9OYS Investigates: Loughner's college "not a mental health facility"
Foreshadowing: A dim outline of Loughner's reflection can be seen in the door of this Pima College building. This frame grab was taken from the creepy September 2010 YouTube video that got Loughner suspended
A sample of Pima College's 5-page flow chart outlining disciplinary procedures. The procedures make no mention of mandatory mental health intervention.
This detail from a student resource guide provided to teachers warns that the college has no authority to make students seek mental health help -- overlooking Arizona Title 36, which provides such a mechanism.
TUCSON (KGUN9-TV) - "We are an 'educational institution,' not a mental health facility."
That official advice from Pima Community College to its teachers, administrators and office workers may well answer one of the key questions the college has been ducking about its handling of mass shooting suspect Jared Lee Loughner: Why, after a series of bizarre, frightening and threatening incidents on campus, did the college never obtain mental health intervention for him?
One of the guiding principles of public relations if that if you have a good story to tell, you tell it. But Pima Community College isn't telling this one. Since the college won't answer questions, 9 On Your Side has had to rely on public records. In March KGUN9 News filed an extensive request under Arizona public records law to see every document the college has on hand related to its procedures for handling troubled students, any training employees have received toward that end, and any mental health outreach programs that might be in place for faculty and students. It took weeks to finally receive all the documents, and then more time to thoroughly study them.
9 On Your Side's examination of the documents has led to some startling revelations. Among them:
-- The college's actions in ending all contact with Loughner while failing to report him to any outside law enforcement or mental health agency conflict with a campus threat training manual funded by the Justice Department after the Virginia Tech massacre.
-- An official college resource guide presented to employees suggests, incorrectly, that the college has no legal authority to require mental health intervention for troubled students.
-- A thick stack of education-related statutes handed out to participants of a legal workshop omits any mention of mental health laws, including Arizona Title 36, which provides a mechanism for an involuntary mental health evaluation.
-- College training materials also downplay the college's responsibility toward mentally troubled students, telling employees that the college is not a mental health facility, and admonishing those employees to act accordingly.
-- If a student refuses mental health help, the training materials instruct counselors to give up.
-- The college's highly detailed disciplinary procedures present no option for involuntary mental health intervention. The procedures are geared primarily toward removing the threatening student from campus, not toward helping the student.
-- Outreach material presented to students about mental health resources is directed almost entirely toward providing voluntary counseling. There is minimal information on how to obtain intervention for those who might need it, but who aren't asking for it or who don't want it.
-- If the college followed its written procedures, then before it suspended Loughner his case must have gone before a committee that included a psychologist or psychiatrist.
The college's Student Code of Conduct contains a lengthy and very detailed set of procedures for dealing with disciplinary issues. The procedures are so elaborate that the training materials for employees present the program in the form of a five-page flow chart. The chart specifies every conceivable option at every point of the process for almost every type of misbehavior. For the most serious infractions the maximum penalty is expulsion.
The Code of Conduct contains a special section -- Section VI -- laying out rules for handling potentially dangerous students who might have mental health issues. Under those procedures, the case of any student suspected of being a danger to himself or others must come before a team known as the Student Behavior Assessment Committee. The rules specify that the team must consist of at least three people, including an administrator, a psychologist or psychiatrist, and a campus police official.
But the procedures do not include an option for mandatory mental health intervention. Taken in that context, the psychologist/psychiatrist's role appears to be one of assessing to what degree a student's mental health might present a threat to the college. The procedures are designed to remove that threat. The maximum allowable mental health response specified in the procedures is to require the student to get a "mental health clearance" as a condition for returning to campus. The rules state, "A mental health clearance is an opinion issued by a mental health professional indicating whether, in the opinion of the mental health professional, the student's presence on a College campus presents a danger to student himself/herself or others."
The procedures for handling dangerous students under Section VI make one point specifically clear: a mental health clearance is not punishment. Nor do the procedures mention a desire to obtain therapy or any other kind of assistance for the student. Instead, the rules specify that a mental health clearance is "for safety (not disciplinary) reasons."
Although the language in the procedures refers to the mental health clearance as a requirement, it is in fact voluntary. The action does not trigger a mandatory mental health evaluation under Arizona Title 36. There is nothing to force the student to get the evaluation. He or she can sidestep the issue simply by never returning to campus. There is nothing in the procedures requiring the college to follow up with the student afterwards to see if he or she actually got help. Nor do the procedures require the college to notify any outside law enforcement agency or mental health authority.
