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	<title>Comments on: Why the VT shootings can happen again</title>
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	<link>http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html</link>
	<description>Ramblings of an Emergency Physician in Texas</description>
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		<title>By: BabsRN</title>
		<link>http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html/comment-page-1#comment-5838</link>
		<dc:creator>BabsRN</dc:creator>
		<pubDate>Thu, 03 May 2007 21:27:14 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html#comment-5838</guid>
		<description>It&#039;s different in Georgia. They are typically brought through the ER for medical clearance and documentation on a 10-13 form for involuntary commitment. Doc only needs to sign that the patient presents a danger to himself or someone else. Mental health access line is called and does their own eval in the ER and then if accepted by the psychiatrist on call for the local CSU (which they have no choice but to do if the 10-13 is signed), they get wait-listed for a bed. Meanwhile the ER holds them. Sometimes law enforcement is present, sometimes not but once that paper is signed they CAN&#039;T leave. If they do, police are called to pick them up. I&#039;ve seen them get the bloodhounds from the local prison out looking for one who eloped from the ER. It&#039;s getting better, actually, with the hospitals and the law enforcement community raising all sorts of Cain to the State about the wait list so they are usually out of the ER and on their way by sheriff deputy in a matter of 4-6 hours.
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		<content:encoded><![CDATA[<p>It&#8217;s different in Georgia. They are typically brought through the ER for medical clearance and documentation on a 10-13 form for involuntary commitment. Doc only needs to sign that the patient presents a danger to himself or someone else. Mental health access line is called and does their own eval in the ER and then if accepted by the psychiatrist on call for the local CSU (which they have no choice but to do if the 10-13 is signed), they get wait-listed for a bed. Meanwhile the ER holds them. Sometimes law enforcement is present, sometimes not but once that paper is signed they CAN&#8217;T leave. If they do, police are called to pick them up. I&#8217;ve seen them get the bloodhounds from the local prison out looking for one who eloped from the ER. It&#8217;s getting better, actually, with the hospitals and the law enforcement community raising all sorts of Cain to the State about the wait list so they are usually out of the ER and on their way by sheriff deputy in a matter of 4-6 hours.</p>
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		<title>By: Nurse 1961</title>
		<link>http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html/comment-page-1#comment-5837</link>
		<dc:creator>Nurse 1961</dc:creator>
		<pubDate>Mon, 30 Apr 2007 02:53:12 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html#comment-5837</guid>
		<description>When I worked in Minnesota, we had the 72-hour hold that was placed by the ED physician.  If the patient needed to be seen by a psychiatrist, they got to spend some time in the locked unit.  

The police could bring them in, but they were held in the security unit until seen by the MD, then if they needed to stay they were placed on the hold.  If they didn&#039;t it, they were left with the police to disposition.

AS for Cho, giving the reason that he was &quot;bullied&quot; in high school and finally took action 4 years later just doesn&#039;t hold water.  If it was back in high school why not do the shooting there?  No that is just an excuse for the fact that he had a mental problem it was looked in to but there was no follow-up.  If one of the teacher had to one-on-one with him because he upset the class, this was not a small problem.

Whose to blame; his parents, the teacher, the campus mental health system?  No!!  Cho is to blame, he had an opportunity to get help, it was available, he chose not to take it.  

Will it happen again?  Yes.  Sometime, somewhere, somehow a crazy person will show up with a gun and start firing.</description>
		<content:encoded><![CDATA[<p>When I worked in Minnesota, we had the 72-hour hold that was placed by the ED physician.  If the patient needed to be seen by a psychiatrist, they got to spend some time in the locked unit.  </p>
<p>The police could bring them in, but they were held in the security unit until seen by the MD, then if they needed to stay they were placed on the hold.  If they didn&#8217;t it, they were left with the police to disposition.</p>
<p>AS for Cho, giving the reason that he was &#8220;bullied&#8221; in high school and finally took action 4 years later just doesn&#8217;t hold water.  If it was back in high school why not do the shooting there?  No that is just an excuse for the fact that he had a mental problem it was looked in to but there was no follow-up.  If one of the teacher had to one-on-one with him because he upset the class, this was not a small problem.</p>
<p>Whose to blame; his parents, the teacher, the campus mental health system?  No!!  Cho is to blame, he had an opportunity to get help, it was available, he chose not to take it.  </p>
<p>Will it happen again?  Yes.  Sometime, somewhere, somehow a crazy person will show up with a gun and start firing.</p>
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		<title>By: TheNewGuy</title>
		<link>http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html/comment-page-1#comment-5836</link>
		<dc:creator>TheNewGuy</dc:creator>
		<pubDate>Sun, 29 Apr 2007 22:09:34 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html#comment-5836</guid>
		<description>I don&#039;t disagree that better resources need to be in place for mental health patients... I&#039;m just not sure the VT shooter would have been caught in that dragnet.

