The rush to institute increased mental health services in Connecticut, initiated in response to the shooting at Sandy Hook Elementary, is troubling for a number of reasons.
The most obvious problem with the rush to legislate costly mental health services, based on the horrific events at Newtown, is that there is no publicly available data to support the need for increased services.
The 6,000-page State Police Report is, well, embarrassing. Beyond the great majority of the report having been redacted, the information that is provided about Adam Lanza’s mental health treatment ends in 2007 – five years before the shooting incident.
But, even the mental health information that was provided about Adam Lanza is limited and, based on recently released information, contradictory. First, though, it’s important to understand what was made available in the State Police Report.
According to the report, Nancy Lanza was actively involved in getting her son all the mental health services available. Between the ages of 5-15 Adam received extensive and continual mental health services. During that time, Lanza had seen several psychiatrists, participated in school mental health specialty programs, was prescribed psychiatric drugs and was even treated at two hospitals, Lehey Hospital in Massachusetts, and the psychiatric department at Danbury Hospital.
In fact, anyone reviewing the limited number of records available would agree that Adam Lanza was not a child who fell through the cracks of mental health services. On the contrary, it appears that Lanza received the best mental health treatment money could buy.
The question that one cannot help but ask is, if Lanza received the best mental health could offer, did that mental health “treatment” contribute to Lanza’s violent behavior? Let me explain.
According to the Police Report of the incident, between October of 2006 and February of 2007, Lanza was treated at the Yale Child Study Center where he was diagnosed by Dr. Robert King as suffering from a “profound Autism Spectrum Disorder” and “Obsessive Compulsive Disorder.”
A nurse at the Yale Child Study Center, Kathleen Koenig, prescribed “a small dose” of Celexa (an antidepressant) to Adam. Immediately after taking the drug, Nancy Lanza contacted Koenig to report that she believed Adam was experiencing an adverse reaction to the drug, telling Koenig that Adam was “unable to raise his arm.”
Rather than advise Nancy Lanza to discontinue the mind-altering drug, Koenig told investigators that she “attempted to convince Nancy Lanza that the medication was not causing any purported symptoms.” Koenig further told investigators that to her reasoning Nancy Lanza was “not receptive.”
After reviewing the adverse reactions associated with Celexa, it appears that it is Koenig who is being unreasonable and completely uninformed. According to the side effects associated with Celexa, “stiff, rigid muscles” is listed as one of the serious side effects, which certainly appears to be what Nancy Lanza was trying to explain to Koenig.
Because Nancy Lanza chose to discontinue the Celexa and never returned to the Yale Child Study Center, Koenig labeled Nancy Lanza as “non-compliant.”
Until a few weeks ago, the above was the extent of the detailed information available about Lanza’s mental health treatment. On March 17th, The New Yorker magazine ran an article by Andrew Solomon titled The Reckoning. Solomon had landed the first interview with Peter Lanza, Adam’s father.
Although there was very little in the way of new information, the author did reveal that Adam Lanza had been prescribed a second antidepressant, Lexapro. This is important information as it conflicts with information provided by Yale Child Study Center’s Kathleen Koenig.
According to Solomon, while seeing Koenig, “Adam tried Lexapro,” which had been prescribed by his primary psychiatrist, Paul Fox. Solomon reports that Nancy Lanza also contacted Koenig about this adverse reaction, complaining that “on the third morning he complained of dizziness. By that afternoon he was disoriented, his speech was disjointed, he couldn’t even figure out how to open his cereal box. He was sweating profusely…it was actually dripping off his hands. He said he couldn’t think…he was practically vegetative.” Nancy Lanza also wrote later that same day “he did nothing but sit in his dark room staring at nothing.”
Wow, certainly sounds like an adverse reaction to a drug and, after reviewing the side effects associated with Lexapro, dizziness and sweating are, in fact, adverse reactions to the drug. But what did Koenig have to say about Nancy Lanza’s concerns?
According to Solomon, “Adam stopped taking Lexapro and never took psychotropics again, which worried Koenig.” Solomon reports that Koenig wrote, “while Adam likes to believe that he’s completely logical, in fact, he’s not all, and I’ve called him on it.” Solomon further reports that Koenig told him “he had a biological disorder and needed medication.” “I’ve told him,” said Koenig, “he’s living in a box right now, and the box will only get smaller over time if he doesn’t get some treatment.”
There are several problems with the information provided in Solomon’s article. First, recall that after Adam’s adverse reaction to Celexa Koenig told investigators that Adam did not return for treatment to the Yale Child Study Center. Now, Solomon is reporting that Adam not only was prescribed Celexa, but also Lexapro and had adverse reactions to both.
Why, if Koenig was involved in Adam’s follow-up treatment, did she fail to provide investigators with the information about the adverse reaction to the prescribed Lexapro?
Additionally, while Koenig believed Adam had “a biological disorder” there is no scientific/medical data to support that any psychiatric disorder is an objective, confirmable abnormality. Apparently Koenig is unfamiliar with the adverse reactions of prescribed psychiatric drugs, and also the subjective nature of psychiatric diagnosing.
As an interesting side note The New Yorker’s Solomon, although writing about the serious adverse reactions associated with the antidepressant, Lexapro, failed to disclose that his father, Howard Solomon, is the CEO of Forest Laboratories, the pharmaceutical company that makes Lexapro and Celexa.
At the end of the day, the argument comes full circle. That Adam Lanza was prescribed and taking two psychiatric mind-altering drugs in 2007 does little to explain his murderous actions five years later. But based just on this limited information, it appears that Lanza had an extensive psychiatric drug history one which the powers that be don’t want made public.
It also is abundantly clear, despite the media’s attempts to somehow demonize Nancy Lanza, this was a mother fully engaged in finding help for her son’s obvious behavioral and emotional problems. Frankly, what is becoming clear is that Nancy Lanza tried to work with the mental health “guessperts,” only to be repeatedly dismissed for raising concerns about Adam’s “treatment.”
Given that the last five years of Adam Lanza’s mental health records still are being withheld, Legislators in Connecticut and throughout the nation have no information that would signal a need for costly increased mental health services.
Based on what little information has been provided about Adam Lanza’s mental health care, it appears that he had access to the best. And if Adam Lanza was receiving the best mental health care services, what, then, does that suggest about the kind of psychiatric treatment available?
Of course, without full disclosure of his medical/mental health records, there is no way to fully understand what, if any, changes to mental health services are needed. This is a disservice to the people of Connecticut and any other state legislating increased mental health services in response to the Sandy Hook shooting.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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