Need to force treatment often is apparent too late

The picture emerging of the gunman in the Virginia Tech massacre is that of a severely mentally ill young man, prompting questions about why he wasn't forced into treatment that might have prevented this week's bloodshed.

Even as it appears that Cho Seung-Hui fell through the cracks of Virginia's mental-health system, Utah experts say it is often the case that such evidence is put together after the fact when it is too late to prevent tragedy.

"The hard part is, nobody has a crystal ball," said Jed Ericksen, associate director of adult services for Valley Mental Health. "We all know now that this guy at Virginia Tech was dangerous."

University officials sought judicial intervention for Cho in late 2005 after an acquaintance reported he might be suicidal. A court-ordered evaluation found that Cho represented a danger to himself or others as a result of mental illness and eventually recommended outpatient treatment for the young man.

Such a recommendation would be likely in Utah, Ericksen said, where being "committed" under the state's civil commitment law doesn't necessarily mean being locked up.

"It's important to realize that commitment in Utah is not necessarily to a place or a facility, it's really a commitment to treatment," he said. "Most of the people in Utah who are committed are in the community."

The process can be difficult, Ericksen said, because it requires striking a careful balance between protecting public safety and safeguarding the person's individual rights. "At what point do you step in and take away someone's civil liberties based on the hypothesis that they could become dangerous?"

Civil commitments in Utah generally begin with an encounter with law enforcement or through friends or family members who believe a person's mental illness presents a danger to himself or others. The law allows for emergency detention of up to 24 hours for that person. After that, authorities must release the person or seek a court order for continued detention.

If detention is sought, a court hearing must take place within 10 calendar days and include testimony to support five criteria, including: The person must suffer from a mental disorder that substantially impairs physical and behavioral functioning; the person must pose a substantial risk of physical injury to himself or others; and the person must be found incapable of making a rational decision regarding his need for care and treatment.