Anonymous wrote:You make some good points. However, from the article it appears that Adam had no involvement with the mental health care system past the age of 14 or so. Multiple trials of medication are often required to find something that works. The nurse apparently told them Adam had a biological disorder that required medication, and expressed concern that he was not taking meds. At that point, who was responsible for ensuring that Adam received proper care? He was 14. There is no mention of further mental health care involvement after that point.

What I find troubling is Mr. Lanza's assertion that nothing could have prevented this tragedy. Do you think that's the right message to send?

There is no one alive who fully understands what happened and why, including Mr. Lanza. Thats the conclusion of the formal investigative report (and they talked with everyone, including Mr. Lanza) and thats the conclusion of everyone who has looked at the situation with professional expertise. Adam had an undiagnosed psychiatric disorder. He had some diagnoses, but not the full set. So while there was clearly an illness that contributed to what he did, no one knows what it was. There are theories but they are all guesses. There is also no one alive who understands why he picked Sandy Hook, specifically, and why mass murder. There are theories -- he went there himself, he was obsessed with mass murder -- but these are again guesses. The one person who knows is dead.

My point is that of course the tragedy could have been prevented but there is no one who knows how it could have been prevented. Mr. Lanza certainly doesn't. Which is why he is left to say he wishes his son had never been born. That is the one clear way he knows it could have been prevented. So I strongly disagree about any message being sent. Mr. lanza is telling the truth.

PP makes has an excellent for why Adam would not have gone through the extended hit and miss trials to find the "right" medication (if it even exists. Again, we don't know that any medication would have helped). Adam did try medication and he had an extreme negative reaction. I know from a medication trial with my DS that when he had an extreme negative reaction, it was YEARS before I was willing to try again with something. Unless you've seen your DC go through it, you don't understand. And Adam was a teen. he was old enough to be fully aware of the negative reaction and therefore not want to try again, and too old to force. How do you force a teenager to take medication? How?

I have one point to disagree with in PP's post. Lexapro is not just an anti-depressent, it is also used for anxiety. It is the first line medication, often, for both depression and anxiety. It tends to have a lower side effect profile than the other SSRIs.

You make some good points. However, from the article it appears that Adam had no involvement with the mental health care system past the age of 14 or so. Multiple trials of medication are often required to find something that works. The nurse apparently told them Adam had a biological disorder that required medication, and expressed concern that he was not taking meds. At that point, who was responsible for ensuring that Adam received proper care? He was 14. There is no mention of further mental health care involvement after that point.

What I find troubling is Mr. Lanza's assertion that nothing could have prevented this tragedy. Do you think that's the right message to send?

Anonymous wrote:Adam Lanza was an adult. How were his parents supposed to "hospitalize him.

+1.

What I thought was sad about the article was the ignorance that the father and the journalist displayed about the VERY COMMON problems that parents of the mentally ill have. I was surprised the journalist didn't ask the father more questions about the medication issue and that the journalist didn't elaborate with more context in the article about these problems as experienced in society. (The journalist certainly did elaborate about the medication in the individual case of Lanza.) The journalist certainly knows, as he has written frequently on mental health issues. Perhaps this is a result of the lasting stigma against mental illness. For a long time we have segmented off certain brain-based disorders like Autism as "real" neurologically-based disorders from "mental illness" which we still stigmatize as deficiencies of character or morals. Even the line between "real, brain-based" and "mental illness" is fuzzy because we know that many children with learning disorders or autism also come to experience depression, anxiety, etc. as a result of the social isolation and failure of society to properly treat and accommodate them and that "neurological" issues may also be co-morbid with mental illness (such as the OCD and anxiety in Lanza's case).

For example, medication is a major issue. Most mentally ill patients have to try numerous medications, some with serious side effects, before they find one that works, if ever. As a parent, I read the description of Lanza's medication attempt and understood why they might not have tried another medication. The severe side effects described, including a loss of touch with reality, would have made me, as a parent, hesitant to try again, particularly when often the next medication to try is in a similar class of medicines. I was also surprised to read that Lexapro was prescribed, which, IMO, was a totally inappropriate med to try in this situation (based on what I could see in the article). Lexapro is an antidepressant, and while it's one of a number of anti-depressants that are often prescribed for OCD, it's side effects would only reinforce the anxiety and sleeplessness mentioned in the article. (The sleeplessness, in particular, would have made me very wary of trying any antidepressant.) Perhaps things would have been different if the psychiatrist had offered sleep and anti-anxiety meds first instead of the anti-depressant.