That is precisely how the college eventually elected to deal with Jared Lee Loughner.
As a previous 9 On Your Side investigation showed, Loughner had a series of five incidents leading to a total of six campus police reports. One such confrontation left a pilates instructor so frightened that she asked the responding officer to stay in the area until her class had ended. By late September, the college was ready to respond by requiring Loughner to sign a behavioral contract, which is one of the lesser sanctions specified in the disciplinary procedures. But when the college learned that Loughner had posted a bizarre and threatening video on YouTube -- a video making a thinly veiled threat against that pilates instructor -- administrators changed their minds. Now the response became a requirement, as provided in Section VI, that Loughner obtain a mental health clearance in order to return to campus. Loughner then withdrew from the college. That ended all contact between the college and Loughner.
The assessment committee's reasoning in reaching this decision is unknown. That's one of the many issues the college refuses to discuss. Nor would the college reveal to 9 On Your Side who was on Loughner's assessment committee, on the grounds that federal law prevents the college from releasing those names.
But when all was said and done, the college had washed its hands of Loughner. And in doing so, it had followed its written procedures to the letter. Loughner was no longer Pima College's problem.
Were Pima's actions prudent, appropriate and sufficient to handle any threat Loughner might still present? That issue forms the basis of many of the questions still swirling around the college's handling of Loughner.
John Richardson, PCC's attorney, defends the college's actions. "Our review of the situation is that employees at Pima Community College acted in a reasonable fashion given what they knew at the time and responded in a reasonable fashion."
However, Charles Arnold, a Phoenix-based attorney and well known mental health advocate, is among those who believe that PCC could have done more to help Loughner. "What they could have done was to transfer that responsibility to the mental health system by making a referral, an application for an involuntary evaluation," Arnold said, adding that Title 36 does not require something terrible to happen before a person is subject to involuntary treatment. "At the very least, the community could've taken comfort in knowing that a mental health professional trained to evaluate against the criteria of our statute, would've participated in the case."
Pima employee training
In light of the training materials handed out to college employees, it would have been surprising if any of them -- police officers excepted -- had tried to trigger any kind of involuntary help for Loughner. The training materials the college provided to 9 On Your Side simply do not present that option.
It's not that the college is unaware of the potential for violence on campus -- far from it. One training presentation contained pointers for employees on how to deal with the threat of violence from students or other members of the public. It presents such advice as:
-- "Arrange yourself so that a visitor cannot block your access to an exit."
-- "Calmly describe the consequences of any violent behavior."
-- "Use delaying tactics which will give the person time to calm down. Example: Offer a drink of water in a disposable cup."
The presentation also offers tips and advice on how to talk to a potentially threatening person and how to offer assistance. But it warns that efforts to help can only go so far. "We are an 'educational institution', not a mental health facility. Avoid working outside of the scope of your duties."
If teachers aren't to deal with mental health issues themselves, then who will? A student resources pamphlet distributed to teachers provides contact information for offices and organizations on and off campus offering various forms of counseling and mental health assistance. But it advises teachers, in essence, that their only option is to point students in the right direction and then hope for the best. "The College does not have the authority or ability to make students seek help...."
That is not true. Arizona Title 36 gives anyone the ability to seek an involuntary short-term commitment for someone who might need mental health intervention. But in all of the employee training material provided by the college, 9 On Your Side was not able to find a single reference to that law.
The omission is significant in light of the wealth of material the college provides to employees about other laws affecting education. Pima gave 9 On Your Side handouts from not one but two legal seminars that it put on for employees. The seminars presented -- in exhausting detail -- laws and court cases applying to education. One handout ran to more than a hundred pages, and listed multiple scenarios and case studies. Another presented the full texts of statute after statute at both the state and federal level. In neither document was Arizona Title 36 among the laws presented or discussed. Nor was any other mental health law or case study presented in the material Pima provided to KGUN9 News.
Are those omissions typical of how other colleges train employees to deal with mental health issues? 9 On Your Side checked with Pima Community College's colleagues at the University of Arizona. Dr. Marian Binder, who heads up the university's psychological services department, said that those who handle student discipline at the U of A are very familiar with Title 36 -- although she would not comment on Pima's handling of Loughner. "It's certainly in the training of CAPS staff and campus health staff," she said. "The Dean of Students' staff are definitely familiar with it. The Residence Life staff are familiar with it."
