The Responsibilities of the University and Threat Assessment

[jjenny]

Holmes was reported and deemed a danger while still a student. Dropping out made him no less a danger. The rest is legalistic bs coverup and damage control. Too late to even offer that up as an excuse imo..

But since they have no control over him whatsoever, what exactly could they do? That's what I am trying to understand.

 

[21merc7]

But since they have no control over him whatsoever, what exactly could they do? That's what I am trying to understand.

If they knew of his plans, they should call LE. That is what the entire point is. Why didn't they call LE. School or not, there is an obligation to protect him or others from harm, IF they knew. That's the if, did they know?

 

[jjenny]

If they knew of his plans, the could call LE. That is what the entire point is. Why didn't they call LE. School or not, there is an obligation to protect him or others, IF they knew.

Well, that is a big IF. She isn't liable unless he communicated to her a serious threat about specific person or persons. Whatever he could have been communicating to her could very well be not a serious threat about specific person or persons.

 

[21merc7]

Well, that is a big IF. She isn't liable unless he communicated to her a serious threat about specific person or persons. Whatever he could have been communicating to her could very well be not a serious threat about specific person or persons.

Exactly!

 

[Curious Me]

BBL = Be Back Later

I have no food! I'm off to grocerie shop.

 

[February]

But if you will think about it, the words are JH could be potentially a danger to others from the mouth of a Psychiatrist....On her career and expertise and have direct contact with JH and have access to his Medical Records as a patient, she will not simply say he is potentially a dangers to others without having some valid points or evaluations leading her to say that. IMO..

But this is just really my opinion...

 

[orora]

Holmes should have been reported to authorities, absolves the university should anything happen and involves law enforcement who have the power to force whatever issues and procedures as required. Columbine did not happen so close by just to have this slip by under the wire. Thats why threat assesment teams are organized and implimented. It is for everyone's safety. Diverting the danger by pointing the gun elsewhere was not the intended purpose.

We did learn from Columbine, we learned that what we are seeing and hearing here is not acceptable. If due to process, it is flawed and needs to be adressed, if due to human error, that needs to be disclosed. The end results of what happened are far to grevious for legalistic maneouvering. How many schools and universities in the country? How often have school shootings happened? We have no process or procedure to deal with it yet?

 

[waitin'4thewrld2chg]

Asking myself why all eyes are on DrF now. I've heard how slow it is to navigate through a school's procedures in a situation like this.

Surprises me if there's no procedures in place that support the idea of "accountability" of the person reporting a concern to the BETA team and who they should report it to in written form.

What I'm trying to say is DrF put the team together, she's the doctor who has concerns, and yet she doesn't have another person to take over from there. She's making phone calls to get this team together to do something and it seems to go no where. It's all up to her. (She only sees patients on Wednesdays? How much is on her plate?) It sounds so loose in procedure for emergency situations. Was everything communicated via phone calls?

Yes, about the phone calls. I know that steering away from putting confidential information in e-mails is sometimes smart, but with the phone calls that Dr. Fenton made to certain BETA team members in early June, documentation of the calls' content will be lacking, I expect. Phone records will show calls between certain phone numbers were made on certain days at certain times, but as to precisely what was said....

 

[orora]

Even the fact several calls were admittedly made denoting the potential for danger, and no follow up ensued soley because of the dropping out process, is a complete abrigation of duty.

The process should not have been curtailed due to internal procedure with no provision for diversion of process to authorities. If sufficient to warrant investigating him prior to dropping out, the need is demonstrated even more so afterwards by that.

Its not right no matter how it is viewed imo. If the Police did not respond, nor found anything to warrant further investigation, that would be their problem, it's part of their job. Members of the University (professionals with concerns) with held that information from the Police and interfered in the ability to stop it.

The University brass has no business defending this on any grounds imo.

(The road to Penn State)

 

[February]

The question you raise is one I have, also.

I am wondering about the general relationship between doctor/patient confidentiality and the functioning of a university team that assembles to evaluate threats and assess behavior.

Is this a sticky area that could potentially cause a group to think twice before convening, since some concerns may be more clear-cut and some more questionable?

This document might be helpful

Patient Resources: HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) of 1996, is a law that protects patient health information and privacy.

