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Were the Isla Vista Killings Preventable? A GOP Congressman Thinks So, and He's Got Bipartisan Support.

Getty Images/Jim Watson

In the immediate aftermath of Elliot Rodger's killing spree Friday in the college town of Isla Vista, California, the internet convened exhaustive debates about misogyny's relationship to violence, Hollywood’s culpability for the carnage, and "the sick world of the Men’s Rights Activist movement." As evidenced by his 137-page manifesto and YouTube videos, Rodger was indeed misogynistic (and racist). But more importantly, this 22-year-old murderer was mentally ill and legally able to purchase firearms in California, one of the country’s more gun restrictive states.

These twin issues—mental health treatment and guns—are what we should be debating, not the merits of #YesAllWomen. And while gun-control is a non-starter in Congress, improving our mental health care system is one of the few things that Democrats and Republicans agree on. There's reason to hope that this week's events spur politicians to act.

Psychiatrist Richard A. Friedman said reform is a moot point in an op-ed Tuesday in The New York Times. He argued that "our current ability to predict who is likely to be violent is no better than chance," and pointed out that while "psychiatric illness is a risk factor for violent behavior," "drug and alcohol abuse are far more powerful risk factors for violence than other psychiatric illnesses." He added, "As a psychiatrist, I welcome calls from our politicians to improve our mental health care system. But even the best mental health care is unlikely to prevent these tragedies.”

Republican Congressman Tim Murphy believes otherwise. The only clinical psychiatrist in Congress, he argues that families of mentally ill people should be more empowered in getting their loved ones treatment—and he introduced a bill in December that would do just that. This week, in response to the Isla Vista shooting, Murphy urged Washington to act on the legislation, asking, “How many more people must lose their lives before we take action on addressing cases of serious mental illness?"

Murphy’s bill, called the Helping Families in Mental Health Crisis Act, would reform the Health Insurance Portability and Accountability Act (HIPAA) so that doctors and mental health professionals can share information with the families and caregivers of patients with serious mental illnesses, even if the patient has not authorized the communication—a controversial measure that some say infringes upon the rights of those with mental illnesses.

The bill would also make involuntary treatment easier. Currently 45 states have laws that allow for use of “assisted outpatient treatment (AOT),” which is essentially court-ordered outpatient treatment for people with a history of not complying with their medical regimen. In most states, violating court-ordered treatment leads to forced hospitalization. Murphy's bill would require the remaining five states to enact an AOT law in order to be eligible for federal block grants that fund mental health programs.

Most significantly, the bill would lower the bar for involuntary commitment. Currently, people can only be involuntarily committed to an institution if they pose an imminent danger to themselves or others. Murphy advocates adopting a more basic “need for treatment" threshold, meaning anyone who “due to mental illness, lacks capacity to fully understand or lacks judgment to make informed decisions regarding his or her need for treatment, care, or supervision.” This would allow families and physicians, rather than the patient, to determine whether he or she is in need of inpatient treatment.

After the bill was introduced last year, David Shern, Ph.D, president and CEO of Mental Health America, released a statement rejecting the expansion of involuntary treatment: “We believe that involuntary treatment should only occur as a last resort and should be limited to instances where persons pose a serious risk of physical harm to themselves or others.” The National Coalition for Mental Health Recovery has said that forced treatment “causes trauma and drives people away from treatment.” Dr. Daniel Fisher, a founding member of the Coalition, said Murphy’s bill would “bring America back to the dark ages before de-institutionalization, when people with mental health conditions languished in institutions, sometimes for life.”

Murphy, who keeps photographs of the Sandy Hook victims on his desk, says that by the time someone poses an imminent risk, it is often too late to force them into treatment. Scores of his colleagues apparently agree: His bill had 87 cosponsors as of Thursday afternoon, including 31 Democrats.

But would this bill have prevented the Isla Vista tragedy? Rodger, diagnosed with Asperger’s syndrome, was in and out of therapy from an early age. One month before the killing spree, his mother, concerned by videos Rodger had posted on YouTube, contacted the police. They visited his apartment, concluded that he wasn't a threat to himself or others, and left; the Santa Barbara County sheriff said this week that Rodger didn't meet the criteria for an involuntary hold. As Rodger later wrote in his manifesto, "If they had demanded to search my room… That would have ended everything." 

Murphy's bill wouldn't have given police the power to search Rodger's apartment, but it would have given his parents the power to ask a court to order an emergency psychiatric evaluation—a right granted in 34 states, but not California. In a Congressional briefing Thursday, he compared Elliot Rodger to other mentally ill mass shooters—Adam Lanza, Jared Loughner, James Holmes, and Aaron Alexis—and said, “What makes these painful episodes so confounding is the reality that so many tragedies involving a person with a mental illness are entirely preventable."