Thursday, April 26, 2007
Mom's murder raises troubling questions
More on CNN TV: Bundy, Dahmer, Cho. No one knew they'd snap until it was too late. "360" investigates: "A Killer Among Us." Tonight at 10 p.m. ET and Friday night at 11 p.m. ET.

In 2005, William Bruce, now 25, was diagnosed as a paranoid schizophrenic. He had attempted suicide a couple of times, thrown his little brother down a flight of stairs, threatened to jump off the rooftop of the family's home in Caratunk, Maine, and pulled a gun on his father.

His parents had tried to get him hospital care after each horrible incident. But the treatment facilities could not keep him against his will. In Maine, unless the patient proves to be an imminent danger to himself or others the facility cannot involuntarily commit him.

In 2006, that happened after William attacked his father, who then called police. William was over 18 so he had the legal right to keep his case file private. His parents were completely cut off. The hospital wouldn't answer any of their questions. His father, Robert Bruce, told me "it was like dealing with the iron curtain."

When William was released last April, he left Riverview Psychiatric Hospital without any medication. His father says his son was never even given a prescription or any follow-up care. Riverview's superintendent would not discuss the Bruce case with us, but said, "Any time someone leaves a care environment and doesn't get connected to the next care environment, then we as a system failed to engage them in treatment."

Robert Bruce isn't sure why his son was released, other than the fact he requested to be released and had the legal right to do so as long as he didn't pose an imminent danger. Doctors determined he did not.

Three weeks after William was released, he chased his mother through the family's home with an axe. She tried to escape, but he cornered her and bludgeoned her to death.

Dr. E. Fuller Torrey of the Virginia-based Treatment Advocacy Center believes a key reason William was released was money.

"The pressure is to discharge patients, to get them out of the hospital. And the reason is to save state money. As long as the individual is in the state hospital, the state is paying most of the cost. If you can transfer the patient, get them out of the hospital, if they then go into an outpatient setting, you're effectively shifting a lot of the cost to the federal government," he said.

All Robert Bruce knows is he lost his wife, and now he's lost his son. William Bruce was found "not criminally responsible" and was returned to Riverview Psychiatric for an "indefinite period of time" -- the same hospital that released him weeks before he murdered his mother.

Does the mental health system seem like it's broken to you?

-- By Randi Kaye, CNN Correspondent
Posted By CNN: 3:40 PM ET
  27 Comments
Randi,

Yes, it seems broken to me. Has anything come up in your research that part of the problem is the closure of state mental hospitals during the Reagan era? As governor, he closed all the facilities here in CA and then when he became president he implemented this policy on the federal level. Were things better or worse before the closures? Is there a before and after that could be explored? I know Reagan walked on water to many, but I am curious if his policy to close facilities those many years ago is a contributing factor to the problems we face today.
Posted By Anonymous Charlotte D, Stockton CA : 4:13 PM ET
Randi--

The mental heath system is not merely broken...it is shattered beyond repair. After years of being bounced around from treatment centre to treatment centre--at times, released before I should have been, in order to keep myself safe--from psychiatrist to psychiatrist, from this medication to that one, often without regard for my own opinions of how the medication was working (or NOT working), I have finally gotten placed with a doctor who acutally cares about me and my welfare, not the drug companies or insurance premiums.
The bottom line? It is all about money. The psychiatric system, in my experience, is not set up to "cure" those who seek assistance. It relies on "repeat visitors". It is merely a system that puts a band-aid on the immediate problem, but lack of care--or inacessiblity to competent care--beyond a hospitalization simply stabilizes the "immediate problem", and rips open countless new wounds.
It is not a system that is set up to focus on the patients. All it effectively does, for some, keeps them bouncing back and forth like a ping-pong ball, not really addressing the core issues. And, they simply don't want to take accountability for what may happen AFTER a patient is released, even if a horrible tragedy occurs.
I, unfortunately, have had the personal experience of losing friends who were caught up in the system, that in light of the Hippocratic Oath, which was supposed to help, and in some cases, protect them.
I'm lucky. I have a great network of care set up, so I am able to have a normal, functional life. Please remind everyone, Randi, that there are hundreds of millions out there who are NOT so lucky.
Posted By Anonymous Andie, Canton, Ohio : 4:24 PM ET
It is so unreal that they will release someone from these hospitals knowing that they are not well enough. But when they hurt or kill someone these hospitals and doctors will never take the blame for what is obviously their fault!

