Expert: Jennifer - 6/26/2008

Question
My brother recently shot and killed his girlfriend and then himself.  This came after months of repeated attempts, threats that he was going to do this and not go alone, after being diagnosed as bi-polar, after being repeatedly hospitalized, after having tested positive many times for abuse of several drugs and alcohol.  He had been arrested for carrying a loaded gun in his vehicle while telling everyone that he was going to shoot himself.  He had recently lost his job, was going to lose his driver's license.  He had called suicide hotlines and had been picked up and taken by the police to the hospital.  He had assaulted my parents, cut himself off from the rest of the family. He had told his ex-wife that he didn't want to die, but that it was the only way, and he wasn't going to do it alone. His primary care physician was concerned enough to call him out of work to come to her office and sent him to a psychiatrist. The hospital papers show that he was clearly suicidal; however when the police told my parents to go to the court and file a petition for involuntary hospitalization, telling the court that they were afraid that he would kill himself and possibly others, they were asked what made them think that they could hospitalize a 37 year old man, told that the police shouldn't have told them that they even had that option.  Where did this all take place?  In Michigan, where Kevin's Law is in effect.  NAMI has a petition form on their website for involuntary hospitalization. All suicide information one reads lists the "at serious risk" signs as having a mental disorder, substance abuse, loss of a job, depression, making multiple threats, making serious suicide attempts.  Why do health care professionls not take these signs seriously?  What would one have to do to make someone take these signs seriously?  As a result of the lackadaisical attitudes of the health care professionals, there are two children without a mother, one without a father.  There are two families living a nightmare.  I know that hospitalization doesn't always prevent a tragedy like this, but at least it is an attempt to help the person.

Answer
 The toll that what happened with your brother has had on your family, the family of his ex (wife?), and the unknown cost that it will be for the children that this situation has left without their parents and no explanation is something that shouldn't have happened.  What makes things worse is the fact that the same kind of thing is happening all over the country, even in states where laws have been passed that should have prevented these tragedies.  There is no one specific person that can be blamed for failing your brother and your family in this, because each step of the way had its contribution to the final outcome.  The police, the doctors, the court, the people who answer the phones for the suicide hotlines -- each separate point could have done things differently that may have prevented your brother from ending his life and the life of someone that had given him children -- because he didn't want to do it alone, which he has chosen for his children.
 At this point, there are two options that you can choose.  You can allow feelings of anger, pain, and frustration to consume your entire life, and prevent any possibility of acknowledging things that should make you happy or appreciate being alive.  Or, you can take your family's experience and use it to do something proactive to change things so that other families do not have to go through the same things.  Even in Michigan, where Kevin's law was passed, the process of having someone involuntarily committed because they are a danger to themselves and others is not easy.  It seems unusual that the court would have responded in the way you indicated, unless some part of the procedure was not completed or was not done in the manner required.  While this action by the court was obviously a poor decision, even a judge must follow the rules established within the laws of the state and federal government.  Doctors must see three to four times the number of patients within the same amount of time that they've always had, which means that they must rely upon the patient when it comes to information about problems that were dealt with by another doctor.  When someone is acting in ways that clearly indicate that they are not well, starting this person's treatment is something that doctors take very seriously, but they cannot make someone do what is in the best interest for their health and the wellbeing of others around them.  Help can come in many forms, even in the time after a tragedy has occurred, but what happens now is up to you.  

Good luck, and hopefully you and your family find peace and strength in each other