Insight
on the News - Investigative Report
Issue: 5/21/01
A Prescription for
Violence?
By Kelly Patricia O'Meara
In the last 10 shooting incidents at schools, a total of 105 students, teachers
and administrators were killed or wounded. Beginning in March 1998 with the
shooting at Westside Middle School in Jonesboro, Ark., and ending with the
March 22, 2001, shootings at Granite Hills High School in El Cajon, Calif., six
of the 12 juvenile shooters are reported to have been on prescribed
mind-altering drugs.
San Diego Deputy Public Defender William Trainor announced last week that his
client, 18-year-old Jason Hoffman, who is charged with the shooting of five
students and teachers at Granite Hills High School, had been prescribed the
antidepressants Celexa and Effexor. Whether Trainor intends to use this medical
information as part of his client's defense is unclear, though he said that
"the drugs [Hoffman] was prescribed may help explain his actions." He
adds that research "indicates that the drugs that were prescribed are
extremely powerful antidepressants with the most dangerous side effects."
According to Loren Mosher, professor of psychiatry at the University of
California at San Diego, "Celexa and Effexor are selective serotonin
reuptake inhibitors [SSRIs] in a class with Prozac, Paxil and Luvox" - the
same drug prescribed to Columbine shooter Eric Harris.
It appears Trainor believes there is a correlation between the drugs and the
shootings. Although he could not provide specific information about his client,
he tells Insight that this is a hot-button issue and there are many people who
don't want to look at the connection. "If you say those drugs may be
involved," says Trainor, "you'll be labeled a kook." But
"with the history of these drugs there is a huge unpredictability factor.
When someone goes off while on these drugs it should raise some eyebrows in the
community. I'm starting to wonder when the public has the right to this
information. What is the balance of rights? It's his medical rec-ords versus
the public right to be safe. Which one has the trump card? It is a legitimate
question."
Although Trainor is not the only public official to consider the possibility
that widely prescribed mind-altering drugs may play a role in much-publicized
school violence, he is among the few to make public the issue of medical
records generally being protected and put off-limits. The privacy of medical
records, including mental-health information, is protected by law. The information
about the prescription-drug history of an accused perpetrator is only made
public when the information is released by the family, school officials,
friends and, sometimes, law-enforcement officers and attorneys.
And, of course, such information seems to be of interest to the public only in
the wave of concern after a violent event, making it difficult even to consider
whether prescribed psychotropic drugs are a chronic cause of otherwise
senseless violence.
In fact, so little information has been made public about these mind-altering
drugs and their connection to shootings and other school violence that the U.S.
Department of Justice (DOJ) isn't even looking at the possibility. When asked
about a community's right to know if an alleged shooter has been prescribed a
psychotropic drug, Reagan Dunn, a spokesman for the DOJ, tells Insight:
"There are two issues that you've raised - medical-record privacy and
criminal records of juveniles. These records are sealed by statute in all
states. It [the connection between psychotropic drugs and school shooters]
isn't an issue we're looking at - there are other priorities we're focusing on,
such as school-resource officers [safety officers] and other programs to reduce
school violence."
But two other federal law-enforcement agencies, the FBI and the U.S. Secret
Service, appear to be concerned about the increasing number of school shootings
and have invested a great deal of time and effort to look into the possible
reasons for them. The FBI published a report last year called The School
Shooter: A Threat Assessment Perspective. The 41-page report was the result of
a joint effort by the National Center for the Analysis of Violent Crime (NCAVC)
and teachers, school administrators and law-enforcement officers involved in
investigating each of the school shootings. They were assisted by experts in
adolescent violence, mental health, suicidology and school dynamics. Eighteen
school-shooting cases were reviewed for the report.
Although topics such as family relationships, school dynamics, social problems,
personality traits and behavior, threat management in schools and the role of
law enforcement are discussed, there is no mention in the report of increased
prescription-drug use by juveniles.
Dewey Carroll of the Clinical and Forensic Psychology Department at the
University of Virginia participated in a threat-assessment conference last year
during which he was asked if, based on the correlation between psychotropic
drugs and the school shooters, this information should be made public. Carroll
argued that there was no correlation. "Six out of 12 [school shooters]
being on psychotropic drugs is not a correlation, it is an observation,"
he said.
"A correlation," explained Carroll, "would be taking a sample of
children on medication and those not on medication and then making the
comparison. There are a lot of kids who take these medications who do not
commit violence. If you want to look at people that have risk factors, you have
to do scientific studies."
