Navy Yard shooting: Dealing with the mentally ill

When Fairfax psychotherapist Linda McLaine witnessed the events at the Navy Yard Monday, her first thoughts were not about her husband, retired from the Navy, and their two children on active duty. They were about the people who witnessed the trauma and how much they'll need a professional ear to hear them out.

She also thought, from a mental health perspective, she doesn't know what else could've been done to prevent it.

"You can have as many safeguards as you want to, but sadly there's always going to be one," Dr. McLaine said.

Nearly 5 million Americans have government security clearance. According to the National Institute of Mental Health, one in four adults suffers from a diagnosable mental disorder. But Dr. McLaine argues, opening up mental health records for inspection would not make our world safer.

"No one would go to therapy if that were the case. I wouldn't."

Sixty percent of Dr. McLaine's clients are active military where, traditionally, there has been a stigma against seeking treatment for emotional issues, especially if it would mean threatening security clearance. She applauds the Department of Defense's approach to Question 21 on the security clearance questionnaire, which instructs applicants to mark "no" to ever having mental health counseling if the issue was PTSD. Particularly passionate about that topic, Dr. McLaine does pro bono work for Operation VetsHaven, a local non-profit group that offers free mental health help or legal counsel within 48 hours of a veteran's first call for help.

"If you have PTSD as a service connection, you should be treated for it. It's a national disgrace that we don't."

McLaine explains, unless a client of hers, military or not, makes a direct threat with a named victim, or reveals an actual plot, she is bound by confidentiality.

"You can see all kinds of red flags, but if there's nothing specific, you can't tell anybody. Whom would I tell? In the US, we work on fact, even though a lot of what we do is gut. And I don't know any way around that."

If she were to report a possible threat, she could lose her license. An innocent man could lose his security clearance, his work lifeline, his privacy, or worse.

But nothing binds a member of the public from reporting the problematic behavior of a friend, colleague, family member or neighbor, especially if that person is one of five million who has military security clearance or is being considered for it.

But Dr. McLaine adds, "The thing is, are they going to listen to you?"