SORRY GRANDPA, BUT THE ILL CAN'T BE FREE:

Psychiatrist E. Fuller Torrey calls a crime like Houston's "a predictable tragedy." That's what he has also called the Gabrielle Giffords shooting; he says the same thing about the Virginia Tech massacre, the Aurora movie theater shooting, the Sandy Hook Elementary shooting, and dozens of other recent homicides, some of them famous mass killings or subway platform shovings, but many of them less publicized. Ten percent of US homicides, he estimates based on an analysis of the relevant studies, are committed by the untreated severely mentally ill--like my schizophrenic cousin. And, he says: "I'm thinking that's a conservative estimate."

Saying that the severely mentally ill are disproportionately responsible for homicides has made Torrey, author of The Insanity Offense and the forthcoming American Psychosis, unpopular in some circles. "[My critics'] argument is you can't talk about these things because it causes stigma," he says. In the aftermath of the Newtown tragedy, some mental-illness advocates insisted that even if Adam Lanza had Asperger's or any mental-health issues, it would be totally inappropriate to cite that as a factor in his actions. But other administrators and caretakers think it's vital to bring up. "We have to think about mental-health care in a public health framework," says Dee Roth, who is on the National Advisory Council of the federal Substance Abuse and Mental Health Services Administration (SAMHSA). "Public health measures solved rickets, cholera, people dying when they're 30." But when it comes to mental illness, she says, "we're not treating the sick people." And while the details of Lanza's diagnosis or any attempts to treat it remain unconfirmed, what is known, as Torrey pointed out in a piece he coauthored in the Wall Street Journal, is that Connecticut is "among the worst states to seek such treatment. It has among the weakest involuntary treatment laws and is one of only six states that doesn't have a law permitting court-ordered 'assisted outpatient treatment,'" which, Torrey notes, "has been shown to decrease re-hospitalizations, incarcerations and, most importantly, episodes of violence among severely mentally ill individuals." Although even Torrey, who founded the Treatment Advocacy Center, an organization that pushes for fewer restrictions on involuntary commitment, admits that such measures would hardly plug all the holes in our mental-health-care system.

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