Sunday, November 18, 2012

"I guess my first thought was: Oh, dear God, thank you for letting him not kill anyone and maybe now he'll get the help that he needs," Lana Hunt told reporters.

(Nov. 15, 2012) Raulie Casteel, 43, is a husband, father, geologist and former company president. He is also currently behind bars in Michigan, accused of two dozen random shootings along a 100-mile stretch of the state’s I-96 corridor.
rauliecasteelNobody was killed, but one person was injured, and thousands were terrorized during the shooting spree. Casteel has been charged with 60 criminal counts and is being held on $2 million bond.
After Casteel’s arrest, his mother told the Detroit Free Press she started worrying that he was mentally ill a year ago when he began expressing paranoid thoughts.
"I guess my first thought was: Oh, dear God, thank you for letting him not kill anyone and maybe now he'll get the help that he needs," Lana Hunt told reporters (“Wixom man, 43, arraigned on weapons charges in Howell shooting,” Nov. 7). 
Incidents like this one – in which someone appears to “snap” midway through a stable, successful life – inevitably raise a number of questions. Here are three of them and their answers.
  • “If he was so sick, why didn’t he get help?” If it turns out that Casteel is suffering a psychotic disorder, there’s about a 50% chance he also was experiencing anosognosia – lack of  awareness of his illness. Anosognosia is the leading reason people with bipolar disorder and schizophrenia don’t seek treatment.
  • “How could someone be this ill after a lifetime without mental illness?” Though psychotic disorders usually first present in the later teens and early adulthood, they can strike at any time in life. Research suggests that violence occurs more commonly with a first psychotic break than with subsequent ones (“Comparison of first-episode and previously treated persons with psychosis found NGMI for a violent offense,” Psychiatric Services, july 2011). 
  • “What could have been done to prevent this?” Michigan has progressive mental illness treatment laws and standards that could have applied if Casteel met the criteria for civil commitment, but there have been no public disclosures that he did. Sometimes families are successful in persuading a family member to seek treatment voluntarily. Tragically, when neither voluntary treatment nor spontaneous recovery occurs, individuals simply continue to unravel until they attract attention by committing a crime, becoming homeless or reaching such an acute stage that involuntary treatment becomes a clear imperative. In cases where an individual cannot or will not seek voluntary treatment, families, community members or mental health professionals might need to intervene by invoking the state’s mental health treatment laws.
If you or someone you know has a loved one whose behavior suggests the onset of mental illness, visit Be Prepared for an Emergency on our website for suggestions.
For essential information about getting an emergency evaluation wherever you live, see "Emergency Hospitalization for Evaluation: Assisted Psychiatric Treatment Standards by State."

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