Just want to chime in and recommend Dr. Torrey’s outstanding book The Insanity Offense: How America’s Failure to Treat the Seriously Mentally Ill Endangers Its Citizens. Part of what Dr. Torrey addresses in this excellent book is the misplaced civil libertarian impulses that have caused states to strictly circumscribe the capacity of families of the mentally ill to have them involuntarily committed for care. He tells the stories of many desperate families of psychotics, who approach mental health authorities and police numerous times about disturbing behavior they witnessed, only to be told there was nothing to be done if the “patient” didn’t choose to be treated. One mother recounted waking up to see her son standing over her bed with a knife in his hand. When the mentally ill person lashes out with violence, it’s too late.
These are not easy questions. Clearly we don’t want families to be able to lock up their relatives in psych units for years at a time for trivial or selfish reasons. Treatment is expensive, and the mentally ill have rights. But the mentally ill are uniquely incapable of exercising their rights and their autonomy when in the grip of mania or delusions. To insist upon their right to refuse treatment, when they cannot reason, is itself unreasonable.
Treatment is not a panacea. It is possible that the mentally ill could be treated, released on meds, and then stop taking the drugs. So a system for checking in on those with paranoid schizophrenia and other serious mental illnesses would be ideal. And, it should always be noted, that most mentally ill people do not commit crimes. On the other hand, nearly 100 percent of those who commit these horrible mass murders are. (Maj. Hassan, of course, was not.) Also, those who commit crimes, sane or not, are evil. We do no one any good by dwelling on their grievances, whether bullying or racism or whatever.
But a rule of reason surely can be found. Short-term commitment, for a person who badly needs to be evaluated and medicated, seems like a reasonable accommodation for all concerned.
The price we are paying now for our excessively libertarian approach is being paid in blood and misery.