And why in the world would they place William back in the same hospital that released him and allowed him to have access to his family and others that resulted in his mothers death! It seems they will probably do the same thing again. I feel so bad for his father and family! The system really failed them!

The mental health system deffinately needs a major overhaul!
Posted By Anonymous Cynthia, Covington, Ga. : 4:33 PM ET
So is this the issue that will be the only focus of CNN for the time being until the next tragedy happens? Does someone there have OCD by any chance?

I get the impression that if I so choose I can falsely accuse someone of being "crazy" and get them shut away. That hardly seems fair. Just because someone says something you don't like you can have them committed or jailed? Geez half the people who post here or on the internet would be in jail.

You know what would be an interesting thing for CNN to do? Some of the reporters or management should go and have the psych test done and see the results, just for curiosity. It'd be kind of like the taser thing that poor Rick Sanchez was stuck doing and was yet entertaining.
Posted By Anonymous Em, Toronto, Ontario, Canada : 4:37 PM ET
Hi Randi,
All the health systems are broken. Any medical condition seems to live and die on how much MONEY is to be made. What's the answer? It's been going on for years now. Year after year it get's worse and year after year we all say something has to change! All I know is that like oil and water...huge profits and our health don't mix. How many more patients or others have to die before we say the system is a big fat zero. Take Care
Posted By Anonymous Lorie Ann, Buellton, Calif. : 4:45 PM ET
my perception is that the most under funded areas in state government are education, music and arts to be specific, and mental health. the first thing cut from the budget is therapy and new instruments...think about that
Posted By Anonymous Alexandra from TN : 5:15 PM ET
I noticed that the tagline of the segment that will air tonight is "Bundy, Dahmer, Cho. No one knew they'd snap until it was too late."

Ted Bundy and Jeffrey Dahmer were serial killers. They did not "snap" like Cho did. There is a great deal of difference between Sociopaths and the violent types like the Columbine killers and Cho.

And yes, the mental health system seems broken. I believe that the Psychiatrists can only evaluate a person's sanity (or lack thereof) using the DSM-IV, and unfortunately, true Sociopaths or Narcissistic Schizophrenics are quite adept at hiding their true selves. So, will it get to the point where everyone is suspect? And to where we would all need to get our brains wired and frequently checked by EEGs to determine whether or not we've lost our minds? Let's hope not. The people in the mental health system are doing the best they can. I cannot see how they could do more without infringing on our basic rights as human beings.
Posted By Anonymous Sharla Jones, Stratford, NJ : 5:16 PM ET
Let's add this up: 1) throwing someone down a flight of stairs 2) pulling a gun on someone 3) threatening suicide and 4)killing someone with an ax. Hmmm...that seems to qualify as crazy to me. To Em in Canada: I'm a little scared of what your definition of crazy is. But I digress...our entire healthcare system needs help.
I thought CNN discouraged offensive comments, and yet I find Em's comment about CNN's management and reporters quite offensive-as well as the one about the participants on this blog.
I'm confuddled as to why she (?) continues to post comments on a blog she so obviously loathes.
Posted By Anonymous Debbie, Denham Springs, LA : 5:20 PM ET
Yes, the mental health system is broken, just as the overall health system in the United States is broken.

In a system where private wealth determines the level of care you receive, there are going to be a lot of failures in the system.

When it's a failure of the mental health part of the system, the results often lead to tragedy when an unbalanced individual is set loose among the population. They are like a time bomb waiting to go off.