Few professionals who are familiar with the data would argue with that
criticism, but one may question how such a study can be conducted, as suggested
by Carroll, if the information about whether a student is on prescribed
mind-altering drugs is regarded as a state secret. And, even when such
information is made available for study, it appears that little use is made of
it.
Take, for instance, the Secret Service, which in collaboration with the U.S.
Department of Education and the National Institute of Justice last year
produced a report on how to prevent school violence. The Interim Report on the
Prevention of Targeted Violence in Schools was made public in October 2000,
involving "systematic analysis of investigative, judicial, educational and
other files and interviews with 10 school shooters."
Although researchers reviewed primary-source materials such as investigative,
school, court and mental-health records and conducted supplemental interviews
with 10 of the attackers, no mention was made in the report about prescription
medications of the kind that Insight has collected. Nor did the Secret Service
respond to Insight's questions about why that issue was not addressed at the
conference or made part of the report.
Despite the fact that two federal law-enforcement agencies had the opportunity
to view the personal files of many of the school shooters, important medical
data gleaned from those files apparently was ignored. This has caused many
interested in this issue to wonder, like San Diego's public defender, when the
public has the right to know such information.
Not surprisingly, while every professional interviewed for this article
expressed concern about the privacy rights of children, there also was concern
about the use of mind-altering prescription drugs. Most are beginning to wonder
at what point communities into which disturbed children are sent while on
psychotropic drugs should be alerted to a potential problem.
JoAnne McDaniels, acting director for the Center for the Prevention of School
Violence, an organization focusing on keeping schools safe and secure, tells
Insight, "There is concern on the part of some in the education community
that we are overmedicating our youngsters - that it is easier to drug them into
appropriate behavior.
"It is important to recognize that the schools today have children that
are being medicated in ways that children were not years ago. We shouldn't be
too quick to isolate psychotropic drugs as a causal factor, but it is an
important factor in trying to understand what is taking place. In a general
sense, in a school population, parents should be able to see this
information," McDaniels says. "If a parent moves to a community and
wants to know the numbers of children who are on these drugs, making such
numbers available would not necessarily violate confidentiality of children. I
think as long as the information is not individualized it should be information
a principal is comfortable providing. It may force the principal to explain how
the school handles the entire violence issue and the use of medication to
control behavior in the school. It's reasonable for a school to share that
information and a parent to ask for it. It's part of the school community and
part of the school's fabric."
"The message," concludes McDaniels, "is that we need to develop
youngsters without stimulants and other foreign substances. Too often we are
opting for a way of treatment that is a lot easier to implement than sitting
down and working out the problems. This is a public-health issue and it seems
reasonable to look at it."
James E. Copple is vice president of the National Crime Prevention Council, a
nonprofit organization that focuses on creating safer communities by addressing
the causes of crime and violence and reducing the opportunities for crime to
occur. He is a former principal and superintendent of schools in Wichita, Kan.,
and sees the merits of both sides of the issue. "I tend to lean on the
side of doing everything possible to protect the student's right to
privacy," he says, "but when they commit an act of violence all the
factors involved in the crime - including medications - need to be known by
that community."
As Copple sees it, "Communities need to know if large numbers of children
are on psychotropic medications. It is increasingly being talked about by
educators, and it has put schools in the position of creating mini health
clinics for drug management on top of having to teach the children and all the
other responsibilities. Why all of a sudden do we have to be a pharmacy? Principals
are forced to choose between hiring another much-needed teacher or another
nurse to dispense drugs."
The executive director of the National School Safety Center, Ronald Stephens,
isn't convinced that releasing information about the number of students being
prescribed mind-altering drugs necessarily is a violation of a child's rights.
"It's legal and it's become common practice to search lockers whenever the
student is involved in an incident, and there are some states now mandating
that teachers be given information about the reasons behind a student who is
returned to school on probation. It's the thought that if you're going to put
Charlie Manson in my class I have a right to know that."
According to Stephens, "We tend to get what we measure. But if we don't
ask we're not going to get real answers. We have kids so medicated it's
incredible. I don't see parents asking the question about the numbers of
children on psychotropic drugs as being all that invasive. The public would be
shocked at the number of file drawers of prescription drugs that teachers are
asked to dispense." Stephens says he thinks "it would be a great
study for someone to go back and see how many of the kids who committed these
violent acts were on these drugs. The community should know who is taking them,
and I think teachers will want to know which kids are on these drugs. Knowing
what I know about school violence, I would support having that information
shared. Of course, there will be a huge outcry that someone's rights are being violated,
but at what point do they lose those rights?"
That is of course the question, and with 6 million to 8 million children
already taking Ritalin, and unknown millions being prescribed the much stronger
mind-altering SSRIs, many are starting to ask it.
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