Massacres and Mental Illness
States have a compelling interest to involuntarily treat any mentally ill person prone to violence.



Serious illness is painful and heart-wrenching for patients, family, and friends, be it physical or mental. Since most medical conditions rarely result in severe behavioral changes that prompt violence, mental illness carries a stigma that does not accompany congestive heart failures, ectopic pregnancies, or psoriasis. It is easy to conflate mental illnesses with evil because the end result — shooting innocent people in a theater or planting a bomb in a day-care center — can have similarly horrific outcomes. Such misunderstandings in the public sphere leave the erroneous impression that most people suffering from mental illness are prone to violence, which is not the case. It would be inappropriate here to prematurely assert a specific diagnosis of the attacker in the Connecticut massacre, but we can certainly examine the role of mental illness in a past attack.

John Warnock Hinckley Jr. suffers from mental illness, which spurred him to stalk President Jimmy Carter in 1980. In his mind — a mind untreated for a mental illness that would be diagnosed only later — he would win the affection of the actress Jodie Foster by murdering the president. With the inauguration of Ronald Reagan, Hinckley’s target shifted seamlessly from one president to another, culminating in a 1981 attack when he fired shots on a crowded street, seriously wounding a police officer and a Secret Service agent, permanently disabling White House press secretary James Brady, and nearly killing President Reagan.

Since then, as if trying to prove a point about the condition of the government mental-health system, Hinckley has slowly but surely attempted to dig his way toward freedom from the mental institution where he resides. (He was found not guilty by reason of insanity and transferred out of prison custody.) Typically, violent mental-health patients operate under the radar until a crime happens that can trigger a paper trail, but after a patient commits a violent act, the fight to keep him in care becomes necessary and never ends. Incredibly, Hinckley was awarded frequent furloughs to his family residence in Virginia several years ago.

From November 2011 to February 2012, a long, expensive, and tension-filled evidentiary hearing in the U.S. District Court for the District of Columbia was held to determine whether Hinckley should be released from St. Elizabeths Mental Hospital. While any release would not be a complete, unconditional parole, it would allow Hinckley to be released into the custody of his octogenarian mother in Virginia, even though the Secret Service currently follows him when away from the hospital because he is considered a threat to the president.

The Hinckley case shows where America is on handling mentally ill patients who are violent threats: A man who shoots four people on a crowded street is considered for release from the mental hospital, with no guarantees or assurances that he will continue taking the proper medication when living among the general public. Hinckley’s petition is thwarted for the time being only because the mental facility near Hinckley’s mother has withdrawn its offer to provide treatment to him after his release from St. Elizabeths. If this mental-health system is so close to releasing an attempted presidential assassin, what are the odds that other systems will allow the next potential attacker to leave, untreated and unmonitored, to commit another massacre?