The only answer is a complete overhaul of the U.S. health care system, including the mental health system.
Posted By Anonymous Joseph Kowalski, North Huntingdon, PA : 5:25 PM ET
This is just another case of our country valuing money above everything else. We can spend massive amounts of money fighting wars and other nonsense but we will not even help the mentally ill. In this case an innocent life could have been saved had William Bruce been helped. We need to begin focusing on the well-being of our people and stop worshiping money.
Posted By Anonymous Brittany Pendergraft Jonesville, VA : 5:29 PM ET
Randi,
Interesting topic. Just like everything else, psychiatry is often all about the money. I don't know about you, but I know people who have been in counseling for years without an improved mental state. Some have even gotten worse.
Psychiatrist often tell people what they want to hear, write a prescription, and say,"see ya next session!" If a mental health clinic can't improve someone's condition, then the clinic should suggest a move to another facility. Of course, the patient has to want to help themself, but these professionals should have never released someone as dangerous as William Bruce.
Aparently Riverview Psychiatric Hospital made a fatal error in judgement by releasing William Bruce. How absolutely devastating for the Bruce family. Someone should be held accountable.
Thanks for the report Randi. I am looking forward to seeing it tonight on 360.
"The aim of psychoanalysis is to relieve people of their neurotic unhappiness so that they can be normally unhappy." guess who?. . .
Sigmund Freud~
Posted By Anonymous Betty Ann, Nacogdoches,TX : 5:34 PM ET
When will we as a society realize that people who have mental problems need to be held accountable for the actions they commit. The problem here isn't that he was released the first time it is that he was not prosecuted the second time. Any one who murders or commits a violent crime has mental disorder...that person should be reoved from society whether it be life in pison without the possibility of parole or the death penalty...
Posted By Anonymous Brant, madison, wisconsin : 5:52 PM ET
To Debbie in Denham Springs:

I wasn't commenting on Williams or Bundy or Dahmer. I didn't say they were "crazy". I didn't say that hunting your Mother down with an axe was a normal thing to do.

I was making the comment that the pendulum can swing the other way. That the rules can be too lax or too tight but who decides? You, not sure that should happen.

Do you think that just because one girl didn't want to date Cho that he should have been thrown in jail for life? No. How do we know that his roommate was telling the truth? The doctors let him go, they didn't think he was dangerous. If I call up the authorities in LA and tell them that I fear you, which I don't, should you be confined to a mental institute just because I don't like what you said?

There has to be balance and justice, oh and anyone can post here, not just people who fawn and belong to "fan" groups.

They used to do segments where the reporter would get tasered, try to fight their fear or go to a sleep clinic, why should this be different?

I don't care what you think anyway, he reads my comments on air. Jealous?
Posted By Anonymous Em, Toronto, Ontario, Canada : 6:03 PM ET
There are two problems here. One is the fact that concerned families can no longer "commit" their adult loved ones against their will, as we have seen done in old movies such as "Francis".(The autobiographical story of Francis Farmer.) The ACLU lobbied and took care of that during the Regan era. The second problem is what is stated all over the comments in this page...... money. My niece has been on SSI since she turned 18,(she is 25 now) but has never been hospitalized for over 72 hours. She has horrible scars all over her body. She has proven she means to harm herself. Still, the family is helpless to do anything to help her. No facily will admit her for long term treatment, which is what she really needs in hopes of getting her meds right.
Posted By Anonymous Cathy, Huntington Beach, CA : 8:46 PM ET
This is the most ridiculous thing I have ever heard. How could someone say that this young man was not a danger to himself or others? He has displayed obvious violent behavior, and he was even diagnosed with a mental disorder of which violence is a serious symptom.
This whole situation could have been avoided, and I think that's what makes it so frustrating. Things like this are happening more and more in our country. I seem to recall the shooter at Va. Tech being released as "not being an imminent threat to himself or others." Look at how both of these situations worked out...broken? OH YEAH!
Posted By Anonymous Lindsay, Baton Rouge, Louisiana : 8:46 PM ET
One ironic aspect of this serious problem is that those who see themselves as protectors of the rights of the mentally ill to refuse treatment unless there are imminently dangerous (i.e. have a history of being dangerous and have a weapon in their hands) actually perpetuate a system that leads to their imprisonment. Eventually, untreated psychotic people end up in trouble. Worst case, they kill innocent others or themselves. Nearly worst case, they likely deteriorate, break the heart of their family, become homeless, are a victim of violent crime or commit a crime and go to jail. Humane comprehensive treatment, even if initially coerced, does save lives. Common sense demands that we help those who can't recognize that they need help so they don't "die with their rights on". Our laws and system of care-giving must make that possible. Otherwise, we are not helping people when they need it the most. We are just waiting for the next tragedy.
Posted By Anonymous Stephen, Philadelphia, PA : 9:06 PM ET
Randi, the quoted statement from the Riverside Psychiatric Hospital reads, to me, as they admit their discharge/follow-up process failed. It would be reasonable to know how many patients does the hospital care for, how many physicians are on their staff, how many nurses and ancillary providers are on their staff. Was this patient on medication while in the hospital? If so, why not upon discharge? Was a follow-up appointment arranged and made known to the patient? The system is very close to failure, in my view, primarily due to lack of appropriate assets, money, providers, and time to meet the mission. Society should step back and give some reasoned thought to our priorities or the health of the nation will erode rapidly, touching all the aspects of the nation's "good health".
Posted By Anonymous John,Centreville,Virginia : 12:45 AM ET
Debbie, I do happen to agree with Em. And Em's comment is not a bit as offensive as other comments that have been previously published on the site, so... Why didn't anybody complain about them. One has the right to say whatever they think. While many might be thinking the same thing, not everybody would voice it.
Posted By Anonymous Mandy, Boston, MA : 2:49 AM ET
Dear Debbie,

