After eliott rogers rampage in california, there has been a lot of blame, and the signs missed that roger might be dangerous. In case where is an individual decides to kill people we hear after the fact that others, family, employers, work mates, knew there were Serious Problems but didnt quite know what to do. This is an area of medicine and law where a lot has changed over the past decades. Privacy laws regarding medical treatment. Making involuntary commission really difficult. Putting an individual in charge of medical care after the age of majority. Getting the balance right is the challenge. How did you protect the interests of those struggling with Mental Illness and those around him. The video and messages eliott roger created before killing six people and himself on friday leave little doubt he was mentally disturbed. Reporting and a statement from a parent suggests the 22yearold had for years grappled with severe mental issues, and had treatment with therapists. But as recently as last month his video messages convinced his parents to seek help from law enforcement. A beautiful environment is the darkest hell if you have to experience it all alone. Reporter they call the police in april and officers stopped by rogers house but after questions they did not find rogers dangerous. Just shy and lonely. Told them that he was having some social problems, and some school issues, and that he probably was not going to continue in school. And told them it was all a misunderstanding that his relative and this other person had taken things the wrong way, and he really wasnt going to hurt anybody or himself. He was going to convince the deputies that he was not a danger to himself or other people. Reporter news of the Previous Police visit stunned the community. Raising questions about what warrants intervention. Richard martinezs son chris was killed in fridays shooting. I cant understand why we werent doing more to prevent this kind of thing. Here you got a guy who they knew there is alli dont know whether its the family or the police or who, but i mean, arent we tired of this . Isnt this justi mean, how can this go on . What are we thinking . This is just unbelievable to me that we have to do this all over again. Reporter in Virginia State senator shares that frustration. His son, austin, known as gus, suffered from severe bipolar disorders. They tried to secure gus a bed i in a psychiatric with regard but couldnt , but days later he stabbed the senator in the face and committed suicide. Today deeds is working to push reforms on the state level getting the sign off last month for a better psychiatric bed registry and an extension on windows. Its a debate we faced before. Is there more to do when the red flags of a persons behavior are wellknown in the name of Public Safety from aurora to newtown to arizona, its a its the question when Mental Illness and violence intertwine. Families knew their sons had various problems and tried to get help. Were not suggesting that any one of these terrible crimes could have been prevented with just the right phone call, yet if you know someone who is beginning to present with a Serious Mental Health problem who do you call . What is the best approach . How do you figure that out. What are the rights of the possibly mentally ill person, and what are the rights of their fellow students or coworkers or neighbors to be safe from them. Joining us for that conversation with from our dc studio, senior director of state policy atment health america, a network advocating for changes in americasment health policy. From philadelphia, a social worker and writer for the atlantic and also here in washington, pete early, author of crazy, a fathers search through americas Mental Health madness. Jeff, let me start with you. Even though there have been advances in neurosciences, advances in treatment and complete set of laws to help everyone along the spectrum, its still not an easy question to answer, what are you supposed to do . Its not, ray. Its not an easy question. You know, each part of the picture has its own complications. There are medicines that people can take to treat psychiatric imnesses, but many of them could with adverse sideeffects that are unpleasant. And the quality of care you may encounter when you present voluntarily, if you seek care voluntarily, sometimes isnt that graduate, and people arent being engaged and retained in the voluntary treatment that they seek. And when things do escalate to a crisis, one thing people dont understand is that first of all the bar is set very, very high in terms of who can be involuntarily committed to a psychiatric facility. Literally im going to kill somebody or im going to kill myself today is where the threshold is set at. But even if you meet that threshold, and you are involuntarily committed once youre in a psych unit its not a very Pleasant Place to be. Its not the best therapeutic environment somebody can be in. And many people find that experience of being taken by police to a hospital very trauma tiding, and that sets back the therapeutic process. Its kind of brought with difficulties each step along the way. You showed us how high that bar can be. Well, hes right. My son was diagnosed with a Mental Illness. His doctor put him on medication, and it seemed to help him. A year later he was psychic. He was wandering the streets of new york for five days. I raced to get him. He talked about how he might kill himself. I took him to the emergency room. Because i didnt have a psychiatric family practitioner. I grabbed a doctor and he said, i cant help you. Youve been sitting here for four hours, no one is hurt. You seem like a nice guy, bring him back when he tries to kill you or someone else. I took him home and 48 hours he was sicker and sicker. Can you imagine what its like watch your child wrap tinfoil around his head because he thinks the fbi is going to steal his thoughts. He slipped into the neighbors house and now hes in jail rather than getting treatment. Did that clear the threshold . No, they took him to a Mental Health center. At that point this really hurt my relationship with my son. I went over and they said even though your son is by polar and hes off his medication, and even though we picked him up psychotic taking a bath in a strangers house, unless you say that he threaen he threatened t, soy lied and i said he threatened to kill me. Necessary the hospital, charged with two