Abraham Cardenas shouldn't be dead.
The little first-grade boy from over by Brockport.
He shouldn't be dead.
The mental illness which apparently drove his mother to stab and decapitate him should not have been allowed to rage unchecked and take its ghastly toll.
Here's the background: Last Thursday night deputies raced to a home from whence 9-1-1 calls had spoken of a suicidal woman with a knife. In the home with her were her two sons, her husband, and her husband's mother.
When police arrived, the woman -- Hanane Mouhib -- was violent and combative. It took pepper spray, Taser and force to subdue her and take her into custody.
It was after she was taken into custody that the disfigured body of her son Abraham was found.
It was an incredible heartbreak for the family and its friends, and for the first responders and investigators.
But it shouldn't have happened.
Hanane Mouhib, herself a psychiatric nurse practitioner, was keenly aware of her mental illness and had twice in recent days called the police for help with her difficulty.
On March 5, she called 9-1-1 in the midst of a psychiatric episode and Monroe County deputies took her to Rochester General Hospital on what is called a mental hygiene arrest, or a mental hygiene transport.
Typically, such an incident allows a person to be held for 48 hours to stabilize them, and to assess whether they are a risk to themselves or others.
If Hanane Mouhib was held for the full 48 hours, that means she was released from Rochester General Hospital on March 7.
On March 8, she called the deputies back to her home, again having psychiatric difficulties and wanting professional help. The Monroe County Sheriff's Office transported her again to Rochester General Hospital, where she remained hospitalized until March 26.
That was 10 days before she cut off her little boy's head.
And that sad outcome raises questions about the quality and effectiveness of the mental-health care she received at Rochester General Hospital, and whether or not she was tracked post-release for a return of symptoms.
Finding out will be difficult because of the federal privacy rules in HIPAA that end up covering for bad care more often than they protect patient interest.
Nonetheless, these questions need to be answered:
-- Had Hanane Mouhib's illness ever been violent before? Had she spoken of violent impulses during the course of her treatment at Rochester General Hospital? Had testing or screeing for violence been performed whileshe was a patient at Rochester General Hospital?
-- What medications was Hanane Mouhib on for her mental illness, and had these medications or their dosages been changed during her Rochester General Hospital treatment or during the weeks leading up to the murder of Abraham Cardenas?
-- What training or guidelines had been given to Hanane Mouhib's family to help them monitor or control her mental illness? Were any warnings of potential violent behavior given?
-- What was the threshold of stabilization or rationale for release that led to Hanane Mouhib leaving Rochester General Hospital? Did she check herself out or was it the decision of her doctors? If her departure was contrary to her doctors' medical judgement, was any sort of legal order sought to keep her hospitalized?
-- Did anyone treating Hanane Mouhib contact the state of New York about her illness under the guidelines of the SAFE Act? And if so, was that information transmitted to her family, alerting people to the fact someone thought she was potentially dangerous?
-- What post-release psychiatric care was set up for Hanane Mouhib? What sort of follow up took place? When, prior to her son's death last Thursday, was the last time she saw a psychiatric professional?
-- Was she taking her medications, and was there any mechanism to track that?
These are some of the questions that hope to get to an answer to how a woman who had twice reached out for help could end up so fundamentally unhelped.
Yes, it was Hanane Mouhib who decapitated young Abraham. Yes, this is an overwhelmingly devastating and heartbreaking event. But it is also either an illustration of the inefficacy of mental-health treatment in general, or a terrible lapse in that treatment in particular.
The murder of Abraham Cardenas is an undeniable failure of his mother's mental-health care. Had the treatment been effective, his mother's symptoms would have been tempered, or she would have been isolated so that they would not harm others.
That simple fact turns the focus in this matter from the carnage of a suburban home to the competence of a health-care giant.
And that is something Rochester General Hospital should address.