GWEN IFILL: As the investigation continues into the Tucson shootings, new questions are being raised about whether alleged attacker Jared Loughner slipped through the cracks in the state's mental health system.
NewsHour health correspondent Betty Ann Bowser reports on some of the apparently missed signals.
BETTY ANN BOWSER: Well before Saturday's shootings, there were signs the alleged gunman had a troubled mental past.
Last year, Jared Loughner had five run-ins with campus police for classroom and library disruptions at Pima Community College. He was suspended in September on the same day campus police found a YouTube posting in which Loughner argued the school was illegal, according to the U.S. Constitution. Loughner officially withdrew from the college days later.
Then, on October 7, college administrators sent him a letter stating that, if he wanted to return, he'd need a letter from a mental health professional indicating his presence at the college doesn't present a danger to himself or others.
Classmates say Loughner was a troubled young man.
DON COOROUGH, former classmate of Jared Lee Loughner: I don't think he ever learned how to engage with the world socially and emotionally.
BETTY ANN BOWSER: Loughner's behavior in the months and weeks leading up to his withdrawal was worrisome. In his algebra class, he wrote "Mayhem Fest" all over his first quiz. He also blurted out random numbers and phrases, like, "How can you deny math?"
Ben McGahee his teacher.
BEN MCGAHEE, former math instructor of Jared Lee Loughner: This guy is not complying, unfortunately, and seems to be quite a threat to our class.
BETTY ANN BOWSER: One classmate, 52-year-old Lynda Sorenson, raised concern about his behavior in an e-mail released to The New York Times, writing in June: "We have mentally unstable person in the class that scares the living crap out of me. He is one of those whose picture you see on the news after he has come in to class with an automatic weapon."
In recent months, Loughner's online posts focused on written tirades against government, currency and even grammar on YouTube. Loughner also had two prior arrests on file in county police for the possession of drug paraphernalia in 2007 and vandalism in 2008.
CLARENCE DUPNIK, Pima County, Arizona, sheriff: There have been law enforcement contacts with the individual where he made threats.
BETTY ANN BOWSER: But Loughner was never convicted of a felony, and he managed to pass the instant background check required under federal law in November when he purchased a Glock pistol at this Sportsman's Warehouse in Tucson. One year earlier, Loughner was rejected from enlisting in the U.S. Army after he admitted to using drugs.
GWEN IFILL: Now we explore some of the questions about mental health care with three who work in the field, Dr. Anthony Lehman, chair of the Department of Psychiatry at the University of Maryland School of Medicine, Bonnie Sultan, a sociologist with the Center for crime prevention and control at the John Jay College of Criminal Justice in New York, and Brian Stettin, policy director for the Treatment Advocacy Center, a nonprofit that lobbies to remove legal barriers for mental health treatment.
Welcome to you all. Dr. Lehman, did the system fail?
DR. ANTHONY LEHMAN, University of Maryland School of Medicine: Well, I think we have to say it has.
Unfortunately, at least what we have heard so far about this man is it's an all-too-familiar story. As I understand, he began having problems as early as high school, dropped out of high school, and was identified as someone who was having problems, and then proceeded in some of the history that we just heard about with involvement with the police and problems in college, but never received, I guess as best we know, any mental health treatment.
We also heard the unfortunate comments of his family, his parents, who seemed to be confused about what was going on. And that part of the story here is all too familiar about the failures of mental health systems to respond to young people with serious mental illness. What, of course, is not typical is to result in this kind of violence.
GWEN IFILL: Bonnie Sultan, what do you think about that? Did the system fail Jared Lee Loughner, or was he so troubled, he would never have been caught?
DR. BONNIE SULTAN, John Jay College of Criminal Justice: Well, I think that not only did the system fail this young man, but the correct systems were not in place.
For example, we didn't have police or other first-responders in all of the interactions that he had become aware of mental illness, become aware of what the warning signs were. For example, if they had crisis intervention training, this would be an opportunity for this young man to be taken in to the mental health sector, as opposed to now in to the justice system.
GWEN IFILL: Brian Stettin, what do you think about that? Is it -- is it possible for just a layperson to have said, this guy is weird, and then call the cops and stop mayhem, or was this just something that was going to happen or something that was unpreventable?
BRIAN STETTIN, Treatment Advocacy Center: Well, I certainly wouldn't call it unpreventable, nor would I say necessarily that someone speaking up would have prevented it. We simply don't know.
But it would have at least given -- created an opportunity for it to potentially be prevented. And I wouldn't necessarily say that reports had to be made to the police, when the behaviors noticed were not necessarily criminal.
But certainly the regional mental health agency that serves that part of Arizona has a hot line set up for the receipt of information about people who seem to be in need of mental health care. And no calls at any time came in from any of the folks who have talked since about how disturbed they were by his behavior.
GWEN IFILL: Now, why is that? I mean, I know you can't get inside their heads, but how is it that someone who acted out so overtly, allegedly, all these cases, there was never a single complaint, even though he had a police record?
BRIAN STETTIN: You know, I think the sad fact is that it simply doesn't occur to people that that's something they ought to do.
And my hope is that, if one lesson really comes from this horribly sad case, it's that people will speak up and make a call when they notice things like this happening in their own communities. I think that if people see, for example, child abuse taking place in their community, there is a natural tendency in most people, I think, to want to report that and say something about it. But this is an area...
GWEN IFILL: But that's behavior. That's an action that has been taken.
