What could be done to help those like him (Cho)?

[drankin]

Does anyone know anyone like Cho has been described? And if we do know someone like this, what should we do for him personally, or as a society?

I'm talking as human beings, regardless of nationality.

 

[out of whack]

Get him laid.

 

[drankin]

Get him laid.

Well, most women like someone they can talk to. He wasn't much of conversationalist from what I could tell.

I think he would need a bunch of guys to take him out, party with him a little, get him loosened up. Hang out with him a bit. Get him to snap out of it a little. But it would have to be consistent thing over a long time.

 

[russ_watters]

Those types of things are both good for a typical shy, akward kid just out of high school, but this guy was a 23 year old senior. His problems were real and he needed professional help.

 

[out of whack]

Then get him laid.

 

[drankin]

Those types of things are both good for a typical shy, akward kid just out of high school, but this guy was a 23 year old senior. His problems were real and he needed professional help.

He had professional help. I "think" a guy can be helped by his peers regardless of his age. The problem with professional help is the "professional" can't be real with his client and that may be what he needed. Personally, I wonder if "professional" help really is "helpful". But I dunno.

He was lonely in the midst of a high density of people enjoying life all around him. Most people reach out in that situation, some people don't. They need to be dragged out.

 

[drankin]

Then get him laid.

And then they need to get laid.

 

[Astronuc]

He was apparently suffering from a mental illness, that apparently went untreated. He was a loner, or perhaps an outcast.

Va. Tech Gunman Sent Package to NBC on Monday
http://www.npr.org/templates/story/story.php?storyId=9604204

NPR.org, April 18, 2007 · The gunman who killed 32 students and professors at Virginia Tech on Monday left the world a rambling, profane and threatening "multimedia manifesto."

"You had a hundred billion chances and ways to avoid today," said an angry Seung-hui Cho, in a video he mailed to NBC News that was received by the network Wednesday morning. "The decision was yours. Now you have blood on your hands that will never wash off."

Investigators Sift Clues for Cho's Motives
http://www.npr.org/templates/story/story.php?storyId=9658304

Newly released documents show that a judge declared Seung-hui Cho "mentally ill" and an "imminent danger to self or others" in December 1995.

Ooops!

From yesterday - Gunman Left Note; Past Writings Called 'Troubling'
http://www.npr.org/templates/story/story.php?storyId=9618705


The support for mentally ill has been steadily eroding in the US. My wife worked in the Texas system, when the Reagan and other republicans (and conservatives) started pushing for less taxes and less government support. In response, Texas, among several states began to de-institutionalizing the mentally ill, who ended up on the streets, and many of whom subsequently became involved in drug abuse (my wife counseled some - usually as a result of an arrest and subsequent court case). Drug and/or alcohol abuse in conjunction with mental illness is a downward path.

Many mentally ill patients require medication, but they may not take such medication as prescribed, or not all. Without medication or consistent treatment, some will spiral downward, and some will be harmful to themselves or others.

 

[Moon Bee]

Does anyone know anyone like Cho has been described? And if we do know someone like this, what should we do for him personally, or as a society?

I'm talking as human beings, regardless of nationality.

You know what 'human beings' is ?

 

[Moon Bee]

He was apparently suffering from a mental illness, that apparently went untreated. He was a loner, or perhaps an outcast.

Va. Tech Gunman Sent Package to NBC on Monday
http://www.npr.org/templates/story/story.php?storyId=9604204


Investigators Sift Clues for Cho's Motives
http://www.npr.org/templates/story/story.php?storyId=9658304
Ooops!

From yesterday - Gunman Left Note; Past Writings Called 'Troubling'
http://www.npr.org/templates/story/story.php?storyId=9618705


The support for mentally ill has been steadily eroding in the US. My wife worked in the Texas system, when the Reagan and other republicans (and conservatives) started pushing for less taxes and less government support. In response, Texas, among several states began to de-institutionalizing the mentally ill, who ended up on the streets, and many of whom subsequently became involved in drug abuse (my wife counseled some - usually as a result of an arrest and subsequent court case). Drug and/or alcohol abuse in conjunction with mental illness is a downward path.