Parents often find that they are not able to "force" their children to accept or comply with treatment -- this issue arises particularly in the teens and early 20s, when the child has become big enough to refuse but is often still supported and/or living with the parents. Many states will not "force" treatment or entry into a psychiatric facility unless the patient is a demonstrated imminent harm to self or others, and there was no history of this with Lanza (interest in violent games or events wouldn't be enough to meet the "harm to self or others" standard. Few states have "assisted outpatient treatment options" which are basically treatment plans forced through the state courts.

It's easy to see how the Lanza's didn't look into hospitalization or further psychiatric treatment. Autism and Asperger's are thought of as neurological disorders of the brain that result in, among other things, social dysfunction. As a parent, it wouldn't have been clear to me that a psychiatrist or psychiatric facility would have known how to treat Adam, particularly if the social isolation was seen as a result of Asperger's and not some other diagnosis like schizophrenia (which often shows as a symptom "flat" affect and social isolation).

Finally, I was saddened to see the reference to how Lanza "refused to accept the diagnosis". It is the experience of many family members of the mentally ill that their "refusal" to accept the diagnosis or accept medications is characterized as "denial" and this is often reinforced by physicians and other health professionals. (I thought this outlook characterizing refusal as "denial" was clearly evident in the nurse's comments that "Adam likes to believe he's completely logical, in fact he's not at all and I've called him on it.") "Anosogonia" is the term that describes a patient's lack of comprehension of their deficits. It is not denial, but rather a real, brain-based, inability to recognize the deficit in full and its implications. How I wish Adam Lanza had had the good fortune to come across a health professional more familiar with anasogonia and prepared with appropriate techniques to guide Lanza toward medication trials and acceptance -- someone like Xavier Amador, perhaps.

It's vey easy to look at the situation and blame the parents for not "insisting" on medications, but the reality is more complex than that.

So you want to blame the father because he's the only one alive? Adam Lanza was an adult. How do you hospitalize someone like him against his will? Sure, we know now that he was a danger to others, but how would his parents? And even if they did, do you know how difficult it is to have someone hospitalized involuntarily? And for what a short period of time they will keep such a person?

So many know-it-alls on this thread. As others pointed out, there is no medication for AS, the medication they discussed was for anxiety/OCD, AND you can't force an adult to take medication.

Very easy for all of you to sit back and act as if you know the answers. Half of you don't even know what Aspergers is.

Anonymous wrote:

Anonymous wrote:Once you are 18, you can't be held against your will in a psychiatric facility unless there is irrefutable proof that you are an imminent danger to yourself or others. There was no proof of that before the incident.

Was Lanza even seeing a psychiatrist or psychologist regularly so that someone would have been aware if he had these tendencies?!? He only communicates with his mother via email and lives in the basement with all the windows covered with garbage bags... The New Yorker article isn't clear if he was under regular psychiatric care and Peter Lanza who hasn't seen his son in two yrs says no one saw any violent tendencies.

A teacher apparently did write a report saying that Adam had "disturbing" violence in his writing and that he was not normal, with anti-social issues." The New Yorker piece mentions no follow up on the parents' part, but it's unclear if they knew of that report.

"All these professionals," the ones Mr. Lanza mentions, seems to be two psychiatrists, one who saw Adam at 13 and one who saw him at 14. He seems to have been 14 when medication was prescribed for him, which he did not take. There is no mention of any other mental health professional being involved with the family after that. If there had been, one would think Mr. Lanza would mention it.

Anonymous wrote:Once you are 18, you can't be held against your will in a psychiatric facility unless there is irrefutable proof that you are an imminent danger to yourself or others. There was no proof of that before the incident.

Was Lanza even seeing a psychiatrist or psychologist regularly so that someone would have been aware if he had these tendencies?!? He only communicates with his mother via email and lives in the basement with all the windows covered with garbage bags... The New Yorker article isn't clear if he was under regular psychiatric care and Peter Lanza who hasn't seen his son in two yrs says no one saw any violent tendencies.