He wasn&#039;t nuts in the traditional sense.  I never got any sort of sense that he had an underlying thought disorder.  Far from being disorganized, his actions showed forthought; he was goal-directed and logical.  He may have been anhedonic, or simply a hate-filled antisocial... but neither of those usually justify incarceration or institutionalization.</description>
		<content:encoded><![CDATA[<p>I don&#8217;t disagree that better resources need to be in place for mental health patients&#8230; I&#8217;m just not sure the VT shooter would have been caught in that dragnet.</p>
<p>He wasn&#8217;t nuts in the traditional sense.  I never got any sort of sense that he had an underlying thought disorder.  Far from being disorganized, his actions showed forthought; he was goal-directed and logical.  He may have been anhedonic, or simply a hate-filled antisocial&#8230; but neither of those usually justify incarceration or institutionalization.</p>
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		<title>By: Jim in Texas</title>
		<link>http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html/comment-page-1#comment-5835</link>
		<dc:creator>Jim in Texas</dc:creator>
		<pubDate>Sun, 29 Apr 2007 21:14:10 +0000</pubDate>
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		<description>Evil such as this is inevitable, unpredictable and thus unpreventable. Everyone should think what they would do in a similar situation and then plan for it. People like Cho want to, for a brief moment, be “in charge,” be feared. As for how crazy he was, well, I realize that’s a subjective thought but he was clever enough to protect himself from the only people with weapons, the campus police, on the campus by locking the doors.

“Gun Free Zones” are stupid and I hope Texas follows Tennessee’s lead in reversing that here. What would you rather have in class, 20 complete strangers who have been authorized to carry concealed weapons or one Cho?</description>
		<content:encoded><![CDATA[<p>Evil such as this is inevitable, unpredictable and thus unpreventable. Everyone should think what they would do in a similar situation and then plan for it. People like Cho want to, for a brief moment, be “in charge,” be feared. As for how crazy he was, well, I realize that’s a subjective thought but he was clever enough to protect himself from the only people with weapons, the campus police, on the campus by locking the doors.</p>
<p>“Gun Free Zones” are stupid and I hope Texas follows Tennessee’s lead in reversing that here. What would you rather have in class, 20 complete strangers who have been authorized to carry concealed weapons or one Cho?</p>
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		<title>By: A Bohemian Road Nurse...</title>
		<link>http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html/comment-page-1#comment-5834</link>
		<dc:creator>A Bohemian Road Nurse...</dc:creator>
		<pubDate>Sun, 29 Apr 2007 18:50:45 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html#comment-5834</guid>
		<description>You make an interesting observation with your statement:  &quot;Mental health laws are one of the things I’d like to see addressed in the country well before we try to change anything else.&quot;

I&#039;m assuming you mean the question about whether or not the country should change to universal health care.

Because that brings up an interesting question: Besides the whole medical/physical scene universal health plans would deal with, I wonder what universal health would mean to the mental health care in this country?  

As it stands right now in Texas, it&#039;s near impossible to get somebody into MHMR mental health hospitals.  You have to be actively suicidal or crazy-type homicidal.  All of the MHMR campuses have down-sized to the about 1/4 of the size they were a few years ago.

So if there were universal health, would the whole system have to be beefed up again?  With outpatient clinics to boot?  And would that mean that just anybody could walk into an ER and c/o mental health issues and be put into the system?