As 9 On Your Side has previously reported, Dr. Binder helps oversee a comprehensive program at the University of Arizona designed, in part, to identify and intervene with students having mental health issues. Binder said in an earlier interview, "You know the probabilities are slim, but the stakes are very high – and the cost of the wrong call could be deadly." Like Pima, the U of A has a reason to know the truth of that statement, having had its own deadly campus shooting in 2002.
Arnold points out that not only does Title 36 provide a valuable tool for mental health intervention, it does not require an immediate threat to invoke it. "The belief is that there first needs to be some manifestation of dangerousness," Arnold said. "That's a false belief."
The Pima College employee training materials 9 On Your Side obtained also neglect to mention a valuable resource on which schools and law enforcement agencies in Tucson frequently rely when dealing with mental health issues: the Mobile Acute Crisis (MAC) Team from the Southern Arizona Mental Health Corporation. The MAC teams are composed of clinicians who can provide a risk assessment of what the needs are of the individual in question and make appropriate referrals.
Another Pima training presentation helps employees spot potentially dangerous students. It offers these warning signs:
-- "Usually not impulsive act. Retrospective studies show a visible process of planning"
-- "Destructive or threatening statements"
-- "Past history of destructive behavior"
-- "Specific plans to harm self/others"
-- "Appears withdrawn"
-- "May "bully" others"
-- "Significant change in mood"
-- "Poor impulse control"
-- "Substance abuse"
-- "Seen by peers as 'different'"
-- "Art/poems/writings violent themes"
-- "Low frustration tolerance"
-- "Externalizes blame for problems"
-- "Frequent disciplinary problems"
-- "Poor academic performance"
-- "Decreased motivation"
Many of those bullet points will be "ah ha!" moments for those familiar with the swath that Loughner cut through Pima College.
So what are teachers to do if they encounter a student exhibiting these behaviors? One option: make a referral to a campus counseling center. And here again, the emphasis is on making it voluntary. The presentation advises, "Suggest that a student seek help instead of telling or ordering them to."
Pima's counselors are not mental health professionals. A presentation for department chairs has this slide defining the responsibilities of a counselor: "Provide career and short term personal counseling, educational counseling and academic advising to a diverse community college student population. Additional expectations include, but are not limited to: developing and participating in student success programs, conducting orientation programs, teaching student success courses, providing guidance on educational goal attainment including student success strategies and career counseling."
But as described under "Student Resources" on Pima College's website, some of the services counselors offer, along with academic advice, are for "personal challenges" such as "stress," "substance abuse," "anger," "relationships"; and "sexual assault."
If a student needs more help than the counselor is qualified to give, the counselor may refer the student to an off-campus mental health resource. But what if the student declines such a referral, and refuses to seek mental health assistance? What's the next step?
There isn't one. "If counselors determine an inability to be of professional assistance to clients, they avoid entering or continuing counseling relationships.... If clients decline the suggested referrals, counselors should discontinue the relationship."
Whether counselors ever suggested to Loughner that he seek mental health treatment is not clear. But what is clear is that if the college did make such a referral and Loughner refused, then under these procedures, that would have been the end of it.
Campus police options
One common thread in most of the employee training material was that in an emergency or crisis, employees should call campus police. As 9 On Your Side found in an earlier investigation, the college's public safety department has its own written procedures for handling people who might be displaying symptoms of mental illness. The police mental illness procedures do contain information about Arizona Title 36, and it specifies conditions under which the officer may invoke the law and have someone committed for an involuntary evaluation, either directly or by way of calling a MAC team for assistance.
But the emphasis is on the word "may." The police procedure does not specify the conditions under which the officer must trigger Title 36 and have the person evaluated. If the responding officer does not elect to trigger a mandatory mental health evaluation at the time of the incident, there is nothing in the disciplinary procedures to trigger such intervention later. The disciplinary procedures simply do not provide a mechanism for any form of involuntary mental health intervention.
As 9 On Your Side has reported, two police officers responding to one of Loughner's outbursts did advise a counselor that they believed Loughner was suffering from mental health issues. One officer documented that observation in his police report. But despite the concern about Loughner's mental health, neither officer triggered a Title 36 intervention.
The issue then became a disciplinary matter. Under those very formal and detailed procedures, the option for an involuntary mental health evaluation for Loughner had passed. The procedures specified no provision for raising the issue again.