Once you are 18, you can't be held against your will in a psychiatric facility unless there is irrefutable proof that you are an imminent danger to yourself or others. There was no proof of that before the incident.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Bless this dad's heart, but calling his son "evil" rather than "mentally ill" is a huge part of the problem.

Failing to treat psychiatric disorders, including ASDs, are a major cause of violence in our society. Our prisons are full of people with mental health problems who committed crimes because they have mental health problems. If people want to do something after an event like Sandy Hook to stop it from happening again, educating society about the need to treat psychiatric disorders, creating a template for what families should do about children and adult children with psychiatric disorders would be a place to start.

Additional resources would also help, but the Lanzas weren't short on money. They just were clueless about what to do with it to help their son.

It's true that most kids with ASDs aren't violent, but some kids with ASDs are violent. It's true that most people with mental health problems aren't violent, but some are very, very violent. We need to address that fact squarely, without panic or scape-goating or witch hunting, and develop means to help those people.

Excellent comments here. Although most ASDs aren't violent, it's also naïve to describe them all as sweet. When they do act out or engage in harm towards others, it's often from a misguided perspective of others. Still, they can display violent behavior. Medication has helped many of them participate in typical school activities, but it seems that Nancy Lanza wasn't in favor of medicating her son. In this situation, I do think he needed meds.

It was recommended by doctors that Lanza be medicated for his severe anxiety not for his Asperger's. While anxiety (and depression) is commonly comorbid for Asperger's, there is no medication "just" for Asperger's itself - when someone with AS is on meds, it's always for a comorbid condition that medication can help like ADHD, anxiety, depression, etc.

ASD is not a mental health disorder but a developmental disorder. There is also no medication for treating ASD.

Exactly. According to the New Yorker article, Adam started medication, the psychiatric nurse said he had a biological disorder that required medication, and she expressed concern that he wasn't taking it. All those things suggest a diagnosis other than ASD. Yet his family allowed him to quit Lexapro after three doses and didn't try any other meds.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Bless this dad's heart, but calling his son "evil" rather than "mentally ill" is a huge part of the problem.

Failing to treat psychiatric disorders, including ASDs, are a major cause of violence in our society. Our prisons are full of people with mental health problems who committed crimes because they have mental health problems. If people want to do something after an event like Sandy Hook to stop it from happening again, educating society about the need to treat psychiatric disorders, creating a template for what families should do about children and adult children with psychiatric disorders would be a place to start.

Additional resources would also help, but the Lanzas weren't short on money. They just were clueless about what to do with it to help their son.

It's true that most kids with ASDs aren't violent, but some kids with ASDs are violent. It's true that most people with mental health problems aren't violent, but some are very, very violent. We need to address that fact squarely, without panic or scape-goating or witch hunting, and develop means to help those people.

Excellent comments here. Although most ASDs aren't violent, it's also naïve to describe them all as sweet. When they do act out or engage in harm towards others, it's often from a misguided perspective of others. Still, they can display violent behavior. Medication has helped many of them participate in typical school activities, but it seems that Nancy Lanza wasn't in favor of medicating her son. In this situation, I do think he needed meds.

It was recommended by doctors that Lanza be medicated for his severe anxiety not for his Asperger's. While anxiety (and depression) is commonly comorbid for Asperger's, there is no medication "just" for Asperger's itself - when someone with AS is on meds, it's always for a comorbid condition that medication can help like ADHD, anxiety, depression, etc.

ASD is not a mental health disorder but a developmental disorder. There is also no medication for treating ASD.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It seems like the remarriage, not the divorce, killed their relationship. So common in the SN world for the dad to move on and get a "life redo". Especially when the SN children are sons. I think a subset of fathers are ashamed of their "defective" sons and want to distance themselves.

Yeah, he got a "life redo" until his son sucked him back in by doing what he did.

I actually felt more sympathy for the dad before he did the interview. The article made it seem like the father was trying to distance himself even now and no other purpose. It certainly didn't answer why Adam Lanza did it.

