James Eagan Holmes Psychiatrist Warned, But Was Ignored, Before Aurora Shooting

James Holmes, the man responsible for killing 12 people and wounding 58 in, the Aurora, Colorado movie theater shooting on July 20th, is not the first person to be suspected of being a threat -- then ignored.

In 2007, Seung-Hui Cho, the man responsible for the Virginia Tech Massacre, was adjudicated (declared by a judge) as mentally unsound. He was also suspected to be a threat when during the last two years of school. There were several instances of abnormal behavior and he submitted writing and plays that depicted violence that worried classmates and teachers. 

But nothing was done until after tragedy struck, when the state of Virginia finally decided to close some loopholes by not allowing those "adjudicated as a mental defective" to purchase handguns without detection, and adding the stipulation to the National Instant Criminal Background Check System (NICS), developed by the FBI. I only say some, because this does not allow those diagnosed with a serious mental illness to be placed on the NICS index, only those judicially declared as mentally troubled.

Much blame was placed after the Virginia Tech Massacre -- from blaming the misinterpretations of privacy laws and gaps in Virginia's mental health system, to blaming the educators and mental health professionals who came into contact with Cho and failed to notice his worsening condition. But aside from the addition to the NICS, what really changed between 2007 and 2012? Nothing is sadly the answer.

I can't pretend to know what goes on during sessions between a person and their mental health provider. But it seems that there were enough disturbances for Dr. Lynne Fenton, Holmes' psychiatrist, to warn a University of Colorado threat-assessment team in June that he could be dangerous. 

Nothing was done because Holmes dropped out of school soon thereafter. Though Holmes was no longer under the jurisdiction of the school, the Behavioral Evaluation and Threat-Assessment (BETA) should be legally required to notify local police officers. The state of Colorado allows for involuntary holds when there is concern of harm (either to self or to others), known as an M-1, or a 2710. Many states have such laws. Such a hold can be enacted by law enforcement. Surely, after hearing about Holmes' apartment in the news in the days after the shooting, red flags would have been raised had police been privy to such information beforehand.

In cases such as this, it becomes clear that there is also a slight issue with the Health Insurance Portability and Accountability Act (HIPAA) in regard to privacy laws. HIPAA states, "Providers may disclose PHI [protected health information] that they believe necessary to prevent or lessen a serious and imminent physical threat to a person or the public, when such disclosure is made to someone they believe can prevent or lessen the threat (including the target of the threat)." They may, not they must, not they are required, and not it is mandatory. Such delicate wording may seem trivial, but it is necessary to realize that nearly anything and everything is always up to interpretation, and that when it comes to assessing a danger, the wording should be -- for lack of a better word -- bulletproof.

Holmes slipped through the cracks provided by policy loopholes. So what the person sitting in the chair should do? They should advocate for easier methods of reporting a patient they believe could actually be dangerous, as well as more clemency and less harmful punishments if they are wrong. 

It is impossible to say that there could be a list of possible stock methods to preventing such tragedies from occurring again, because humans often defy what we know to be logical reason. Ultimately, there is no easy way to go about knowing if the client or patient sitting across from you will one day be responsible for murdering a dozen people. It is, however, up to and the responsibility of the professional with close contact to read the signs, take every thought or expression seriously, and be aware that no disturbing hint or feeling should go ignored, because it could save lives.