BRIAN STETTIN: Well, this is behavior, too. Jared Loughner's behavior was troubling enough to people that someone said that they were sitting by the closest chair to the door in the classroom, in fear of what he was going to do next.
Someone else said that when they heard that Congresswoman Giffords was shot, that, immediately, it sprung to mind that this was the individual who did it. So, there were behaviors that were noticed here, too.
GWEN IFILL: Dr. Lehman, how reasonable is it to make the link between mental illness and violence?
DR. ANTHONY LEHMAN: Well, I think they're -- I mean, that's a tricky question. And when these things occur, that always comes up.
Certainly, it's certainly true that, at times, folks with mental illness commit violent acts. But the reality is that that's not necessarily that much more common than in the general population. There are certain characteristics associated with increased violence.
So I think there's this misconception that most people with mental illness are violent, and, vice versa, most violent acts are committed by people with mental illness. But when we have these conversations, I think it's important to, just as the prior speaker said, to reflect on: What are the ways to be more attentive to the signs? What are the ways to intervene?
And there are a variety of levels of intervention, certainly before even having to call the police, that can be done to help somebody who seems to be having problems. So, I would hope that the lesson that we go away from this with is to intervene and to be aware as early as possible, I would say, in a young man like this, perhaps in high school to be aware of students who are having problems and to begin to try to understand what's going on with those kids at that point, before it gets to the point it has here, and then also to remember, though, that most people with mental illness do not commit violent acts.
GWEN IFILL: Bonnie Sultan, I was struck by a number from the National Institute of Mental Health -- 20 percent of young people suffer some sort of mental disorder, and 36 percent of them, only 36 percent of them, get treatment. What kind of intervention are we talking about that Dr. Lehman is alluding to here?
BONNIE SULTAN: Well, the type of treatment that can happen first and foremost is an education, not only for the mental health consumer, but for the public.
As Dr. Lehman said, this was an opportunity for folks to see that there was a problem with this young man and to get him the assistance needed. So, what we could have had here was a real opportunity and education for folks to get themselves into mental health treatment.
What we see is, there's a large stigmatization of people with mental illness in this country. So, even though there is a population of people dealing with mental illness, they're afraid of shame, they're afraid that people will judge them or think that they're perhaps dangerous, and, therefore, do not seek that treatment.
But if we educate ourselves and the public, more people can get the assistance they need, as opposed to this young man, who did slip through the cracks and is now in the situation that he's in.
GWEN IFILL: Brian Stettin, once we have established that someone has some mental challenges, should they be then denied access to guns?
BRIAN STETTIN: You know, that's not an issue that my organization takes a position on, on specifically, and so I'm going to punt on that question, if that's all right.
GWEN IFILL: You're going to punt on that.
GWEN IFILL: Well, let me ask that to Dr. Lehman.
Do you think so?
DR. ANTHONY LEHMAN: Well, I don't think in a categorical way.
For example, there may be folks who have been treated briefly for anxiety or interpersonal relationship problems. They may have sought help in a mental health setting. In that kind of example, it's not clear that the intent here is to deny folks like that access to guns.
On the other hand, I think for folks who -- where there may be a risk, it needs to be assessed. And I think it does make sense in certain kinds of cases for folks not to have access to guns. But I think it's not as simple a question as one might think. And I'm not an expert on that policy.
GWEN IFILL: OK. Bonnie Sultan, I want to ask you about another thing. It seemed like he was crying for help by use of social media. Is this something that somehow we should have found way to track, to link, to interact, so we knew that all of these things were happening on all these different fronts?
BONNIE SULTAN: I think that it could have been something that someone with the education of mental illness would have been made aware of.
So, example, this is a young man who did try to put himself out there with social media. He was putting messaging out there. He was trying to join the Army. This is someone who was trying to go to school. And nobody really linked together that there was a problem with this young man.
So, certainly, when we're paying attention to social media, and if you're connected to social media and you see these issues happening with someone that you're connected to, this is a great opportunity to learn from this issue and to say, what can I do to help?
We need to start to take responsibility as a society and as a community as to what we can do to help our neighbors, as opposed to just read a Facebook status update or put a link up on YouTube. This is something that we can respond to and take the power back, and assist our neighbors, as opposed to letting them slip through the cracks, as they did in this situation.
GWEN IFILL: Brian Stettin, how do we link all of these different indicators together? At a time of financial stress, Arizona cut six $65 million from its mental health budget in the last -- since 2008. How do you begin to make all those indicators work together?
BRIAN STETTIN: Well, you know, in a time of fiscal restraint, such as we're in now, I think it becomes more important than ever to be smart about the services that we spend money on and make sure that we're not wasting money on services that people are not accessing.
A big part of the work that my organization does is promoting an intervention called assisted outpatient treatment, court-ordered outpatient treatment. And the reason that there is a need for court orders with respect to folks who are in the community and hopefully accessing services is because of something called anosognosia.
A lack of insight in to illness in many folks who have these very severe illnesses causes them not to understand that they're sick, not to believe they're sick, and to not access the services that are put in place.
And so, when you have services in the community that are available for people who are not accessing them, you are essentially wasting money or services that are not being used. And so, by leveraging the power of the court, we do a lot to ensure that the services actually reach the folks who they are intended for.
And I believe that's more important than ever, given what's happening fiscally.
GWEN IFILL: Brian Stettin, Anthony Lehman, and Bonnie Sultan, thank you all very much.
BRIAN STETTIN: Thank you.
BONNIE SULTAN: Thank you.
DR. ANTHONY LEHMAN: Thank you.