University Physicians, Inc., the University of Colorado and the University of Colorado Hospital adhere to HIPAA legislation by establishing policies and procedures to ensure patient confidentiality and the protection of patient information.
http://www.upicolo.org/images/pics/notice_private_practices_v1.pdf
http://www.upicolo.org/patient-resources/hipaa

 

[21merc7]

Since we have nothing to go on but speculation, maybe he threatened Fenton?

I have no idea, just thinking why no action was taken. Maybe he just showed her the stick figures. (Still think that was snark though.) Maybe he told her about buying guns and ammo? No specific threat to anyone?

All of the above is just me thinking out loud, no facts, just thoughts.

 

[February]

BBL = Be Back Later

I have no food! I'm off to grocerie shop.

You just made me hungry! :cupcake::coffeeup:

 

[21merc7]

Interesting post by a post-grad student diagnosed schizophrenic, and thoughts on JH:

http://phenomenologyofmadness.wordpress.com/2012/07/20/maeror-meror-in-mourning/

 

[February]

Since we have nothing to go on but speculation, maybe he threatened Fenton?

I have no idea, just thinking why no action was taken. Maybe he just showed her the stick figures. (Still think that was snark though.) Maybe he told her about buying guns and ammo? No specific threat to anyone?

All of the above is just me thinking out loud, no facts, just thoughts.

Interesting read..

11. Psychiatric patients most commonly become the source of malpractice actions if they injure
themselves or others. Psychiatrists may be found liable for damages if psychiatric patients
injure themselves, commit suicide, injure others, elope, prove false imprisonment, or prove
sexual abuse. Psychiatrists should take appropriate steps to avoid such allegations. At all
times, they should use good clinical judgment, and adequately document the risks and
benefits of treatment.

http://www.ablminc.org/A Day with t...rs_pdf/14a_Psychiatry Liability-Firestone.pdf
MEDICAL MALPRACTICE SURVIVAL HANDBOOK, ACLM, 2007
Psychiatric malpratice

 

[February]

Interesting post by a post-grad student diagnosed schizophrenic, and thoughts on JH:

http://phenomenologyofmadness.wordpress.com/2012/07/20/maeror-meror-in-mourning/

Thank you for the link.

some people think that this JH's school dropping out is just regular and students do that a lot and that this exam is just an ordinary exam.

This is a Neuroscience Phd Program. They are studying on science and the brain and cure and Mental Illnesses. JH is presenting a MicroRNA Biomakers and if anyone search for it, it is a cure for cancer and Billion dollar Pharmacies are on top of this and they believe this is going to be huge in the future.

These graduates could make millions of dollars. This is not an ordinary school, class or exam. Everything here matters. I am not giving an excuse for JH but i could have understand that a failure on this great education is gonna be hard to accept specially for someone who cant find a job other than Mcdonalds. IMO

 

[CARIIS]

http://www.ucdenver.edu/about/departments/InstitutionalResearch/Documents/Clery/StatsAMC10Report.pdf

Has anyone found more specifics about this 2010 incident? Did it make the local news/campus newsletter? I have heard about some grad school departments being known for high levels of suicides, so it's not that large of a step for me to wonder whether this department suffered from a mix of conditions which lead to a gun buying pattern. (Not saying there is a pattern or that the 2010 incident was even the same department, just wondering...as usual, with little real info...)

I tried to find it but nothing came back! It just struck me as ironic this woman started this Beta , and then they miss the biggest mass murderer for a month and a half, after lying to the world for a week.

Something is amiss..........................

 

[waitin'4thewrld2chg]

This document might be helpful

Patient Resources: HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) of 1996, is a law that protects patient health information and privacy.

University Physicians, Inc., the University of Colorado and the University of Colorado Hospital adhere to HIPAA legislation by establishing policies and procedures to ensure patient confidentiality and the protection of patient information.
http://www.upicolo.org/images/pics/notice_private_practices_v1.pdf
http://www.upicolo.org/patient-resources/hipaa

Thank you for this interesting and important link. The linked document states that all of the ways permitted to use and disclose medical information without prior written permission will fall into one of the categories listed in the doc.

Reading the information and just guessing, maybe the categories of treatment alternatives and health-related services cover the BETA team as it discusses private medical information in a group setting, since referrals is one of the things they do.

 

[Curious Me]

Interesting post by a post-grad student diagnosed schizophrenic, and thoughts on JH:

http://phenomenologyofmadness.wordpress.com/2012/07/20/maeror-meror-in-mourning/

Back now, and so glad I have food.

