IIRC (and its been a long time, so hopefully this is correct), if a person was declared incompetent, the guardian could give permission for the depot injection of prolixin or treatment with Clozaril. But as @MaineLonghorn said, there are side effects (sometimes irreversible tardive dyskinesia), and with Clozaril there can e a dramatic drop in WBC (white blood cells) requiring careful monitoring. Or, if a person was adjudicated NGRI (not guilty by reason of insanity) th courts could remand treatment. Here’s a case from Wisconsin (the person was trying to get released but it was denied) https://www.wicourts.gov/ca/opinion/DisplayDocument.html?content=html&seqNo=34583
There are many better antipsychotics , with fewer side effects, nowadays, but again they require compliance.
My son tried Clozaril - his doctor said he had never seen it NOT work!! So we were very excited. But my son developed a RARE side effect, not the common one (drop in WBC). The doctor said we could try it again at some point, because I guess the side effect might not reoccur, but my son said no thanks.
Somebody way upstream mentioned that it was okay for Trump to call the Parkland shooter “a sicko” because its true and I’ve been thinking about that today. I think the idea that shooters themselves might be more than one-dimensional evil is hard to look at. It could be that what he did was pure evil…while at the same time, it could also be true that he suffered from mental illness since birth (i don’t believe anything is known about the birth father) and that despite a loving adopted family, it couldn’t be overcome. And that then losing both of those parents took a person with severe mental illness and cast him adrift (even when he called 911 to report himself). Honestly, an horrific disaster from start to finish. And i’m not sure what can be done to avoid more cases like him.
Oh, ML, I’m so sorry you are going through this. It must be so frightening for you. 
@“Cardinal Fang” not sure if “move away from” was the right terminology but its my belief that the lack of beds in group homes and adult foster care sites has led to more patients/clients being released or moved into independent situations with financial (Section 8 housing, food stamps, Medicaid) and supportive services (bi-monthly visits of a nurse and a social worker and homemakers a couple times a week for housekeeping.) I would assume it is also less expensive. Some had proven themselves (I’m not sure how) to be capable of independent living but I can’t tell you what those guidelines are. Many had nurses that came in daily to administer meds. I spent a good portion of my allotted time at food banks supplementing the minimal food stamps they were given, teaching how to make basic meals so they didn’t exist on PB&J until my next visit, helping get cell phones turned back on, working with landlords to get improvements done in the apartments, providing transportation to medical appointments, that sort of thing. I did have clients who lived in independent apartment settings that had daily assistance with meal prep, job training, housekeeping, etc. with a clubhouse on site for all residents but this was for those with learning and intellectual disabilities and those with significant mental illness diagnosis (schizophrenia, or dual diagnosis, etc) were not accepted.
I spent several years working in a very large homeless shelter (1,000+men) during the years when our state was deinstitutionalizing the mentally ill. Our shelter because a de facto back ward (plus people with various disasters, drinkers and other): examples include a catatonic young man who stared ahead continuously, an old man who wore three coats in summer, wore a long beard, and preached in the corner, and a gentle man who was clearly hallucinating while making odd hand gestures in the air and speaking to himself.
Shelter staff, who were social workers and even psycholgists, as well as nurses, worked very hard to deal with both the chronic and the acutely homeless but let’s just say that hospitals and detoxes often used the shelter in discharge plans and dropped clients off in the bed/soup line.
The term “the mentally ill” is awfully broad. The resulting picture for mental illness depends in many ways on social class and context. There are very wealthy people who do private pay for a few months at a well-known private hospital. There are people living in group homes who may have a higher rate of violence as cited by a poster back aways. There are people who are isolated and people who live in families, very young and very old, people in mansions and people on the street.
Furthermore, there are the clinically distinct mental health diagnoses like bipolar 1 and schizophrenia (both of which involve psychosis) which really aren’t the same as “emotional problems.”
Most people with mental health issues (and I prefer this terminology to THE mentally ill) are not violent, and many people who are violent are not mentally ill.
