologies and promises to get better. I've heard those promises for years. I don't believe them anymore.
On the intake form, under the question, "What are your expectations for treatment?" I wrote, "I need help."
And I do. This problem is too big for me to handle on my own. Sometimes there are no good options. So you just pray for grace and trust that in hindsight, it will all make sense.
I am sharing this story because I am Adam Lanza's mother. I am Dylan Klebold's and Eric Harris's mother. I am Jason Holmes's mother. I am Jared Loughner's mother. I am Seung-Hui Cho's mother. And these boys - and their mothers - need help. In the wake of another horrific national tragedy, it's easy to talk about guns. But it's time to talk about mental illness.
According to Mother Jones, since 1982, 61 mass murders involving firearms have occurred throughout the country. Of these, 43 of the killers were white males, and only one was a woman. Mother Jones focused on whether the killers obtained their guns legally (most did). But this highly visible sign of mental illness should lead us to consider how many people in the US live in fear, like I do.
When I asked my son's social worker about my options, he said that the only thing I could do was to get Michael charged with a crime. "If he's back in the system, they'll create a paper trail," he said. "That's the only way you're ever going to get anything done. No one will pay attention to you unless you've got charges."
I don't believe my son belongs in jail. The chaotic environment exacerbates Michael's sensitivity to sensory stimuli and doesn't deal with the underlying pathology. But it seems like the United States is using prison as the solution of choice for mentally ill people. According to Human Rights Watch, the number of mentally ill inmates in US prisons quadrupled from 2000 to 2006, and it continues to rise - in fact, the rate of inmate mental illness is five times greater (56 percent) than in the non-incarcerated population.
With state-run treatment centers and hospitals shuttered, prison is now the last resort for the mentally ill - Rikers Island, the LA County Jail and Cook County Jail in Illinois housed the nation's largest treatment centers in 2011.
No one wants to send a 13-year-old genius who loves Harry Potter and his snuggle animal collection to jail. But our society, with its stigma on mental illness and its broken healthcare system, does not provide us with other options. Then another tortured soul shoots up a fast food restaurant. A mall. A kindergarten classroom. And we wring our hands and say, "Something must be done."
I agree that something must be done. It's time for a meaningful, nation-wide conversation about mental health. That's the only way our nation can ever truly heal.
God help me. God help Michael. God help us all.
liza long is an author, musician, and erstwhile classicist. she is also a single mother of four bright, loved children, one of whom has special needs.
Original story republished with permission from the Blue Review, a non-profit publication affiliated with Boise State University that publishes a mix of scholarly essays and journalism.
"I AM ADAM LANZA'S PSYCHIATRIST": A RESPONSE FROM THE MENTAL HEALTH TRENCHES TO "I AM ADAM LANZA'S MOTHER"
Over the weekend, the viral blog post "I Am Adam Lanza's Mother" spoke to the complicated relationship of a mother to a potentially dangerous and mentally ill son. xoJane asked a psychiatrist to respond.
"I am sharing this story because I am Adam Lanza's mother. I am Dylan Klebold's and Eric Harris's mother. I am James Holmes's mother. I am Jared Loughner's mother. I am Seung-Hui Cho's mother. And these boys -- and their mothers -- need help. In the wake of another horrific national tragedy, it's easy to talk about guns. But it's time to talk about mental illness."
These are the words that spread across the Internet written by Boise mother Liza Long describing the challenge of grappling with her exceptionally gifted -- and exceptionally aggressive -- teenage son. Long gave a voice to the complicated "risk" burden that lies on parents, doctors and community to identify these potential dangers before it's too late.
Or as in the case of the "Dark Knight" shootings, to prevent another mother from wearily confirming over the phone after being informed her 24-year-old son could be the culprit of mass homicide: "You have the right person."
As Long wrote incisively in her essay about her 13-year-old, "I live with a son who is mentally ill. I love my son. But he terrifies me."