Many mentally ill patients require medication, but they may not take such medication as prescribed, or not all. Without medication or consistent treatment, some will spiral downward, and some will be harmful to themselves or others.

being out of symbols socalled rule is the last step to do

 

[denverdoc]

I have given cho a lot of thought today. My business, psychiatry, at its essence is pattern recognition. So I wondered what if I had seen him three months ago? I have been fooled by many customers and saw a colorado school of mines student last year I felt was in the early stages of schizophrenia. He seemed to have no violent tendencies, had no record of such, and was not willing to take medications. The problem with the going postal problem is it is circular. The best evidence for a propensity toward violence is a history of same. cho had none, But there is always a first time.

I read both his plays and while they certainly suggest sexual abuse, hard to say whether he was a victim of same. Maybe/maybe not he could have been abused, ignored, or both. But it may be that he had a bad illness, that tragically, took not his own life but all the others.

 

[drankin]

You know what 'human beings' is ?

I'll have to answer you with a simple, "yes". Other than that, I don't follow where you are going.

 

[J77]

I read both his plays and while they certainly suggest sexual abuse, hard to say whether he was a victim of same. Maybe/maybe not he could have been abused, ignored, or both. But it may be that he had a bad illness, that tragically, took not his own life but all the others.

Was talking to my gf -- who's a teacher -- about strange writings her kids have done. She said that it would be impractical to report everytime a kid wrote something which could be considered a bit weird or even dangerous to others, as it happens so frequently -- tho'she does teach moody teenagers, not 23 year olds.

 

[Bladibla]

It sure would have helped him to have socialzed more.. But guessing that he couldn't do because of his reclusiveness.

 

[Astronuc]

I have given cho a lot of thought today. My business, psychiatry, at its essence is pattern recognition. So I wondered what if I had seen him three months ago? I have been fooled by many customers and saw a colorado school of mines student last year I felt was in the early stages of schizophrenia. He seemed to have no violent tendencies, had no record of such, and was not willing to take medications. The problem with the going postal problem is it is circular. The best evidence for a propensity toward violence is a history of same. cho had none, But there is always a first time.

I read both his plays and while they certainly suggest sexual abuse, hard to say whether he was a victim of same. Maybe/maybe not he could have been abused, ignored, or both. But it may be that he had a bad illness, that tragically, took not his own life but all the others.

Therein lies a Catch-22, and it is a handicap for law-enforcement. This is a particular problem for law enforcement personel when dealing with domestic violence, often because the threat is not witnessed. How many people have been killed or severely injured by an estranged spouse or bf/gf who violated a restraining order because the police cannot arrest the violent person until they commit an act of violence.

It is against the law to threaten someone (assault), which involves a explicit threat to a specific person, and certainly to batter someone. It is not against the law to express violence in general, although it is possibly an indication that a person could be thinking of acting up on it.

Already people are asking what could have been done to prevent the tragedy at V-Tech and help Cho.

The key question is - how does one distinguish an expression of anger or frustration from a planned attack?

being out of symbols socalled rule is the last step to do

Please elaborate. The statement is not clear.

 

[justsometime]

It sure would have helped him to have socialzed more.. But guessing that he couldn't do because of his reclusiveness.

you are right, but there are people who are energic in relationship, there are people who aren't. It's not they are afraid of anything, they just find themselves happy to do that. Are you happy if you have a son like that ?

 

[Art]

Was talking to my gf -- who's a teacher -- about strange writings her kids have done. She said that it would be impractical to report everytime a kid wrote something which could be considered a bit weird or even dangerous to others, as it happens so frequently -- tho'she does teach moody teenagers, not 23 year olds.

Yes, you'd wonder what Stephen Kings' English teacher would have made of him.

 

[Art]

I have given cho a lot of thought today. My business, psychiatry, at its essence is pattern recognition. So I wondered what if I had seen him three months ago? I have been fooled by many customers and saw a colorado school of mines student last year I felt was in the early stages of schizophrenia. He seemed to have no violent tendencies, had no record of such, and was not willing to take medications. The problem with the going postal problem is it is circular. The best evidence for a propensity toward violence is a history of same. cho had none, But there is always a first time.

I read both his plays and while they certainly suggest sexual abuse, hard to say whether he was a victim of same. Maybe/maybe not he could have been abused, ignored, or both. But it may be that he had a bad illness, that tragically, took not his own life but all the others.

Didn't some recent study show Omega 3 supplements alleviate schizophrenia? I read somewhere they were looking at this for patients who didn't take their medication.

 

[denverdoc]

actually it was bipolar disorder, and yes they do have modest benefit according to a study done at NIMH. And obviously very good for heart.

