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The Virginia Tech Massacre: Strategies and Challenges for Improving Mental Health Policy on Campus and Beyond PDF

289 Pages·2014·1.672 MB·English
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The Virginia Tech Massacre Developmental Perspectives In Psychiatry SERIES EDITOR James C. Harris, M.D. Johns Hopkins University BOOKS IN THE SERIES Tuberous Sclerosis Complex, Third Edition Manual Rodríguez Gómez, M.D., Julian R. Sampson, D.M., and Vicky Holets Whittemore, Ph.D. Neurodevelopmental Disorders: Recognition and Treatment Randi Hagerman, M.D. Demystifying Anorexia Nervosa: An Optimistic Guide to Understanding and Healing Alexander R. Lucas, M.D. Intellectual Disability: Understanding Its Development, Causes, Classification, Evaluation, and Treatment James C. Harris, M.D. The Virginia Tech Massacre: Strategies and Challenges for Improving Mental Health Policy on Campus and Beyond Edited by Aradhana Bela Sood, M.D., MSHA, and Robert Cohen, Ph.D. The Virginia Tech Massacre Strategies and Challenges for Improving Mental Health Policy on Campus and Beyond Edited by Aradhana Bela Sood and Robert Cohen 1 1 Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trademark of Oxford University Press in the UK and certain other countries. Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016 © Oxford University Press 2015 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by license, or under terms agreed with the appropriate reproduction rights organization. Inquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above. You must not circulate this work in any other form and you must impose this same condition on any acquirer. Library of Congress Cataloging-in-Publication Data The virginia tech massacre : strategies and challenges for improving mental health policy on campus and beyond / edited by Aradhana Bela Sood, Robert Cohen. — 1 Edition. pages cm. — (Developmental perspectives in psychiatry) Includes bibliographical references and index. ISBN 978–0–19–539249–4 (hardback) 1. College students—Mental health—United States. 2. College students—Mental health services—United States. 3. Virginia Tech Shootings, Blacksburg, Va., 2007. I. Sood, Aradhana Bela, editor of compilation. II. Cohen, Robert, 1941– editor of compilation. RC451.4.S7D48 2014 616.89—dc23 2014014462 1 3 5 7 9 8 6 4 2 Printed in the United States of America on acid-free paper For my Mother Sushila Avasthy and For my Sister Neeharika Naidu Two women who gave me The courage to notice injustice The will to be an (un)tempered radical with an optimism to believe in the possibility of change —B.S. For Katherine Cohen-Filipic and Alison Moritz and To the memory of Ronald Townes and Frank Palumbo, Who knew too well our mental health care system —R.C. CONTENTS Foreword by James C. Harris ix Acknowledgments xiii About the Editors xv Contributors xvii PART ONE: LESSONS FROM VIRGINIA TECH 1. The Tragedy at Virginia Tech 3 Aradhana Bela Sood 2. An Unchecked Descent into Madness: The Life of Seung-Hui Cho 13 Hollis Stambaugh and Aradhana Bela Sood 3. Insights from Interviews and Other Firsthand Accounts 33 Aradhana Bela Sood and Hollis Stambaugh 4. Getting into the Mind of the Killer: A Psychological Autopsy of Seung-Hui Cho 45 Aradhana Bela Sood PART TWO: MENTAL HEALTH CARE ON CAMPUS 5. Failures in Campus Mental Health Systems: Lessons from Virginia Tech 65 Aradhana Bela Sood and Adele L. Martel 6. Best Practices and Resources: National Models for College Student Mental Health 93 Adele L. Martel and Aradhana Bela Sood 7. Predicting Violence in Public Places 127 Cheryl S. Al-Mateen, Sala S. Webb, and Aradhana Bela Sood PART THREE: THE MENTAL HEALTH CARE SYSTEM IN THE UNITED STATES 8. Mental Health Services in the United States: Problems and Promising Approaches 157 Aradhana Bela Sood and Robert Cohen vii viii CONTENTS 9. Global Perspectives on Mental Health Care 179 Robert Cohen and Aradhana Bela Sood 10. Toward More Responsive Systems of Care: Challenges and Strategies 195 Robert Cohen and Aradhana Bela Sood Conclusion: Closing Thoughts 215 Aradhana Bela Sood Postscript 229 Appendix 231 References 235 Index 255 FOREWORD The Virginia Tech Massacre: Strategies and Challenges for Improving Mental Health Policy on Campus and Beyond is the first book-length examination of this tragic event by one of the principal members of the investigating commission. It is strengthened by being a first-person account and a continuing reflection on what happened at the time of the event and what has transpired since then. This case study of the perpetrator, Seung-Hui Cho, provides a lens through which to examine the current state of college mental health and provide recommendations to avert future campus disasters. The events at Virginia Tech spawned an extensive reevaluation of the origins, roles, importance, and availability of mental health services on college campuses; the preva- lence of mental disorders in youth transitioning into adulthood (emerging adults aged 18–25); individual rights and privacy issues for college students and their families; needed changes in privacy laws; and, inevitably, the continuing role of stigma and cul- tural beliefs regarding mental health in students’ decision to utilize available services. This book is a welcome examination of how the tragedy came about, what lessons can be learned, and what changes in college mental health policy and reforms to mental health systems have been initiated and those that still need to be instituted to prevent other such tragedies. The lead author and her team are well qualified to write this book because of their special knowledge of what happened at Virginia Polytechnic Institute and State University (Virginia Tech). As the psychiatrist on the Virginia governor’s commis- sion, Dr. Bela Sood had personal access to family members, faculty, administrators, and state officials. As a commission member she was intimately involved in the dis- cussions that led to new legislation, policy changes, and recommendations made in regard to the mental health system. Within a year after the disaster the Virginia legis- lature improved the emergency mental health evaluation process, modified criteria for involuntary commitment, tightened procedures for assisted outpatient treatment, and increased state funding for community mental health services. This book examines the effectiveness and implementation of these changes and asks: Has there been meaning- ful change? Throughout the book the authors continually refer back to the Seung-Hui Cho case as they examine college mental health, mental health practices more broadly in ix

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