I know what challenges she faces, because -- in the words of Long -- I am Adam Lanza's psychiatrist. I am Dylan Klebold's and Eric Harris's psychiatrist. I am James Holmes's psychiatrist. I am Seung-Hui Cho's psychiatrist. And it is absolutely time to talk about mental illness.
Parents like Long definitively do not cause these types of mental illnesses that morph into violence. More often than not, the desire is there for the best treatment possible. Unfortunately, my chosen field of psychiatry has a lot of limitations.
In terms of the relationship between mental illness and violence, here is the little we do know. According to APA Council on Law and Psychiatry (Access to Firearms by People With Mental Illness: Resource Document, Arlington, Va., American Psychiatric Association, 2009), "The 'absolute risk' message is that the vast majority of people with mental illness in the community are not violent. The 'relative risk' message is that people with serious mental illness are, indeed, somewhat more likely to commit violent acts than people who are not mentally ill. And the 'attributable risk' message is that violence is a societal problem caused largely by other things besides mental illness (ready availability of guns, for example)."
I have had patients who have believed they were "chosen" to carry out a mission or who started to speak of the devil being present in the form of human beings. But are they violent? Do they need to be locked up? At what point do I inform the authorities when no specific plans to commit violence are mentioned to me, but the words start to become more terror-inducing. "Enemies" are mentioned. "Hate" punctuates every other word. Conscience can appear strikingly absent or little, if at all. Behavior is erratic -- but does not pose a technical threat.
I have had patients that are ticking time bombs.
I know the responsibility that lies upon me. When there is a sense that a patient is near breaking. When it is missed, I spend the rest of my life second-guessing myself and wondering what I may not have seen. It happens. Too often.
It is fair to say that pretty much everyone is enraged at my profession right about now. This is what happens when the time bomb is not caught, not stopped, not prevented.
We as psychiatrists need to find a way to catch our troubled sons -- the next Adam Lanza -- in the moment when he changes from chronically dangerous (that dreaded sense of ticking time bomb) to acutely dangerous (when the violence amps up to meeting the criteria for commitment to a hospital).
Because this boy was missed. That moment is now gone, and we as a nation are grieving with the consequences of the failure.
The only move left is for me to ask for help. And that's exactly what I am doing.
1) The US Congress: Please create better laws to ensure the ticking time bomb is caught before it is too late. Make it much easier for a family to get a potentially dangerous person into mandated treatment. This means less paperwork, too. We need to support parents and mental health professionals.
2) The US Justice Department: It's time we enacted a Health Law Court. Have doctors serve as judges and streamline legal proceedings for tough medical and psychiatric cases. Go to commongood.org for ideas on how this can be done.
3) Health Insurance Companies: Man up. My main complaint is with you. You make it so hard to keep people in the hospital when they need to be there, and it's even harder to keep them in intensive outpatient services. Please create protocols for difficult cases and loosen the purse strings for extremely troubled individuals –- before it's too late.
4) Network TV: Please create some exciting television that is actually educational about mental illness. Or least give us a "Gossip Girl" who takes her medication and sees her psychiatrist regularly. Less stigma, better health.
5) Drug Companies: You are always trying to ply me with coffee and doughnuts. I have trust issues with you. Don't want anything, thanks.
6) The Hollywood PR Machine: Please find the mental health community a really attractive celebrity to get the US mental health system some money. I am glad that George Clooney and Angelina Jolie are doing so much for Africa, but can we borrow one of them please?
7) High School Students: Tell the popular kids to stop being such dicks to the odd kids or the ones they don't understand.
8) Community Psychiatry Health Researchers: You have kick-ass and innovative ideas for how to reform the system. Could one of you put on a sequin dress and walk a red carpet please? We need to get you more money.
Me? I will keep trying to do my job. But I want to be better equipped the next time the risk appears before me. Because these young men need help. We all do.
Gawd. Has facebook really taken over the personal web log? It's scary.