In my town this morning. 23 year old man stabbed a 22 year old woman apparently at random in the town library. She died and a 77 year old man was also stabbed.
The guy had been acting violently for years, terrorizing the neighbors. He had been arrested before for threats but was still on the streets.
I’m not sure what the procedure is to get someone involuntarily committed, but I’m sure it’s not an easy one. And there isn’t always space for people, which seems like something that should be addressed. Remember when the former VA gubernatorial candidate tried to get his son committed a few years ago? He was given the run around by the state hospital system and his son acted out violently, attacked his father, and then shot himself. Hopefully, that sad incident has led to some reforms.
https://www.cnn.com/2014/01/26/politics/creigh-deeds-attack/index.html
We do not deal well with mentally ill people, violent or not. Between inadequate understanding of mental illness and insufficient resources for mental health services, law enforcement, and the justice system, stuff like this continues to happen. It seems like it shouldn’t. There have been some horrifying incidents in Wisconsin in recent years, too, such as a man who decapitated his mother, with whom, it is thought, he had as good a relationship as he did with anyone.
When I was in high school, I attended a piano performance workshop at UT and took lessons from Danielle Martin, a wonderful professor and pianist. Years later, I was shocked to see a headline on AOL - she had taken a troubled graduate student into her house and he had killed her. He thought she had a chip embedded in her head that needed to be taken out. 
Social stigma is a huge challenge with our nation’s mental healthcare system. People refuse to seek treatment or refer their friends and loved ones for treatment. We need a focused campaign to change society’s perception. We’ve seen past successes with increasing the use of seat belts, reducing drunk driving, and reducing smoking. Certainly we need everyone to be able to access effective mental health care, but until we reduce the stigma of seeking such care it will remain behind closed doors.
Probably need more mental hospitals and facilities. Seems we have shuttered many. More engagement. Many are homeless as well.
What if it were possible to look at other societies from around the world and see how they handle the problem? Then we could consider how those societies are similar to or different from ours, and then adapt the practices that seem most likely to work here? Oh, I forgot. American exceptionalism. Just as in healthcare, general management of gun violence, infrastructure, etc.
I believe it goes hand in hand with universal healthcare. Provide healthcare for all and deal with the health issues.
@JustaMom If you look at the Canadian media you will see that mental health care is just as inaccessible as in the US. If they manage to get treatment it is free of course. There have been many violent incidents committed by the mentally ill there too.
@TomSrOfBoston , that is horrific! It hits way too close to home for me, as we used to live in Lexington, and have several friends in Winchester. And I have a 22 year old daughter who hangs out in libraries.
I don’t know what can be done. My nephew, who is autistic and is prone to violence, is on all kinds of medication to keep him stable. But unlike many others who are violent and mentally ill, my nephew has a supportive family who oversee his care. Others may lack resources, or are in denial.
Though it is no consolation to the young woman’s family, I am relieved that the man was only armed with a knife. Many more people could have been killed if he’d had a firearm.
@Massmomm But if someone stops taking their medication there is virtually no way to force him/her to take them.
Both this and the Parkland incident were not cases of someone suddenly snapping and killing people. Both men had numerous run ins with the police and the “warning signs” were evident to everyone. Yet they were still able to walk freely.
Younger people might not remember but we used to have thousands of state hospital beds, no antipsychotic medications, and thousands of chronically mentally ill committed indefinitely. When de-institutionalization happened in the 60’s and subsequently, many thought is was a civil rights success. However, it depends on whose rights you are considering. It is technically easier to be psychotic and murder someone than it is to be psychotic thinking about murdering someone and then being committed for a long period of time.
State hospital beds have been decimated throughout the country. Of the beds remaining, virtually none are for long term commitments. Depending on the region, county governments might be responsible for payment and there are only so many people they are willing to pay for forever. For example, if a young adult is committed to a state hospital many counties away and then is released after 10 years to the local community, who owns his future care? The home county will often do anything possible to extricate itself from financial responsibility including one way bus tickets across the country. And it is hard to fault them. Often the patients are intransigent, want nothing to do with care, and they seek out attorneys and others willing to press their case.