Before reading the accounts I would have guessed that Cho had bipolar disorder, which is often aggravated this time of year by the mismatch in circadian rhythms one experiences because of rapid photoperiod lengthening during equinoxes,(the sin/cos relation at play here between length of day and rate of change). In fact suicide rate amongst bipolar patients surges in March, April to something like 10x the average rate.

 

[Moonbear]

Before reading the accounts I would have guessed that Cho had bipolar disorder, which is often aggravated this time of year by the mismatch in circadian rhythms one experiences because of rapid photoperiod lengthening during equinoxes,(the sin/cos relation at play here between length of day and rate of change). In fact suicide rate amongst bipolar patients surges in March, April to something like 10x the average rate.

Thanks for reminding me of the details on this. I was talking to someone else on the phone about the story, and they commented about the timing being similar to Columbine. I remembered there being a seasonal component to bipolar disorder, but was fuzzy on the details, and thought it was an increase in mania in spring as they came out of the winter depressive state (possibly a comorbidity with seasonal affective disorder). When I had come across a paper on it a year or so ago, I wasn't sure if it was a sufficiently large study to make that conclusion definitive or if it was regularly observed in psychiatric practice (there are a lot of studies that report a seasonal effect on this that or the other thing, and then you'll find other studies that report exactly the opposite or no effect, and it turns out it's just a sample bias with small groups of people in some studies, or cultural influences rather than biological in a particular population).

Anyway, as for what could have been done, I keep hearing conflicting reports in the news as to whether he was under the care of a psychiatrist. They do seem to all concur that he was at some point involuntarily committed based on suicidal threats, but it sounded like that was only a day and then he was released again for outpatient treatment.

The most frustrating part of getting someone help if you're NOT a psychiatrist is that the psychiatrist you refer them to isn't allowed to tell you if they have followed through with seeing them and continue to do so due to doctor-patient confidentiality, so you're somewhat left in the dark as to whether the person you know needs help is actually receiving it unless they volunteer that information to you. Or, they could lie and tell you they are going when they aren't.

In this case, it wasn't his writing alone that sounded warning bells, but the accompanying affect. But, it sounds like his professors had done what they could have done and had him referred for treatment. So, I don't know what more could be done in a case like that on the part of the university anyway.

As for whether his psychiatrist should have known he was an immediate threat to himself or others, again, only his psychiatrist is likely to know that. We don't know if he ever expressed these plans in a session with the psychiatrist, or when he last saw the psychiatrist relative to when he started to form the specific plan. And, he may have come across as potentially suicidal, but never gave any inkling that he would consider taking others with him. Sometimes you get highly intelligent people with mental illnesses who can hide their illness. There may be some signs that something is "off" about them, but they know enough of what to say or not say to people to keep them from knowing their real thoughts.

It is entirely possible that either starting a new medication or the change in seasons helped make it possible for him to go from suicidal thoughts to actually acting out his plan. Someone very depressed often lacks the motivation to do anything, and as they are on the recovery process from depression, they begin to have the motivation or energy to do things but unfortunately still have the depressive thought process going on, so the thing they act out on is the self-destructive thoughts.

About the only thing that comes to mind, if it wasn't done already, is that if the campus psychological services receives information or calls of concern about a student from multiple sources, that they bring together the people making these reports, along with other professors of theirs or roommates, etc., and have a conference session to piece together as much information as possible to see what patterns exist. Some people just appear weird in some contexts, but nothing is wrong overall. For example, a creative student might write a violent story in a writing class, but not be violent themselves. If you get together with their roommates and other professors, you could find out that there is no pattern of concern and it's just an isolated issue not likely to mean anything. On the other hand, when their roommates tell you they are weird and never make eye contact, and other professors tell you they won't even share their name in class, or that they've felt threatened or nervous around this person (we're used to encountering painfully shy students, and can tell if there's something more brooding than just shyness to some extent), and you have reports from other students saying they were receiving harrassing calls from him that were a lot like stalking, etc., it starts to paint a clearer picture that this is a truly troubled student when these behaviors are consistent in all facets of their life and interactions with others.

However, what would be the way to deal with it from there? Is that cause to have him involuntarily committed again? Or do they decide it's cause to expel him from school, in which case he may have gone on the shooting rampage anyway, or been prompted to do it even sooner in his anger at the school for expelling him?

The problem with cases like this is they are very rare. It's hard to find patterns and make predictions and identify rules to follow to prevent it when there just aren't enough cases to study to find patterns.

 

[usahockey]

Lock him in a cell and throw away the key.