felonies. The hospital was three days with people sitting there take your medication. Take your medication and then out the door. There was no real treatment after you went through this process where all of a sudden youre the parent and youre sitting there, and your son is outraged because you just had him taken to the hospital, and he didnt think he was sick. Hes charged with two crimes that you have to find someone to defend him on because hes psychotic. The system females all the way around. Debby, is this an answer that differs depending on where you are in the United States . Very much so, ray. Commitment laws differ and how theyre interpreted differ. In philadelphia there is a system of outreach workers who will come out to people on the street, where there is a psychiatric Crisis Centers where people can come to. But most importantly where there is in philadelphia and other places are connections once people leave the hospital. What pete and jeff described when people are in the hospital they get essentially emergency care. Its triage in an emergency room like what happens in any other health condition. But in any other Health Conditions you have the nurse who calls the next day. You have the peer who follows up to make sure that things are fine, so we drop the ball. Not only do we not get people in to get treatment, we dont follow up with after they get out. Two parents who are disturbed with what they hear and have seen from their son wally call law enforcement. Officers respond, not train ed psychiatric case workers, but officers who respond. They talk to him. He seems oriented to place and person. He seems not to be a threat to anybody at the time. They wrap it up and leave. Even eliott roger himself says if they had searched the apartment the jig would have been up, they would have known exactly what i was up to. Right, right, and again, this is a question of training and of connection in the community. Again, another piece of excellence is crisis intervention teams where Police Officers are especially trained to engage with citizens so that they would come to somewhere that there is a call that perhaps there is a Mental Health involvementish and they would take the time to actually engage long term with a person i dont mean over weeks, but to engage with them in long conversation, and then to make sure there is follow up in the community. That is part of when their c. I. T. Teams there is Community Follow up and connecting with services. It doesnt always work but its a very good program. Well take a short break right now. When we come back well talk about striking that balance between the rights of a person who you suspect is mentally ill, and the rights of the wider community. This is inside story. Al Jazeera America presents the system with Joe Burlinger the dna testing shows that these are not his hairs unreliable forensics the problem the bureaus got is they fail, its a big, big deal. Convicted of unspeakable crimes did flawed lab work take away their freedom . I was 18 when i went in. When i came out i was 50. You dont get it back. Shocking truths revealed the system with Joe Burlinger only on al Jazeera America a manifesto promising murder in Santa Barbara they called 911 and rushed to the scene. Long after the shooting at Sandy Hook Elementary School in now town, connecticut, an we hear from the senator whose son would have killed him in the heartbeat. We talk about someone we may know who may be in the grips of severe Mental Illness. What was written to protect us protects your son. Youre trying to protect him, too. Absolutely. The parents are shut out of the process. You have to understand that based on our history in our country there was a time when if you had an Mental Illness , you were taken away and thats wrong. There was a time when an ice pick would be stuck up behind your eyelid to scramble your brains, and thats wrong. No one knows when someone is going to be dangerous. As long as you have that bar to protect someones civil rights and they need protection, it limits you from interacting before someone becomes dangerous. When we have people with schizophrenia or bipolar disorder who are in prison, theyre on probation, they cant get the help. You can change the commitment law. You can do it in virginia. I helped change that law, and it made no difference because there are no services. You have to provide the services and have a much more reasonable standard to help people get in it. Thats where the real fighting comes in. In england they have a need for treatment where a Family Doctor or a psychiatrist can say they need for treatment and dont have to wait. Were a lot of these laws were put in place because the system had been so abusive before . Well, yes, thats absolutely why they were put in place. Honestly, i think thats the reason why they remain important. You got to think that the Police Officers in Santa Barbara, honestly, they probably get calls like this pretty regularly. Where families are calling and saying im concerned about my child or loved one or whatever, and they go to the scene, and they determine that the person is not in imminent danger. The person says, i was up pet, but im okay now. I posted something stupid online, i took it down. I have a follow up appointment with my therapist. In those situations, you know, they made the right call to not intervene, and by the law when they met with eliot roger, they did the right thing, too. I know thats really frustrated for everybody to hear. But if you change those laws to make is easier to allow Police Officers into the lice of mentally ill people, its important to stress, ray, people with penal illness, they are our brothers, our sisters, our wives, fathers, mothers, coworkers, its a very, very strong number of very severely mentally ill people were talking about here. If you change the system that potentially impacts millions of people with Mental Illness to try to better target this one very, very small section to try to catch them right before they do something really severe, those. If you make it easier for people to become voluntarily committed, do people become nervous. If they think they go to their therapist and vent and say they had a bad day and then a couple of hours later a Police Officer shows up at their door and says they think you could be a workplace shooter, i think thats going to pull a lot of people away from voluntarily engaging the system. Thats really