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Opening Arguments


What we should be talking about but aren't very much in the gun-violence debate:

Far more frightening than episodes like that is the violence that a small percentage of the severely mentally ill inflict on society. In recent years, untreated mentally ill people have committed many of America’s mass homicides. The list includes Seung-Hui Cho, who in 2007 killed 32 and injured 24 at Virginia Tech; Jared Lee Loughner, a diagnosed schizophrenic who in 2011 killed six people and injured 14, including U.S. Representative Gabrielle Giffords; and possibly James Holmes, who is currently awaiting trial for opening fire in 2012 on a crowded movie theater in Aurora, Colorado, killing 12 and injuring at least 58. It may include, too, Adam Lanza, who last December killed 26 people at Sandy Hook Elementary School in Newtown, Connecticut. While Lanza’s condition at the time of the shootings remains a mystery, it has already been determined that he had a history of mental disorder.

Psychotic breakdowns on a smaller scale pose an even greater public concern. A 2008 study in Indiana found that 10 percent of inmates imprisoned for homicide had been diagnosed with severe mental illness, a number consistent with similar studies in Europe.

[. . .]

While the backers of deinstitutionalization recognize these problems, they have largely doubled down on their own solution, calling for even more funding of the poorly managed local facilities that replaced the asylums. But recently, a few psychiatrists and other members of the mental health profession have joined urbanists and law enforcement officials in questioning the wisdom of deinstitutionalization. Last April, H. Steven Moffic, a tenured professor of psychiatry at the Medical College of Wisconsin, wrote an article called “Is It Time for Re-institutionalization?” in the Psychiatric Times. “Have we gone too far in making it difficult to hospitalize someone,” he asked, “and are our hospitalizations generally too short anyways to help clarify diagnosis and carefully make any medication adjustments?” His answer: Yes. Moffic went on to praise recent expansions at a handful of psychiatric hospitals in Massachusetts and Vermont. The tide, he said, was turning back toward the institutions.

A long and fascinating read on an important subject -- highly recommended.

Our failure to deal with that handful of those with severe mental illness who inflict violence on us also hurts the vast majority of the mentally ill who aren't violent, because it adds to the stigma they bear that makes seeking treatment seem so problematic to them. The title of the article is "A new moral treatment" for severe mental illness. To give ourselves credit, we've always searched for that. What we have now isn't it.