Panic Over College Rape May Be Causing Harm

A tragic case example, of a young man who reached out for help, and is now worse

Posted Sep 11, 2014

We all want to prevent rape and violence, and assure that the mentally ill are safe around other people. Unfortunately, we are not yet acknowledging that our current social panic may actually be making problems worse, creating problems where none existed before, and preventing people from getting help.

Iatros was a Greek physician who used bloodletting, harming when he thought he was helping

I received the below email (edited to protect confidentiality and discussed with her permission) from a concerned mother. She wrote me about her son's unfortunate recent conflicts with the mental health system and authorities, in response to his obsessive compulsive fantasies and thoughts/fears of rape. It is a sad case, and reflects many of the current concerns about the lack of confidentiality in mental health services and the indirect consequences of addressing rape on college campuses. This case also demonstrates, in my mind, the degree to which our social hyperbole and paranoia on the issue of rape, sexual assault, and the danger of mental illness is becoming iatrogenic in creating and exacerbating dysfunction.

"I am a mother of a 21yr old son who has recently been diagnosed with OCD. He was disturbed by some thoughts which he did not share with us, and went to the ER for help himself. He was admitted in the hospital for two weeks, and diagnosed with OCD. After a while he allowed the doctor to share his problem with us, the family.

He and his doctors shared that he was haunted by a minor incident in the past 8 years ago, when he simply touched his penis to the skin of his friend for a couple of seconds. He even called up the boy and apologized, but the incident still kept haunting him.

My son said he also has rape fantasies, when he is trying to sleep, and sometimes in his dreams, which sometimes make him doubt if he is a good boy or not. But when asked he always replies he will never carry out the fantasies, as he is a law abiding person, and will never want to hurt anyone.

During discharge the doctor told us that he was very well behaved with all patients and nurses, and never resisted taking medications and also when given time to go out, always came back before the period expired. The doctor said at the time that he is not a threat to family or anyone.

However after coming back my son was still haunted by the thoughts of the past, to the point that he finally called a Mobile Mental Health Crisis team and shared his fears and concerns with them. His primary problem was thought of the incident in the past, and the fear that he may have committed a crime, during that sexual incident eight years ago. There is a police officer accompanying the crisis team, and he insisted that my son share details of his rape fantasies and asked him if he has any particular persons in the fantasies, to which he named three girls in his college. My son was again taken to the ER where he was discharged in few hours by the psychiatrist after reviewing his past records.

But, after the interviews, the police officer went to the College and informed the three girls that my son could be a threat to them. They say they were bound by duty, and this is not a breach of confidentiality. My son was so disturbed to learn this information was given to the three girls, that he later said “the only way they can be sure I am not a threat, if I am not alive” He denied being suicidal, but it’s clear that these thoughts are in his head.

The college has restricted his return to school, asking for the psychiatric report. But because of the delays, he is now missing the semester. My son loves college, and wants to go back, but I am worried if they will even accept the report. And, while he is waiting at home, he is ruminating and worrying, brooding about all of this, and feeling worse and worse about himself.

He is a boy who trusted the system, but now is scared of seeking any help from the police or helpline. He just wants to talk to the doctor so he can go back to school.

My son struggled through school with learning disabilities, and it was never easy for him. I’m worried that these events are crushing any positive feelings he has about himself, and represent a major setback for him, in his self-esteem and belief in his ability to succeed. I hope the college accepts him...they have repeatedly asked him if he will like to carry out his fantasies, and he has always firmly replied in a negative.

I understand this is a very misunderstood thing, but I fear for my son's well-being. I want him to be a confident person, and not hold fears or grudges for being discriminated based on his honest disclosure. I am afraid that the stigmatization against mental health is such that, Police and the College security are likely to take him as a threat despite all reassurance."

Is this young man truly a risk to society? Did Tarasoff rules really apply here, such that these three young women needed to be informed of his fantasies about them? Tarasoff rules typically set the standard of “imminent risk,” and there is little here that suggests imminent danger. But, such rules apply to mental health providers, and a police officer attached to a mental health crisis team may not be subject to Tarasoff or confidentiality rules, though I suspect that this wasn’t clear to the young man, or to people in mental health crisis who see such teams. However, confidentiality in mental health treatment continues to diminish, in service to public safety.

Christina Hoff-Sommers has written extensively about the danger of a harmful backlash, as colleges attempt to prevent college rapes. This case may be an illustrative example, of the ways in which attempts to assure safety may go too far, and worsen problems, rather than preventing them.

This young man is terrified that his thoughts may make him a “bad person,” and that his thoughts of rape make him dangerous to others. Unfortunately, that’s the message that he is getting, everywhere he turns. I’m truly sad that this young man reached out for help, shared his fears and struggles, and is now learning that asking for help can result in punishment. Research with sex offenders (not that this young man is one), shows that isolation, exclusion, punishment and shaming increases the likelihood that such offenders will act out towards others.

What this young man needs, is help understanding that his thoughts don’t make him abnormal, and don't mean he's a rapist. Many people have thoughts of rape, but never act on them. With treatment for his obsessive compulsive symptoms, he can very likely learn to manage these thoughts and fantasies, and other disturbing, persisting thoughts that come with OCD. Unfortunately, this vulnerable young man has been inundated with panic and fear, surrounded by a system that is driven by panic and fear. And this panic and fear is making problems worse, not better. Systemic reactions like this make it less likely for people to seek out help, and make it more likely they suffer alone, without assistance to keep themselves and others safe.

Follow Dr. Ley on Twitter: @DrDavidLey

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