Justice Department-funded training advice
One of the documents the college provided to 9 On Your Side was a ring-bound training manual entitled, "Campus Threat Assessment Training." The campus safety consulting firm Margolis, Healy & Associates prepared the manual following the 2008 Virginia Tech shooting, operating under a grant from the U.S. Department of Justice. The manual notes that although the Virginia Tech massacre was the most lethal, it was one of only 14 such campus shootings since 1966.
The manual lays out a series of steps for handling potentially violent students, including formation of a case management plan. "If the person does not pose a threat of harm, does the person show a need for help or intervention, such as mental health care?" In such a case, the manual advises connecting the person with the necessary resources.
In cases of students found to pose an immediate threat of harm -- in other words, a case like Loughner's -- the manual emphasizes the need to deal with that threat immediately. But it also warns that an expulsion or suspension alone may not solve the problem. It advises colleges to "recognize that a person can continue to pose a threat even after he/she ceases to be a member of the campus community." And to deal with that, it recommends that the case management team "continue to monitor the situation through its relationship with local law enforcement agencies and mental health agencies, as well as in direct cooperation with the person, if possible."
The manual recommends that the college sustain the monitoring, with the help of those outside agencies, as long as the student might be "reasonably assessed to pose a threat." As 9 On Your Side previously reported, Pima College police remained very concerned about Loughner even after he withdrew from the college. Officers issued a campus-wide alert to be on the lookout for him just days before the shootings.
Dr. Gary Margolis, one of the experts who wrote the manual, would not comment specifically on PCC's dealings with Loughner. But Margolis did tell KGUN9 News that he advises schools to err on the side of safety, given all the recent tragedies at educational institutions. "We're advising legal institutions to overnotify, tell law enforcement, tell mental health providers whatever you can tell them legally."
The Margolis training manual also urges a campus-wide educational effort to help students and faculty identify threatening individuals and to encourage reporting. It suggests that the campus perform this outreach "on a regular and frequent basis." How frequent? The manual includes the outreach efforts on a list of suggested monthly activities.
Among the documents 9 On Your Side asked Pima Community College to provide was anything related to any outreach programs designed to help educate students on how to identify and handle threatening or dangerous classmates. The materials that PCC provided to 9 On Your Side contain no documentation of any such student outreach program. The closest thing to it is information provided to students directing them to call campus police when faced with an emergency.
In September of 2009 Margolis, Healy & Associates began hosting a series of ten training seminars to present its material to educators. Representatives of Pima Community College attended the next to last of the seminars on January 11, 2011 -- three days after the Tucson mass murders of which Jared Lee Loughner now stands accused.
What has Pima College learned?
As 9 On Your Side has reported at length, immediately after the January 8 shootings Pima College Chancellor Roy Flores ordered an extraordinary college-wide media clampdown. Initially the college withheld all public documents of any kind related to Loughner. Finally it was forced to admit that FERPA, the federal privacy law it was using as an excuse to withhold the information, did not protect all the material the college was seeking to keep secret. The college then released 51 pages of Loughner's police files - which is how the public knows today what it knows about the college's handling of Loughner.
Later the college released several thousand pages of emails containing the word "Loughner." But the college redacted the emails so heavily that they provide no new information about him at all. In their current state, the emails serve only to document the college's extraordinary media blackout. Pima's circle-the-wagons defense is so strong and so thorough that recently the college even stiff-armed its own colleagues, ignoring a forum on mental illness at the University of Arizona.
The Arizona Republic is suing Pima Community College, arguing that PCC is violating public records laws. "This is not about some voyeuristic need to see things," said attorney David Bodney, who represents the newspaper. "This is about the public's right to know how this community college evaluated the threatening, disruptive conduct of one of its students who, within a few short months, went on to commit these horrific acts of violence." A Pima County judge is now reviewing the disputed files.
Arnold, the mental health attorney, told KGUN9 News that there is an important lesson to be gleaned from the mass shootings in the recent years. "After we've seen tragedies such as Columbine, such as Virginia, such as Tucson, I think the stakes are great. The stakes are high and we're now becoming aware of the risk if we don't act to help those students in need."
Is the college listening to experts like Arnold? Has Pima learned anything about what happened? Will it handle future cases any differently? Will the college ever implement the recommendations contained in the Margolis manual?
Perhaps time will tell. Pima Community College certainly isn't.