The Corner

Virginia Tech, Tucson, Aurora, and Counting

The shootings in Colorado have a familiar ring. Young man with a marked recent change in personality, bizarre behavior, then a rampage killing. It was the story of Seung-Hui Cho at Virginia Tech and Jared Loughner in Tucson. And although the history is not yet clear, it appears likely that the governor of Colorado was correct when he blamed this tragedy on a “deranged mind.”

This incident should not surprise us. Over the past half century, we have emptied out the state psychiatric hospitals but then failed to provide treatment for half of those discharged. They have ended up, in increasing numbers, homeless on the streets, in jails and prisons, in emergency rooms, and committing violent acts, including homicides. Three studies suggest that individuals with untreated severe mental illnesses are responsible for approximately 10 percent of all homicides, and another study suggests they are responsible for more than 10 percent of rampage murders. We are now seeing about two such mass killings associated with mental illness each year.

Treatment should be the operant word for this discussion. There is no evidence whatsoever that people with severe mental illnesses who are receiving treatment are more violent than the general population. But it is a different story when people with severe mental illnesses are not receiving treatment. The situation is complicated by the fact that some of these individuals have damage to the parts of the brain we use to think about ourselves. In medicine we call this anosognosia. Such individuals will not voluntarily seek treatment, because they don’t believe there is anything wrong with them. Therefore a few of them — approximately 1 percent of all people with severe mental illnesses — should be on court-mandated treatment as a condition for living in the community.

Why don’t we provide proper treatment? The main reason is that state governors and legislatures think they are saving money. They are not, of course, since these untreated people end up costing us money in jails and prisons or by causing tragedies such as the one we are witnessing. Ultimately we need to hold governors and state legislatures responsible for such tragedies. And, sadly, it seems to take tragedies like this to even get their attention.

— E. Fuller Torrey, M.D., is author of The Insanity Offense: How America’s Failure to Treat the Seriously Mentally Ill Endangers Its Citizens

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The shootings in Colorado have a familiar ring. Young man with a marked recent change in personality, bizarre behavior, then a rampage killing. It was the story of Seung-Hui Cho at Virginia Tech and Jared Loughner in Tucson. And although the history is not yet clear, it appears likely that the governor of Colorado is correct when he blamed this tragedy on a “deranged mind.”

Nor should it surprise us. Over the past half century we have emptied out the state psychiatric hospitals but then failed to provide treatment for half of those discharged. They have ended up in increasing numbers, homeless on the streets, in jails and prisons, in emergency rooms and committing violent acts, including homicides. Three studies suggest that individuals with untreated severe mental illnesses are responsible for approximately 10 percent of all homicides, and another study suggested that it was more than 10 percent of the rampage murders. We are now seeing about two such mass killings associated with mental illness each year.

Treatment should be the operant word for this discussion. If people with severe mental illnesses are receiving treatment there is no evidence whatever that they are more violent than the general population. But if they are not receiving treatment it is a different story. The situation is complicated by the fact that some of these individuals have damage to the parts of the brain we use to think about ourselves. In medicine we call this anosognosia. Such individuals will not voluntarily seek treatment because they don’t believe there is anything wrong with them. Therefore a few of them — approximately one percent of all people with severe mental illnesses — should be on court-mandated treatment as a condition for living in the community.

Why don’t we provide proper treatment? The main reason is that state governors and legislatures think they are saving money. They are not, of course, since these untreated people end up costing more money in jails and prisons or by causing tragedies such as we are witnessing. Ultimately we need to hold governors and state legislatures responsible for such tragedies. And, sadly, it seems to take tragedies like this to even get their attention.

E. Fuller Torrey, M.D., is author of The Insanity Offense: How America’s Failure to Treat the Seriously Mentally Ill Endangers Its Citizens. 

 

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