Mental health is in the news again in the most heartbreakingly tragic way.
The revelation that the shooter in Lewiston, Maine, exhibited mental health issues for months prior to killing 18 people has renewed the discussion of red flag laws, yellow flag laws, the adequacy of our mental health system, coordination between law enforcement, the military and mental health providers, and the use of involuntary commitment as preventive measures to gun violence. While law enforcement and psychiatric treatment were involved with the shooter prior to the tragic events, it was not enough to stop him.
For many months prior, Robert Card was broadcasting clear signs of a mental health crisis. Nearly everyone he knew – friends, family, coworkers, fellow reservists – understood that he was hearing voices. Card said that the voices were giving him commands and/or persecuting him, which indicates a complicated diagnosis that is very difficult to treat. If he was experiencing command hallucinations telling him to kill people, that is the highest risk. The people who cared about him called the military and law enforcement, which was appropriate because he possessed dangerous weapons, but he needed mental health crisis intervention. We know that people with serious mental illness who are receiving treatment are not more likely to commit violence than the general population. However, left untreated and especially when there are command hallucinations (voices telling someone to kill themselves or others) and persecutory delusions, mental health professionals know that these symptoms indicate high risk and the need for urgent intervention.
Maine governor Janet Mills is quoted as wanting to know “what more could have been done to prevent this tragedy from occurring” according to an AP report published by multiple sources. In the aftermath, many missed opportunities have been identified that may have prevented this tragedy. Governor Mills has called for a comprehensive investigation to uncover the lessons learned so these opportunities aren’t missed in the future.
The question is, can a tragedy like this happen here in Newport County?
In fact, there was a Newport connection to a mass shooting in 2013. The 34-year-old Washington Navy Yard shooter, Aaron Alexis, called the police who responded to a Newport hotel where he was exhibiting similar persecutory delusions 40 days before he would bring a shotgun into the Washington Navy Yard, killing 12 and injuring 18. Between this encounter with local police and the shooting, he was treated in two Veterans hospitals and released. Another similarity is that in both the Lewiston and the Washington Navy Yard shootings the local community mental health resources were not contacted.
What is different here now?
Newport County public safety officials work much more closely with our local community mental health resources. Thanks to the advocacy of Chief Pesare in Middletown and others, all Rhode Island Police Officers are now trained in Mental Health First Aid to better identify the signs and symptoms of serious mental illness. Officers in our area police departments are also in the process of being trained in the Crisis Intervention Team (CIT) Model, another evidenced-based approach that promotes strong community partnerships between police, behavioral health providers, and people with mental and substance use disorders.
Newport Mental Health (NMH), as a Certified Behavioral Health Clinic, provides 24-hour mobile crisis clinicians to respond to behavioral health crises in our community. These crisis clinicians are located in the dispatch center for the Middletown Police after hours to respond with all Newport County police to behavioral health 911 calls. Additionally, NMH has a second level of response with three Rhode Island Outreach (RIO) staffed vans on the road from 7am to midnight to respond to people in behavioral health crisis who reach out through 988 calls or our help line (401-846-1213). The cooperation between our community, the mental health system, and the police is a model partnership in Rhode Island.
For more than a decade, NMH has also developed a strong collaboration with the Veterans Administration in Rhode Island, as well as other veterans organizations. In 2022, NMH launched progressive Veterans Outreach programming that includes support groups, walk-in counseling, and mobile outreach.
On the legislative side, Rhode Island passed one of the most stringent Extreme Risk Protection Orders in 2018. This is commonly referred to as a “Red Flag Law” and through the leadership of Senator Jack Reed it was used as a model law and incorporated in last year’s federal Safer Communities Act. This allows a law enforcement agency to file for temporary removal of a firearm upon receiving credible information that a person poses an imminent threat with a firearm. It was used 128 times in Rhode Island during the first four years following enactment, but as of July 2022 (the last information available) it has never been used in Newport County. The good news is that this law is available but more training and support on when and how to use it may be warranted.
It’s important to note that clients never leave an interaction with Newport Mental Health without a next step. We have a multidisciplinary staff who work as a team to either provide or connect clients with psychiatric treatment, rehabilitation, and support services. Housing issues, transportation, access to medications, or more intensive care or hospitalization are examples of the services we “wrap around” our clients to ensure they get the ongoing care they need.
Will these efforts insulate us from a mass shooting in Newport County? There are no guarantees, but we hope this high level of resources, training, and collaboration will bridge any gaps experienced in the past and reduce the likelihood significantly.
If you or a family member require outreach or assistance, please call Newport Mental Health at 401-846-1213 or call 988. Veterans are encouraged to contact Erika Westbrook, NMH’s Veterans Services Coordinator, at 401-846-1213 x1254.