The solution is not to go back to the institutions as they were. Anyone can pick up a book entitled “Frances” to see what publicly funded long term care was like- with stories of rapes and abuse. Patients were powerless. Some had epilepsy or migraines and didn’t even have a mental health issue as now defined.
Deinstitutionalization happened for a number of reason: yes, budgetary ones, but the advent of psychiatric meds may have made long term hospitalization less necessary (in theory) and caused changes in insurance; and civil liberties advocates has an impact on the process of emptying hospitals too.
The issue of controlling anyone who could potentially be dangerous, always raises the possibility of limiting civil liberties. This happens with child abuse too: if a child’s death causes a lot of publicity, social workers crack down harder and some families get caught in the system who have no cause for being monitored.
Homelessness and mental health issues are very complicated and right now everyone is simplifying in reaction to some horrific events. I lean toward preserving freedom. I also really pray that all this discussion of mental health and shooters doesn’t stigmatize people. We don’t even know I Cruz had a mental health diagnosis. He lost his adoptive mother in November and seemed very alone in the world.
@WISdad23 not most activists at least. The idea was to shift that money to community and home based care. We didn’t. We chucked them on the streets and deserted them. We also redirected that money to prisons.
OK, so then we’re in agreement here. We never “moved away” from having beds in group homes and adult foster care sites and providing support for the residents. When the deinstitutionalization happened, we should have created many more group homes and care sites, but we never did, because it costs a lot of money and we didn’t want to spend that money on people with mental illness.
When mass shootings happen, many people talk about increasing mental health services instead of other measures that might stop people from getting guns and shooting groups of other people with guns. But typically, the people who bleat about mental health services as a way to stop shootings are unwilling to spend a nickel on them, and indeed are attempting to take away government money for mental health services.
I’m very much in favor of increase mental health services to improve the lives of mentally ill people. But I doubt that will do much to stop shootings.
This site is a great resource for those interested in mental health policy:
https://mentalillnesspolicy.org/
Much debate centers around the ethics of treating someone against their will. Some antipsychotic medications are available as injections that last a month or more, making compulsory treatment more feasible.
Mental health services are not effective in all cases either. The Colorado movie shooter and the Virginia Tech shooter had both been treated. And IIRC so had the Sandy Hook and Santa Barbara killers. It’s sad that in the Winchester case and the Parkland case, lay people knew the killer was dangerous and the police ignored it.
That’s silliness. “I called that black man a n****** but it’s true!” No. The derogatory part of a slur can’t be true or false; it is only derogatory.
NIMBYism also contributed to the failure of the neighborhood group home system. People who voice strong support of the concept tend to be less supportive if the fourplex across the street from their yard, or next to their kids’ playground is slated for housing the mentally ill.
Most of the discussion here has been about violence against other people. The much larger problem is suicide. Hopefully some of the solutions that we try to help prevent school shootings will also help stem the growing rate of suicide.
@“Cardinal Fang” @dietz199 Working in such group homes can have its dangers:
http://archive.boston.com/news/local/massachusetts/articles/2011/01/21/mental_health_counselor_at_group_home_is_found_slain/
“REVERE — A 27-year-old mentally troubled man was arrested last night and charged with the murder of a young female employee of the small group home where he lived.”
As a response to the first question: we throw them in prison with little to no treatment. Once their sentence is up, we release them with virtually no treatment.
^^^ and as kids we ignore their issues, with little to no treatment, until their violence reaches a level that we are forced to throw them in prison. So sad.
Undoubtedly restricting gun access would help the growing rate of suicide.
“If someone wants to kill themselves, they will.” No they won’t. Suicidal impulses are fleeting. Failed suicides don’t usually try again. Making it harder for someone to kill himself or herself will mean some suicidal people won’t be able to muster the energy to try.
Working in group homes can be dangerous, but if the people with mental illness were locked up, working in their mental institution would also be dangerous.,
My old next door neighbor took her adult son to the hospital because she was afraid that he would hurt himself or others, the son went willingly. They refused to admit him the next day he committed suicide (decapitation by chain saw!), I just thank God he didn’t go after his young daughter or wife!
So should there be restrictions on chain saws??