17:36 again. I agree. The article is supposed to be about Peter Lanza searching for answers, but I didn't see much of that in the piece. Lanza wanted to control the narrative so he selected a sympathetic writer who didn't ask him any tough questions. Why didn't Solomon ask why the Lanzas let Adam give up on medication after trying one med for three days? Why didn't he ask if the family tried family therapy prior to or after the divorce? Why didn't he ask Peter Lanza if he was really okay with all those guns in the house?

Additionally, I think Adam's parents should have considered hospitalization for him. Perhaps they were consulting with professionals who don't support hospitalization except in the most extreme cases, but I don't think Adam should have been allowed to shut himself away in a basement and isolate himself within his own home to this degree. Doesn't seem much different from 100 years ago when those with mental illness were locked in an attic.

It is not at all clear from the Solomon piece that Adam's parents were working with any professionals at the time of this tragedy. The psychiatric nurse at Yale had expressed concern that Adam had a biological disorder that required medication. How many years elapsed between that and Sandy Hook? Were they working with any professionals at all following the Yale consult and Adam trying but not continuing medication? Maybe this information is available somewhere else, and perhaps they were working with someone, but the piece does not indicate that.

I had a cousin who was schizophrenic and while it's not easy, an adult can be hospitalized even if they don't agree. Now how long they can be hospitalized against their will is another question and procedures differ by state.

But it sounds like Lanza's parents never hospitalized him at all.

Adam Lanza was an adult. How were his parents supposed to "hospitalize him.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It seems like the remarriage, not the divorce, killed their relationship. So common in the SN world for the dad to move on and get a "life redo". Especially when the SN children are sons. I think a subset of fathers are ashamed of their "defective" sons and want to distance themselves.

Yeah, he got a "life redo" until his son sucked him back in by doing what he did.

I actually felt more sympathy for the dad before he did the interview. The article made it seem like the father was trying to distance himself even now and no other purpose. It certainly didn't answer why Adam Lanza did it.

17:36 again. I agree. The article is supposed to be about Peter Lanza searching for answers, but I didn't see much of that in the piece. Lanza wanted to control the narrative so he selected a sympathetic writer who didn't ask him any tough questions. Why didn't Solomon ask why the Lanzas let Adam give up on medication after trying one med for three days? Why didn't he ask if the family tried family therapy prior to or after the divorce? Why didn't he ask Peter Lanza if he was really okay with all those guns in the house?

Additionally, I think Adam's parents should have considered hospitalization for him. Perhaps they were consulting with professionals who don't support hospitalization except in the most extreme cases, but I don't think Adam should have been allowed to shut himself away in a basement and isolate himself within his own home to this degree. Doesn't seem much different from 100 years ago when those with mental illness were locked in an attic.

Anonymous wrote:

Anonymous wrote:Bless this dad's heart, but calling his son "evil" rather than "mentally ill" is a huge part of the problem.

Failing to treat psychiatric disorders, including ASDs, are a major cause of violence in our society. Our prisons are full of people with mental health problems who committed crimes because they have mental health problems. If people want to do something after an event like Sandy Hook to stop it from happening again, educating society about the need to treat psychiatric disorders, creating a template for what families should do about children and adult children with psychiatric disorders would be a place to start.

Additional resources would also help, but the Lanzas weren't short on money. They just were clueless about what to do with it to help their son.

It's true that most kids with ASDs aren't violent, but some kids with ASDs are violent. It's true that most people with mental health problems aren't violent, but some are very, very violent. We need to address that fact squarely, without panic or scape-goating or witch hunting, and develop means to help those people.

Excellent comments here. Although most ASDs aren't violent, it's also naïve to describe them all as sweet. When they do act out or engage in harm towards others, it's often from a misguided perspective of others. Still, they can display violent behavior. Medication has helped many of them participate in typical school activities, but it seems that Nancy Lanza wasn't in favor of medicating her son. In this situation, I do think he needed meds.

It was recommended by doctors that Lanza be medicated for his severe anxiety not for his Asperger's. While anxiety (and depression) is commonly comorbid for Asperger's, there is no medication "just" for Asperger's itself - when someone with AS is on meds, it's always for a comorbid condition that medication can help like ADHD, anxiety, depression, etc.

Anonymous wrote:

Anonymous wrote:Read the New Yorker piece. It's eye opening.

+1 I recommend people read the entire article before commenting on it.

+2