Thank You so much for posting this link. It's really heartbreaking. I, for one, don't doubt for a minute that it is possible JH's dropping out was preceded by some urging to find alternative goals in life. The school demands 150% from students, so if you aren't cutting it...

The thinking process explained in the article describes how a revenge and need to prove something is operating and growing without some intervention. I've heard so much about the laws and the teams, and yet clearly this latest tragedy may remind us that the human quality of really caring still matters too.

 

[jjenny]

Back now, and so glad I have food.

Thank You so much for posting this link. It's really heartbreaking. I, for one, don't doubt for a minute that it is possible JH's dropping out was preceded by some urging to find alternative goals in life. The school demands 150% from students, so if you aren't cutting it...

The thinking process explained in the article describes how a revenge and need to prove something is operating and growing without some intervention. I've heard so much about the laws and the teams, and yet clearly this latest tragedy may remind us that the human quality of really caring still matters too.

Well if somebody doesn't cut it as a graduate student, they aren't going to cut it as a faculty either. So what would be a point of training someone if they don't cut it? Hypothetically speaking, that is, since there is no evidence anyone tried to urge JH to find alternative goals in life.

 

[CARIIS]

A hunch here. I have found it somewhat confusing, that there is this prevalent notion that involuntary commitment equates with locking someone up. It just hit me that it might be, because law-enforcement is often involved. There are thousands of solo practitioners that are in practice, alone.

When we encounter any individual who is in an agitated state and potentially aggressive and dangerous, and feel that they need an additional evaluation in order to assure their safety we called law enforcement for transport. Law enforcement is the taxi. No one, can nicely escort, an aggressive, psychotic, delusional, individual suffering with MI, alone, in our personal car, to take them to assessment in an inpatient facility.

The only role of law enforcement, in involuntary commit ant evaluation, is to escort the individual, safely; in their vehicle because they have the ability to call for backup should the individual become more threatening and or aggressive. They’re trained, in any context, to deal with aggressive individuals. That is the sole reason, law-enforcement, is elicited.

There also appears to be, this notion, that involuntary commitment is used it in some sort of fashion as a punishment. It is only about safety. Frequently, and more often, the involuntary commitment is actually about keeping the escalated individual safe from him or herself.
.
All initiating involuntary commitment is, at the onset, one trained professional, making a judgment call, (determined by much more than an utterance or verbalization of a threat of some sort) that they would like an additional evaluation, by other colleagues, to ascertain if the individual in question might benefit from being in a safe and secure environment.
There is nothing judgmental or punitive about the process.

I also think, in my opinion. There is a misnomer that once a clinician initiates the process it goes on and on. It does not.

Here’s how it works. A practitioner initiates the process. Translation tons of paperwork. Law-enforcement arrives. They transport the patient to the inpatient facility. Upon arrival, the skilled team of professionals further evaluates the individual.

If at that time, they determine that the individual meets criteria to be held possibly against their will, (often if it’s a skilled team that patient will voluntarily admit themselves after they’re they are at the facility) That hold, is intensely reviewed every 24 hours in order to justify possibly holding that individual for another 24 hours. It is serious tough criteria to meet every 24 hours in order to hold for another 24 hours.

I.e: screaming, kicking, threatening, swinging , throwing things, hitting themselves, spitting, flailing around, talking to things that are not there, glaring, rolling around the floor uncontrollably, petrified, body slamming - etc,

You guys need to know, that this system is very tough on holding someone against their will. Every 24 hours the documentation is immense. In fact, this system is geared, to actually make the professional prove that the individual meets criteria to be held for another 24 hours.

That process can only happen for up to 72 hours. If the individual, by 72 hours, in the opinion of the treatment, is not safe to be released, then the court must get involved in order to determine whether the commitment can go further than 72 hours,

It is a very protective of freedom of the individual type of encounter. Its only purpose is safety

Believe it or not, often, after discharge and the patient has settled down therr grateful for having been placed in a safe and secure environment!
None of us can predict the future.

I truly do believe however, that because his delusions were so entwined with opening of the film, that if something that might have intervened, (yes doc you) it might (might) have facilitating his either missing opening night or might have been more stable on July 20.

There are no power control issues here, punishment.
Just IMO!