All in the Family

Mental Illness and Caregiving Across the Generations

Boston Marathon

Bizarre behavior should be professionally evaluated.

Shortly before 7 p.m. on April 15, 2014, the anniversary of last year’s Boston Marathon tragedy that killed three people and left 260 injured, a man wearing a long black veil shed his shoes in Copley Square and ran down Boylston Street barefoot shouting “Boston Strong.”  It was a cold, rainy evening. His face was painted yellow and blue, the traditional colors of the marathon. He carried a black backpack, much like the Tsarnaev brothers’ backpacks that concealed pressure cooker bombs that exploded near the marathon’s finish line.

Boston police, informed by passersby of this bizarre behavior, did what police officers always should do when faced with aberrant or suspicious behavior—they investigated, detained the man, Kevin “Kayvon” Edson, and then referred him to a state psychiatric facility for evaluation.

The backpack, which contained a harmless rice cooker, was destroyed. According to a police report, after Edson was read his rights, he told an officer, “I knew what I was doing. It was conceived in my head. It’s symbolism. The performance got the best of me.”

In a statement, an Edson family member said, “Our family is so sorry and emotionally overwhelmed by the events at the finish line of the Boston Marathon. To have this happen on the one-year anniversary of such a horrific crime is unfathomable.” Edson’s mother, Joie, explained that her son had battled bipolar disorder for many years and that his mental state had recently deteriorated because he stopped taking his medication.

In this case, the police were empowered to do what should always be done when odd behaviors are observed because Boston was under high alert as the first marathon following last year’s tragedy approached.

Unfortunately, the hands of the police (as well as families and mental health practitioners) typically are tied by laws that bend over backward to protect the rights of individuals at the expense of the rights of society. Consider some recent tragedies:   

  • Jared Loughner’s parents and the local police knew he was troubled. Jared’s parents disabled his car each night to try to prevent him from harming others. They confiscated his shotgun after Pima County College police warned that their son might be a danger to himself or others.  Despite their pleas for help, Jared Loughner was neither taken into custody nor evaluated.  Instead, he was left free in the community—until he killed six people and wounded Rep. Gabrielle Giffords and 18 others.
  • James Holmes was not living with his parents when he killed 12 and injured 58 people at the Aurora, Colorado movie theater screening of The Dark Knight Rises, yet Holmes was clearly on the radar screen of mental health professionals at the University of Colorado prior to the massacre. They too were powerless to intervene. 
  • Adam Lanza’s odd behaviors caught the attention of his teachers. The adult Adam taped black trash bags over his bedroom windows. He communicated with his mother by e-mail even though they shared a home. He hadn’t left his house in three months. Yet there are no records suggesting that his bizarre behaviors were professionally evaluated before he killed his mother, 26 people at Sandy Hook Elementary School, and himself.

Our current state laws are a backlash to the atrocities associated with enforced institutionalization of the 19th and early 20th centuries that robbed persons with mental illness of their autonomy. To be sure, those laws were inhumane, but the pendulum has swung too far.

Surprisingly, laws governing the rights of individuals and society when mental illness is suspected are not consistent with laws governing these rights pertaining to other health conditions. We have laws prohibiting people with typhoid fever from working in restaurants because such workers would pose a threat to public health. We do not allow people with active tuberculosis to use public transportation, and we insist that people with epilepsy take medication if they are going to drive cars for exactly the same reason. Mental illness should not be treated differently than other organically based illnesses because mental illness, when allowed to go untreated, can pose a danger to others.

I’m not advocating locking up people because they have green hair or talk to themselves. But I am suggesting that when bizarre behavior is observed, it should be taken seriously and professionally evaluated. Truly odd or unusual behavior represents reasonable justification to put the needs of society over that of the individual.

The reality is that only a tiny proportion of people with severe mental illness are violent. In fact, people with mental illness are more likely to be victims of crime than perpetrators. It is not mental illness that is associated with violence, but rather untreated mental illness.

Because it is nearly impossible to predict who will become violent, we owe it to ourselves and to society to follow the lead of Boston’s police and pay attention when the signs of concern are obvious. We must put greater focus on protecting the rights and safety of the many—of people in a movie theater and children attending school—even if it means the rights of some may be compromised.

Rachel Pruchno, Ph.D. is Endowed Chair and Professor of Medicine at Rowan University School of Osteopathic Medicine. Her memoir Surrounded by Madnessis available at online bookstores.

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