It adds a whole new dimension to the universal health issue that I admit that I hadn&#039;t even thought of before.</description>
		<content:encoded><![CDATA[<p>You make an interesting observation with your statement:  &#8220;Mental health laws are one of the things I’d like to see addressed in the country well before we try to change anything else.&#8221;</p>
<p>I&#8217;m assuming you mean the question about whether or not the country should change to universal health care.</p>
<p>Because that brings up an interesting question: Besides the whole medical/physical scene universal health plans would deal with, I wonder what universal health would mean to the mental health care in this country?  </p>
<p>As it stands right now in Texas, it&#8217;s near impossible to get somebody into MHMR mental health hospitals.  You have to be actively suicidal or crazy-type homicidal.  All of the MHMR campuses have down-sized to the about 1/4 of the size they were a few years ago.</p>
<p>So if there were universal health, would the whole system have to be beefed up again?  With outpatient clinics to boot?  And would that mean that just anybody could walk into an ER and c/o mental health issues and be put into the system?</p>
<p>It adds a whole new dimension to the universal health issue that I admit that I hadn&#8217;t even thought of before.</p>
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		<title>By: Bad Shift</title>
		<link>http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html/comment-page-1#comment-5833</link>
		<dc:creator>Bad Shift</dc:creator>
		<pubDate>Sun, 29 Apr 2007 18:09:03 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html#comment-5833</guid>
		<description>Me: county ER doc in CA.  

Every drunk or minor trouble-maker in town ends up on a 5150.  They scoop &#039;em up and bring &#039;em in, then cite/release them.  I call psych, they release the 5150 hold.  Guess who&#039;s stuck with the disposition?  You guess it.  Around here, the 5150 is just a way to legally round up unsavory folks and dump them on us.

The same people who are calling the police for drunks in the park are the same ones who are upset that the ER is full of drunks and they have to wait 5 hours to be seen.

If I have a point, it&#039;s probably that 5150 doesn&#039;t really solve anything.  Most of the people they use it for would have been better off sleeping it off in the park.</description>
		<content:encoded><![CDATA[<p>Me: county ER doc in CA.  </p>
<p>Every drunk or minor trouble-maker in town ends up on a 5150.  They scoop &#8216;em up and bring &#8216;em in, then cite/release them.  I call psych, they release the 5150 hold.  Guess who&#8217;s stuck with the disposition?  You guess it.  Around here, the 5150 is just a way to legally round up unsavory folks and dump them on us.</p>
<p>The same people who are calling the police for drunks in the park are the same ones who are upset that the ER is full of drunks and they have to wait 5 hours to be seen.</p>
<p>If I have a point, it&#8217;s probably that 5150 doesn&#8217;t really solve anything.  Most of the people they use it for would have been better off sleeping it off in the park.</p>
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		<title>By: Greg P</title>
		<link>http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html/comment-page-1#comment-5832</link>
		<dc:creator>Greg P</dc:creator>
		<pubDate>Sun, 29 Apr 2007 13:52:20 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2007/04/why-the-vt-shootings-can-happen-again.html#comment-5832</guid>
		<description>This is a common refrain, &quot;mental health laws need to be addressed&quot;, but what do people want that would be constitutional?

We will not see people put in mental institutions just because their thinking is not right. First of all, this is a judgment call that is harder to make than it seems, plus the fact that the cost is not something that the country wants to bear. There is probably more risk from all the criminals being released because prisons are overcrowded -- another example of the lack of will to spend the money.

It&#039;s easy to look in the retrospectoscope from a tragedy like VT and say, &quot;something should have been done.&quot; The rarity of this event says more than anything about the difficulty if not impossibility of successfully preventing this regardless of how much we spend, in the mean time turning our society into one in which we look for signs of mental illness in everyone we meet, ironically creating a societal paranoia.</description>
		<content:encoded><![CDATA[<p>This is a common refrain, &#8220;mental health laws need to be addressed&#8221;, but what do people want that would be constitutional?</p>
<p>We will not see people put in mental institutions just because their thinking is not right. First of all, this is a judgment call that is harder to make than it seems, plus the fact that the cost is not something that the country wants to bear. There is probably more risk from all the criminals being released because prisons are overcrowded &#8212; another example of the lack of will to spend the money.</p>
<p>It&#8217;s easy to look in the retrospectoscope from a tragedy like VT and say, &#8220;something should have been done.&#8221; The rarity of this event says more than anything about the difficulty if not impossibility of successfully preventing this regardless of how much we spend, in the mean time turning our society into one in which we look for signs of mental illness in everyone we meet, ironically creating a societal paranoia.</p>
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