Simply changing the laws in each state to allow easier and longer commitments won’t work. There are so few psychiatric beds (and psychiatrists) that there is no place for those potential patients to go.
Also, there are no reasonable standards for preventative commitment. There is no way to predict accurately who will act out. Even as a psychiatrist, I might think that someone will definitely act out (eventually) but how long a commitment is reasonable based on my hunch? Twenty years? And who will continue to pay that bill given that nothing untoward has yet happened? There are no easy solutions. Freedom is dangerous at times.
I don’t think universal healthcare would help at all. It is more likely to make things worse in many cases. For example, in a bureaucracy the mental health budget would be capped. With a finite budget and finite resources, an inordinate amount of the budget would be consumed by indefinite commitments in locked, secure settings which would result in a lack of treatment for more numerous, more treatable cases like depression and anxiety. That would not sit well with the taxpayer-patient.
@JustaMom For those not familiar with the sociogeography of the Boston area Winchester is an affluent town and lack of health insurance is not the issue. The call for universal health care to solve this problem is a naïve but popular mantra that is irrelevant to these situations, as @WISdad23 points out.
A former state hospital in the next county is now a community college. People who used to be involuntarily commited are now wandering the streets. Many are homeless and are a threat to primarily other homeless people. A recent survey of why ridership is dropping on the bus and rail system found that people don’t want to share the space with ranting, raving, and sometimes worse mentally ill people, or take the risk of being attacked. It’s a huge problem.
It is a huge conundrum.
Many of those places were fairly horrific. I don’t think going back to that state would be a good solution.
As far as stigma, it probably doesn’t help that the prez is calling the Florida shooter a “sicko”.
An involuntary commitment program would be better than the nothing we have now. About a year ago, in my neighborhood, a well-meaning mom took in a ‘troubled’ kid whose own family had kicked him out. One afternoon, her husband and two sons came home to find her dead, stabbed multiple times. There should have been some place his own family could have committed him for treatment and for the safety of others.
Then what do you suggest is a good solution?
Unfortunately, we probably need metal detectors at the entrances of public libraries since so many in desperate situations take daily refuge there.
Another thought would be to adequately fund & properly manage funds for the VA hospital system.
Free prenatal care. Free breakfast & lunch in public school systems for those in need.
Create homeless shelters with a strong social services presence.
My son knows a woman who is schizophrenic. When she was on her meds, she was absolutely fine. She’s my age and when we lived next door to each other, she and I would socialize. When she was off her meds, she was a danger, primarily to her parents with whom she lived. Her delusion was that “they” were poisoning the water, so she would shut off all the water in the house. Eventually, when things got bad, her parents would call my H to turn the water back on and take her to the hospital. Finally, she was placed on a monthly injection that keeps her symptoms in check. If she doesn’t show up at the clinic to get the shot on schedule, a social worker and nurse go to her home to give it to her. This system has worked for years. She is able to live on her own and work in a sheltered environment. It seems to me that if there are meds available, at least for some conditions, that are long term, that might be a treatment of choice. This woman once told me that after a year or so of refusing to go for the shots and having someone come to administer them, she realized that she felt so much better on them that there was no point in refusing.
Of course, some meds, like those for bipolar, can make a person feel less than themselves and not want to take them. I had a bf for many years who was bipolar. Even though he knew that the meds allowed him to function, he would complain about how they made him feel. Three times while we were together, he stopped taking them and eventually wound up hospitalized. He was never violent but I always worried that his delusions and false beliefs would make him a target and/or get him hurt. Finally, he decided that taking the meds was just the better way to live and he became compliant. I last saw him about 10 years ago and he looked fine.
This is a very sad situation. I do believe that the state should be able to direct that people comply with their meds if they want to be out on the street, although this should perhaps be limited to people who are known to be violent when off their meds. It’s such a hard thing. I see so many homeless people on the streets (I work in midtown Manhattan) and I often wonder how much some of them might benefit from being on a regular medication program, like my former neighbor. I am not really certain how there is the authority to go and give her the meds if she doesn’t show up, it might have originally been part of the disposition of a criminal case against her for assaulting her mother.