How the Navy Yard Tragedy Could Have Been Prevented

With the very dark shadow of Newtown still engulfing us, once again, we mourn for innocent by-standers who have been slain or maimed by a shooter. The tragic events at the Washington Navy Yard sadly are similar to previous tragedies in Newtown, Aurora, Tucson, and Virginia Tech. They also are different in very important respects. We must learn from and act upon these differences to reduce the likelihood of future similar tragedies.

Media reports this week strongly support the conclusion that Aaron Alexis was descending rapidly into serious mental illness. His close friends and colleagues noted rapid changes in his behavior over the past year, and police actually chronicled his symptoms just a few months ago. His reported symptoms are consistent with those of someone experiencing untreated schizophrenia. Apparently, he was sufficiently concerned about these changes to seek care from the Department of Veterans Affairs (VA), since he was a military veteran.

Several key actions must be taken to prevent a recurrence of the Navy Yard Tragedy. These actions are summarized below.

Implement Our National Call to Action. Just eight months ago, in the immediate wake of the Newtown Tragedy, the mental health and substance use care and prevention fields came together to issue a National Call to Action (see:  https://www.behavioral.net/blogs/ron-manderscheid/time-act-innocents-0). This effort advocated strongly for three things:

• Implementation of school, family, and community programs that improve prevention, early recognition, and early intervention for mental health and substance use problems..
• Training of students, teachers and other community members to recognize the signs and symptoms of mental illness and substance use, and, equally important, training to know what actions to take when encountering someone with these symptoms.
• Immediate doubling of the capacity of the mental health and substance use service delivery systems.

The President and Vice President heard our request, and the first two of our proposals were included in Administration legislative recommendations. These recommendations subsequently became a Senate Bill, The Mental Health Awareness and Improvement Act. That Bill now is languishing in the Senate. Just this week, Senators Begich and Ayotte urged once again that the Senate pass this Bill.

What You Can Do: Urge your two senators to pass this essential Bill before the end of the year.

Provide Crisis Intervention Training to Police. When the Newport, RI, police were called to Mr. Alexis’ hotel room just a few months ago, he reported his symptoms to them in a very detailed way. Unfortunately, the police did not act on that information to seek care for him. Thanks to the work of Leon Evans, Director of the Center for Hope in San Antonio, excellent Crisis Intervention Training (CIT) is now available to police so that they know what action to take in this circumstance. If Mr. Alexis were actually taken to a treatment facility that night, the Navy Yard Tragedy might never have occurred.

What You Can Do: Advocate that CIT is made available to your local police force, and to all persons who perform civilian police functions.

Improve the Mental Health Services of the VA. Mr. Alexis sought care from a VA emergency room. Questions must be raised about this care: Why was the emergency care ineffective? Why was there no follow-up by the VA mental health program?  These are very serious questions, especially in light of the large number of veterans returning from Iraq and Afghanistan with mental health and substance use conditions.

What You Can Do: Advocate that the Administration investigate why Mr. Alexis was not provided effective care by the VA, and then immediately develop a remediation plan.

Along with millions of other people, we extend our sympathy to the families of those innocent people who were killed or maimed in the Navy Yard Tragedy. Their lives have been changed forever.

But we also must do more. Inaction on essential legislation, failure to train policy to act appropriately, and failure to deliver effective care have proven to be a very deadly combination. The Navy Yard Tragedy must prompt our immediate attention and advocacy.

You and I should be absolutely indignant until these actions are taken.