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November 2 2018

Mental Health and Mass Shootings

by Charlotte Hays

After each horrific massacre, we say, "This must end."

Yet, as Philip Terzian notes in an article in The Weekly Standard, we know that it is probably not going to end any time soon.

Gun control, even if it comes, might not reduce violence--gun violence, ironically, is more widespread and savage in places that have the most restrictive gun laws (Chicago is the best example).

Terzian, however, suggests that there is a way to address the causes of and even reduce the frequency of these massacres: first, recognize that the majority of the shooters are mentally ill. Terzian writes:

Ponder the mug shots, or postmortem case histories, of the great majority of mass shooters in recent decades, and you don’t need professional medical training to recognize them as insane.

This is not to say that all psychotics are violent or potentially dangerous; obviously, most are not. And it is certainly true that the modern revolution in psychotropic drugs has allowed untold numbers of sufferers who would otherwise have led tortured lives to approach a semblance of normality.

Unfortunately, the benefits of therapy and routine medication are not available to all. And to the extent that mental equilibrium is dependent on the capacity of patients to seek regular treatment—or enjoy the luxury of concerned families or support networks—a disturbing number of people fall through the cracks.

Any resident of any American city encounters them regularly on the sidewalk or in subway stations or parks, sleeping in daytime, occasionally malnourished, usually threadbare, freezing in wintertime, unwashed and malodorous, occasionally violent.

No doubt there are homeless people down on their luck or victims of economic dislocation. But like their brooding, obsessive brethren in the basements of our parallel universe, they are largely mentally ill—and as is often the case, unintended victims of a well-intentioned reform.

The well-intentioned reform was deinstitutionalization. Deinstitutionalization began, as Terzian recalls, as a humane endeavor. Mental institutions were overcrowded, underfunded and in many instances dangerous. So why not release the mentally ill from these hellholes?

Smaller "mental health centers" closer to "the community" would be better, reformers reasoned, in helping the mentally ill, who would check in periodically for counseling and adjustments to their medications. What could go wrong?

A lot went wrong. Great Society programs used up the money that was supposed to go for these friendly mental health centers. As Terzian notes, the dramatic growth of the number of homeless on the streets coincided with deinstitutionalization.

And that's not all:

What began as a series of corrective measures, however, was swiftly superseded by a doctrinaire form of civil libertarianism.

Vagrancy laws disappeared from the statute books, or were no long­er enforced, and the process by which sick, endangered, or violent people could be involuntarily committed for observation and treatment—whether by families, courts, or emergency rooms—became almost impenetrable.

This is a fraught matter. The mentally ill have civil rights just like the rest of us. But it might be time to begin factoring mental health into the equation. Terzian concludes:

Still, it seems self-evident that the highway to Pittsburgh does have an exit ramp: We need to reconsider the inchoate system by which we determine what people are genuine dangers to themselves and to their fellow citizens, how to discern such dangers, and what to do about it. The old state hospitals were not nice places, and new ones aren’t guaranteed to be better. But living in a medicated, insulated state is preferable to self-inflicted torture on the street—and safer for the rest of us.

In a society preoccupied with rights and privileges it will not be easy to balance constitutional requirements with demands for public safety, respond to warning signs as well as overt acts, or act coercively at all. New approaches, new laws, and new institutions won’t emerge overnight. No system is perfect and no cure is absolute.

But nothing thus far—blaming Trump, conducting vigils, debating the differences between one gun and another—has had much discernible effect on a problem that stares at us vacantly, and hauntingly, from the mug shots of killers.

Rich Lowry had an excellent piece on recent mass killers as a small fringe of malicious and "socially disconnected" people.

Lowry didn't get into mental health matters or suggest actions we might take to help.

But his piece is still a good companion piece to Terzian's.



Independent Women's Forum is an educational 501(c)(3) dedicated to developing and advancing policies that aren’t just well intended, but actually enhance people’s freedom, choices, and opportunities. IWF is the sister organization of the Independent Women’s Voice.​
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