where we need to focus our resources is on making those services for people who voluntarily want to engage them better or that we retain them over time. Thats the mystifying problem. That you do want to protect the rights of people, yet, it must be very frustrated to those families to hear that they were tantalizing close in the case of eliott roger, if someone had entered the argumen the apartmey washington have found 4,000 rounds of ammunition and pisto pistols. There are a couple of things to understand, how rare it is of people who have Mental Illness and commit acts of violence. Those who are in jails and prisons are most are in there not because of a violent crime. Thats the first piece, to put that in context. Then to know if people are called with legitimate concern we dont want to step on peoples rights, but we really do want to make sure that they and the rest of the community is okay. And what we dont have is the political will to fund systems. It takes money to have follow up, to have someone come back and check, knock on the door, engage with the person, but we know that thats how you find out that someone like this young man is feeling isolated and angry and may have some other ideas or have been working on acting on them. That would be the only way to know that. He was very secretive and very isolated. And sometimes what you just need is some engagement. Thats not to say that we could have predicted it, because we cant. Were going to take a short break right now. When we come back well talk about the fact that these crimes are still tremendously rare for all the publicity that they get, can we make a blanket policy to help those in need, watch their rights and maybe even save some lives. This is inside story. Every saturday join us for exclusive, revealing, and surprising talks with the most interesting people of our time. Rosie perez i had to fight back, or else my ass was gonna get kicked. A tough childhood. There was a crying, there was a lot of laughter. Finding her voice i was not a ham, i was ham cheese. And turning it around. You dont have to let your circumstance dictate who you are as a person talk to al jazeera only on al Jazeera America ay to. Al Jazeera America, take a new look at news. Welcome back to inside story. Im ray suarez. Susan, the mother of one of the columbine killers, has written about how people view her. Reporter we perceived his actions to be hour failure. I tried identify a pivotal event in his up bringing to account for his anger. Had i been too strict . Not strict enough . Had i pushed too hard or not hard enough . If you suspect that your loved one will hurt himself or herself, or others, what should you do, what should you say . What does the law say . Today across the country someone is going to notice that someone they are very close to is acting usually. Maybe were going to be more sensitive to it because of everything that has been in the news, what is the best first thing to do . Well, you know, what i would recommend first, ray, is for families of people that they suspect may have Mental Illnesses would be to toinvestigate your local landscape of resources. As mentioned earlier these systems really differ from place to place. Rural parts, now know, of the country may have very little in terms of options for treatment available. And so i think it starts there to figure out what is available to you in the community that you live in. If you suspect that you may be headed towards ament Health Crisis you want to be sure to investigate basically where is the nearest emergency room or in cities like philadelphia as mentioned earlier, we have Crisis Response centers, crs, which are psychiatric Emergency Rooms specialized to receive people in a state of psychiatric crisis so youre met by a psychiatric nurse followed up with a visit with a psychiatrist very soon after. Investigating with those resources are, and educating yourself what is available is the best way to go. Look, if you have a Family Member saying theyre going to commit suicide, you have to call 911. The bottom line, thesesome people meet the threshold, you know what i mean. They do meet this very high bar, and thats what its there for. Once youre inside the psych unit you know, we can absolutely debate basically what the quality of the treatment is that youre going get once youre in there. One thing that they will certainly do is provide for shortterm observation to make sure you dont hurt yourself. They will reassess you over the next several days. Let me jump in because i want to hear from everybody before we close. Debby, with all the efforts that have been made in the recent pass to destigmatize Mental Health treatment, you wouldnt he is tate to call if you thought that your son might have hypertension or diabetes, but you might not want Mental Illness in her records that follow her from place to place. Are we getter . We need a major culture change. Many people recognize that Mental Health conditions are common and arent afraid to call for help. That is getting better. However, what has not gotten better is how we treat Mental Health in this system. For example, we wait until people are in crisis before we reach out to them and give them help. If you had an heart condition we would have monitored your blood pressure. We would have monitored your cholesterol. We would have stepped in before the heart attack. With regard to Mental Health we dont do anything until there is a crisis, an episode, that is waiting until the worst things happen. How is your son . My son is great. After being tasered by the police in another incident he finally got into the help that he needed, and now he helps people who have Mental Illness. You can provide all these services, but what about the individual someone like eliott who was selling a therapist. Who had parents who wanted to help him, who were doing all the things that were right, and still our system did not react . That brings us to the end of this edition of inside story. Thanks for being with us this time around. In washington, im ray suarez. Here is my bottom line. America must always lead on the world stage. Defining americas role. Barack obama outlines his Foreign Policy vision for the rest of his presidency. Hello, im jane dutton you are watching al jazeera life from our headquarters in doha. Air strikes in libya. Ill be reporting live from continuely on a former generals latest attempt to tackle armed groups that he