Mental illness: When schizophrenics kill

Jared Loughner’s deadly gun rampage in Tucson may have shocked the nation, said psychiatrist E. Fuller Torrey in The Wall Street Journal, but this was a “predictable tragedy.” Loughner, it’s now clear, is mentally ill, and is probably one of the U.S.’s 4 million untreated schizophrenics, who, studies say, account for as many as 1,600 homicides a year. A half-century ago, most of these people would have been in a hospital, but in the 1960s, the U.S. started emptying its state mental facilities—many of which, admittedly, were the stuff of nightmares. The problem is that states failed to complete the second stage of “deinstitutionalization,” which was to provide care for and supervision of seriously ill people living in the community. Today, as a direct result, about half the people who commit crimes and wind up in prisons are mentally ill. The government should “protect the public from persons who are potentially dangerous,” like Jared Loughner, even if that means hospitalizing them against their will.

Locking up every mentally ill person isn’t the answer, said Bradford Plumer in The New Republic. The vast majority of people suffering from mental illness are not dangerous; would you give the government authority to put people away for what they might do someday? There have already been Kafkaesque cases of sane, safe individuals who got locked in mental facilities for years, while authorities ignored their pleas. The balance between civil liberties and protecting a community is fiendishly difficult to get right, said psychiatrist Sally Satel in National Review Online. Loughner was clearly delusional, but “acting weird” is not a crime.

“People are rightly skittish about infringing on a person’s freedom,” said Jeffrey Geller in USA Today, but when delusions lead to angry, frightening outbursts, it’s time to act. Under current Arizona law, any one of the people who were troubled by Loughner’s alarming behavior—the college administrators who suspended him for angry classroom rants, the classmate who always sat by the door in case he started shooting, the cops who visited his home—could have petitioned a court to evaluate his mental health and, if necessary, commit him for treatment against his will. But no one did. This speaks to a deeper problem in our culture, said David Ignatius in The Washington Post. We Americans are more isolated, transient, and guarded than ever; when we see strangers in distress, we look for excuses not to get involved. “We leave people alone in America, to a fault.

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