 

[radou]

The most frustrating part of getting someone help if you're NOT a psychiatrist is that the psychiatrist you refer them to isn't allowed to tell you if they have followed through with seeing them and continue to do so due to doctor-patient confidentiality, so you're somewhat left in the dark as to whether the person you know needs help is actually receiving it unless they volunteer that information to you. Or, they could lie and tell you they are going when they aren't.

I didn't know about that aspect of the doctor-patient confidentiality issue. Why is it so? I mean, I understand, but then again, if you refer someone to a psychiatrist, you most definitely want to know how they're doing. Of course, not in detail, but a pinch of information, like if the sessions are regular or not, could do some good.

Lock him in a cell and throw away the key.

Too late.

 

[Artman]

My guess is that he had other personality disorders as well as being Bi Polar. From his tape, he took very little or no blame for the harm he was going to cause, stating that "You had a hundred billion chances and ways to avoid today." To me that means he viewed his life as almost daily incentive to harm others, overreacting to his interactions with other people. I think that points to Antisocial Personality Disorder (psychopath).

How can you do anything to help such a person, when they view all interaction with hostility? I doubt spending time with "friends" would change this attitude and may actually make it worse, if he was truly derranged (which I would say he was).

 

[usahockey]

Too late.

Obviously. Hence my response being in reply to "what could be done to help those like him"

 

[denverdoc]

BTW, I'm not saying he was bipolar, only that would have been my guess before reading anything about the case. And I would agree with Artman that he had some personality disorder like shizoid/shizotypal, if in fact we wasn't outright psychotic as in schizophrenia or the bipolar blend known as schizoaffective disorder. But what I found so striking in reading his plays the amt of sheer rage he had bottled up.

 

[light_bulb]

has anyone asked what caused the rage?

 

[Moonbear]

BTW, I'm not saying he was bipolar, only that would have been my guess before reading anything about the case. And I would agree with Artman that he had some personality disorder like shizoid/shizotypal, if in fact we wasn't outright psychotic as in schizophrenia or the bipolar blend known as schizoaffective disorder. But what I found so striking in reading his plays the amt of sheer rage he had bottled up.

I wouldn't be surprised to learn he had multiple disorders, or a more atypical disorder that would be hard to classify.

It sounds likely there was a nasty feedback loop going on too...his disorder left him somewhat flat in affect and antisocial, which led people to avoid him, so then he sees that as people don't like him, so they avoid him more or start taunting, so he starts thinking the whole world is against him, etc.

 

[Astronuc]

has anyone asked what caused the rage?

I am sure that is being asked. Only his parents and close friends (?), and perhaps teachers/students from primary/secondary school would be in a position to answer.

One would have to look into the past.

I wonder if the rage has just evolved from a nihilistic perspective of the world. I wonder about how supportive his parents were in the preteen or early teen years. I wonder if he felt ostracized by his peers or the world.

And then there is the matter of whatever mental illness was present.

It sounds likely there was a nasty feedback loop going on too...his disorder left him somewhat flat in affect and antisocial, which led people to avoid him, so then he sees that as people don't like him, so they avoid him more or start taunting, so he starts thinking the whole world is against him, etc.

Definitely a nasty negative/downward feedback loop. I don't know if he was flat in affect, or just withdrawn and quiet.

The taunting is a problem for many children who are not part of the mainstream. My kids have experienced it in junior high and high school, because they are not part of the mainstream or part of a particular clique. Children with learn disorders or more particularly delayed development or delayed social development are sometimes (often in some cases) targets for bullying.

Vonnegut had a point - be kind!

 

[Artman]

I don't know if he was flat in affect, or just withdrawn and quiet.

From what I read, he was anti-social. In one of his classes, when the students each introduced themselves, he sat silently. When the teacher looked at the sign in sheet for his name, there was a question mark (?) written where his name should have been. They referred to him as the "Question mark man." He wore dark glasses even inside, probably to avoid eye contact.

 

[edward]

I would imagine that the incident below only aggravated his mental condition.

University Police Chief Wendell Flinchum said his officers confronted Cho in late 2005 after two women separately complained that he had harassed them through a variety of means, including in-person, through phone calls and with instant messages. After the second incident in December 2005, Cho’s roommate warned police he might be suicidal, prompting them to issue a “temporary detention order.” Police then sent him to a nearby mental health facility, Access Services, for a psychiatric evaluation.

http://psychcentral.com/news/2007/04/18/virginia-tech-killer-committed-for-psychiatric-evaluation-in-2005/