MENTAL ILLNESS AND VIOLENCE
Recently, there have been a series of mass shootings or violence in which the perpetrator has been identified as having mental illness. The general public, and even the press, who are mostly untrained regarding mental illness, often think that the actions and thoughts of the perpetrator indicate that they should have been hospitalized, medicated, and/or jailed rather than allowed to move freely through the streets. They also want to blame/scapegoat the mental health professionals for not appropriately intervening to keep the community safe.
What the public largely does not know is that right now there are hundreds of thousands of equally ill/disturbed/risky people on the streets of the U.S. Very few of these will actually commit serious violence. It has been shown that even for professionals, it is extremely hard to reliably pick out the few that will commit severe violence. Ask a judge how often they regret not giving a longer sentence to someone who later proves lethally violent.
We are faced with a tradeoff between a much more restrictive society or an ongoing stream of these senseless deaths. So what can be done? The best hope is to do a better job of engaging the whole public, and especially its risky group, in more mental health care. As a retired psychiatrist I regret that the medicines and techniques of mental health are still more primitive than those of our sister branches of medicine. The good news is that progress in the field is beginning to accelerate. However, just as 9/11 triggered a great increase in resources for security, we need a big increase in resources for mental health, not just for dangerous people but also for the health and happiness of the average citizen.