I think she [Em] was commenting more on the idea that there is a fine line between committing someone by reasonable assesment of their actions, and committing someone because they seem weird. I think she was thinking more of Cho than Bruce, Bundy, or the stalker with a definite history of threatening behavior.

I happen to agree with her, and many others here, that we don't have sufficient definitions of just what constitutes mentally unstable to a dangerous degree. Instead we have vague statements that kinda, sorta, maybe could be the case, but noone wants to risk being sued.

We need better definitions and more appropriate procedures to deal with these suspicious people, not just for the safety of the communitty, but to safeguard innocents from those who might exploit the system for personal gain or satisfaction.

I have to admit, I felt a bit insulted at first as well, but after reading it a second time, I recognized the sarcasm and humor... come on... seriously, could you see Anderson onna couch with some Psychologist leaning over him with pad and pencil asking... "Zo, shtart frum za beginink." :D
Posted By Anonymous James Foley Kamiah, Idaho : 3:41 AM ET
You know, not too terribly long ago people that exhibited similar behavior were just admitted to an asylum - no questions asked. While this was extreme I also fear we now have reached the other end of the spectrum - so afraid we will squash someone's rights that it is forgotten that other's have rights as well. I am not entirely sure what the answer is - but somehow a happy medium has got to be achieved or the victims will continue to increased and the number of sick people that need help will also.
Posted By Anonymous Angela, Cincinnati Ohio : 8:39 AM ET
If someone really doesn't want to be helped, I believe they're not going to be helped and you will be wasting your time. I agree that the mental health system is broken in our society. It's insane that he would be sent back to the same mental health hospital that released him the first time, with no medication or therapy, or anything, just so he can go do something else and expose himself as really being paranoid schizophrenic. If you murder your mother with an axe, something is definitely wrong with you and it's sad that mental health is left in the dark so much. In Columbia, South Carolina the mental health institution on Bull St. was closed down to build apartments. That's just what we need, luxury apartments on the same site where people with mental health problems were getting help. What about the ones that don't have money to go anywhere else? They're probably out walking around the streets now with nowhere to go because they don't have any money. There's a homeless schizophrenic man in Columbia who walks everywhere and he stuffs his clothes with layers and walks around town. It's sad that he has nowhere to go. The mental health system has definitely crashed, and it's like no one really cares anymore.
Posted By Anonymous Alyssia D - Columbia, SC : 11:22 AM ET
There have been hundreds of mental health hospitals closed all across the country, due to budget cuts. Here in Kansas, we now have only two that remain open. Two, for the entire state.

Chances are, Cynthia, that Maine is the same way. The hospital that released him to begin with may be the only one in his area that is still in operation.

