Being that Virginia has a system alleged to be worse than ours [I speak about WA.]it could be that there was not a proper assessment done with regard to Cho's presentation of "mental illness".There are 2 things to consider here. One, was he evaluated by a mental health team, which includes a psychiatrist. Two, he would have had to present a dangerous disposition to himself or others before he got there or while being observed there. And tossing in a 3rd point, inpatient beds are scarce, though one can be detained in an ER for that purpose until a bed opens up. Also, lack of insurance plays a large part as well, so all of these things together would have determined gaining Cho and bed and a shot of Haldol. If he didn't appear aggressive enough those things just don't happen.He could have shown up "out of his mind" and unless violent to the screening team, he and most people are sent home. Until dangerous enough to be held/detained. So in this way, the system did not fail Cho, the psychiatrist either. It is like waiting for a switch to flip and it becomes a wait and see situation, and in this case Cho flipped a switch, and with such magnitude and pre-planning, coherent enough to create video tapes, and carry out a plan, this causes me to categorize him as a cold-blooded killer, his reasons we will never understand, and authors and such should be wary of broad brushing Cho as "mental patient who was not taken care of properly in the system". The system, and people who work in it cannot lock someone up or force medication on anyone just because they "appear" a certain way. It's actions that get a person locked up.

Cho did have a bed in a psych. unit, but he was only there for 14 hours. His independent "evaluation" lasted all of 15 minutes and since he arrived at night, the hospital staff never got to evaluate him at all as his hearing was held the very next day. It seems that this county has an unusual way of handling commitment hearings, they hold them on Mon., Wed. and Fri. irrespective of when people arrive in the hospital on a temporary detention order. Most hospitals hold hearings every weekday, so they aren't so rushed before the hearing and actually have 48 hours to evaluate the person.

Virginia's community mental health system is both vastly underfunded and more importantly in my opinion, accountable to no one. Each community service board provides different services, they are not held to any real standards, the only service they all have to provide is emergency services and even there many just provide an answering service on weekends and evenings. More funding won't solve our community mental health crisis without both accountability and consumer input into what services are required/available. Our biggest waiting lists are for counseling and yet the CSB's never ask for more money for counseling which is reimbursed at so low a level they lose money providing it.

As many have said, you can't commit folks to a non-existent system.

Despite the continued "underfunding and understaffing" Americans are told ad nauseam that our mental health system is being transformed to one predicated on the principles of Recovery and Wellness. We have experienced this before when all services were evidence based and even earlier when all services were predicated on the principles of psychosocial rehabilitation. It must be difficult to live in the Potemkin Village of Recovery and Wellness when mental health services rarely evidence either.

A 1964 Chevy doesn't become a 2008 Cadillac simply because one slaps on a new decal nor is an under-resourced mental health system transformed simply because the names have changed. I was a patient, then a client, and then a consumer but the only thing that changed was my medication, Anonymous.

National Consensus Statement on Mental Health Recovery: 10 Fundamental Components of Recovery
http://mentalhealth.samhsa.gov/publications/allpubs/sma05-4129/

re:"state's programs are likely underfunded and understaffed"
More Government funded psychiatry?

Where are the defenders of liberty and justice?

Only sane people have the ability to go around killing? If one is insane, he/she should be locked up (by the government) for the safety of its citizens. If one is free to pursue life and liberty he/she must be assumed sane. If there is a third status (mental patient on probation FOR LIFE, forceably medicated), how different is that status from slavery?

The founding fathers of U.S.A. wrote that the Government and Religion should be seperate."separation between church and state"

People believe mental illness is disease , that medicine can treat the ill. Yet there is no lab tests for any mental illness, and psychiatric medical files are being used in place of criminal files. There is no way to prove or disprove the psychiatrists beliefs of their patient. Only criminal actions should be prosecuted. Mental patients and sane people, should have the right to think thoughts and beliefs they want to.

Since the general public now believe psychiatry is a science and medicine, (when in fact it isn't) it makes it possible for the Government to control its undesirable citizens. If psychiatry is funded further more liberty will be lost (without justice).

Szasz wrote"Most persons experience their coerced psychiatric treatment as punishment. That is why psychiatrists insist that the persons subjected to psychiatric coercion are psychiatric patients, not psychiatric victims; that psychiatric coercion is treatment, not punishment; and that individuals who oppose their "benevolence" are wicked enemies of caring for the sick, not defenders of liberty and justice. He who controls the vocabulary controls social reality."

Regarding Cho, and the Asperger's/mental illness angle, I found an abstract worth reading. It also references an abstract by Wozniak and Biederman.

Autism and Familial Major Mood Disorder: Are They Related?

"And it may not be amiss to think of autism, in some cases, as a chronic psychosis."

"The special case of Asperger's syndrome deserves attention. In our experience, as well as others, a majority of patients with Asperger's syndrome have clinically-evident major mood disorder by adolescence. An unexpectedly high proportion of individuals from family pedigrees of Asperger's patients have a history of social phobia, social withdrawal, or hermitism."

referenced: (11)Wozniak J, Biederman J, Faraone SV, et al: Mania in children with pervasive developmental disorder revisited. J Am Acad Child Adolesc Psychiatry 1997; 36(12):1646–1647[Medline]