Act on mental illness

Newtown is the latest locale in America to become synonymous with senseless slaughter. The shock and the horror are so intense, it almost guarantees that Congress will act.

There will inevitably be an enormous brouhaha around guns and ammunition, leading to nothing likely to prevent the next massacre. Democrats are talking about a renewed assault-weapon ban and a prohibition on high-capacity magazines. But Adam Lanza could have killed just as indiscriminately with any semiautomatic gun, and if he didn’t have a high-capacity magazine, he could simply have reloaded with smaller magazines, something the Virginia Tech and Columbine killers managed to do.

If we are going to have a rush to action, it shouldn’t be on guns. It should be on mental illness. It doesn’t make for high political drama or emotional cable chatter, but getting treatment for more of the most seriously mentally ill might actually prevent future shootings. Even if it doesn’t, it would improve the lives of sick and vulnerable people.

We may never know what the dynamic was in the Lanza home. For too many parents of the mentally ill, though, it goes something like this: Their child becomes withdrawn, delusional and erratic. If they call the mental-health system, they are told to bring the child in for an appointment and the sick child won’t go. If the parents call the cops, the cops show up and say the child doesn’t appear to represent a threat, and they leave. If they take him to the hospital, he is quickly released back to the parents even if he is admitted. The choice might become living with a deteriorating child increasingly out of his mind or forcing him out of the home and into the streets.

Yes, this is 21st-century America. Where we have better means to treat mental illness than ever before, but choose to let the insane people decide to get it or not. Where we supposedly de-institutionalized the mentally ill by closing down psychiatric hospitals, and then reinstitutionalized them behind bars. About a third of homeless men and two-thirds of homeless women are seriously mentally ill. Imagine the national outrage if people with Alzheimer’s were permitted to wander around the streets uncared for. But, by some perverse logic, it’s considered OK for schizophrenics.

The federal government can act on this travesty only at the margins. It is largely up to the states. They can make a real difference by stopping the further closure of public hospital psychiatric beds and making it easier to compel treatment. Civil-commitment laws that require imminent danger to self or others are too strict. As DJ Jaffe of Mental Illness Policy Org puts it, that standard doesn’t prevent violence, it requires violence in order to get care to someone too irrational to realize that he needs it.

We don’t know yet if Adam Lanza was mentally ill, or if a better system would have helped him. We do know that somewhere out there a young man is about to get very sick. He could become the next Jared Loughner or James Holmes — unless someone gets him treatment.