Yes, money is part of the problem. Even if a psychiatrist or therapist believes a person is a danger to himself or others, it can still be difficult to get them into a hospital, even if the patient wants to go. Funding has to be looked at. And even if funding is established and the person is hospitalized, there may be a limit set on how long they can stay. Long-term hospitalization is frowned upon anymore.

I work with people who have mental disorders, and it is far too easy for them to con the system, either to avoid being hospitalized in the first place, or to get released far too soon. Every hospital requires, as part of the release procedure, that the patient talk to their psychiatrist. So many times I have seen people talk calmly and rationally to the doctor, be released...and then return right away to the behavior that got them hospitalized in the first place.

Psychiatry is not an exact science. Doctors can and do get conned, not only by people who do not have mental disorders but want that disability diagnosis, but by those who are truly ill and try to hide it.
Posted By Anonymous Linda, Ottawa, Kansas : 11:56 AM ET
To say that the system is "broken" is a bit harsh. Hospitals, including mental institutions, are rated by states and insurance companies according the number of in-patient days. Like Randi mentioned in the article, the objective is to release patients as early as possible to sustain profitability. Otherwise higher cost of claims will eventually translate into higher premiums. These costs are then indirectly absorbed by everyone. It is really an unfortunate catch 22.
Posted By Anonymous A. Lynn, Boston, MA : 11:59 AM ET
I believe that the mental health system in the United States is not adequate. We are releasing too many mentally ill patients who are a danger to themselves and to others for no good reason other than money. There is no follow-up to make sure these patients continue to get the proper medication to control their behavior; therefore, once they get out into society they do harm, and usually to someone else. Maybe while they are in the mental institution and under medication they are not a danger, but once they are released they are forgotten until they harm or kill someone. The system has to be working to be broken. This system has never worked.
Posted By Anonymous Jackie from Aurora Colorado : 12:55 PM ET
It really doesn't matter where someone lives anymore, most states simply do not have the resources or the mental health facilities and staff to handle the needs. I lived in California for over 30 years and only in a city like L.A. can you find the help. My niece was diagnosed with Bi-Polar Disorder. If it had not been for the Didi Hersh Mental Health Center on Sepulveda, I don't know what would have happened to her. She received the help she needed, thanks to them and now lives a stable life in Dallas, Texas. The Didi Hersh Mental Health Center is a non-profit organization that needs to be copied through out the country. I am eternally grateful for the counseling for not just my niece, but for her sister and me as well. They provided medication, which by the way is very expensive (approximately $2,000 a month was needed for medication) along with the valuable services of their staff. In a culture where drug abuse is rampant, which brings on mental illness and manic episodes that are hard to deal with if you have the financial and emotional resources will only soar in the years to come. I don't know where we will be as a country, or as a society if we continue to deny the need for extensive mental health facilities and resources beyond our current standards. Twenty years from now the problem will be even worst. We need leaders with the foresight to plan and set aside funding for organizations such as Didi Herst. The horror this poor woman suffered will be repeated again and again if we don't act NOW to put much needed funding in place nationwide.

Thank you,
Posted By Anonymous Beverly Shurden, Jackson, MS : 1:00 PM ET
Randi:
Yes, I feel the mental health system is broken.

Through the "de-institutionalization" of mental health hospitals, under-funded group homes and limited therapy opportunities, many acute patients who would normally be able to function well in society are slipping through the cracks and ending up on the evening news as a statistic committing a violent crime.

Another case in point: As of January 2007, only 22 out of 196 psychiatrists have returned to New Orleans since Hurricane Katrina hit almost two years ago. The amount of neglected psychiatric care in NOLA must be deplorable.
Posted By Anonymous Sharon D., Indianapolis, IN : 2:47 PM ET
I recently attended a meeting on how to improve the health care system in BC. One area that is seriously lacking is mental health/substance abuse. Despite all the money spent on our health care system we are taking no better care of people with these problems.
The main burden lands on the family members and the non-profit organizations--neither of which are able to meet the needs of either group.
I believe we need to see the cost of not dealing with both these issues as far outweighing the cost of effective treatment and help.
It's apparent that social ignorance and political indifference is alive and well on both sides of our borders.
Posted By Anonymous Tina Laursen, Courtenay, BC : 11:45 PM ET
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