It’s an interesting question partly raised by Walter Russell Mead’s The Invisible Trigger. Mead notes a study that shows that more than half of mass shooters were suffering from mental illness. He goes on to discuss the dehospitalization movement.
Today, the picture is eerily reminiscent of the 19th century. According to the National Institute of Mental Illness, approximately half of people living with bipolar disorder or schizophrenia are left untreated in any given year. Large numbers find themselves on the streets or in prison. The Los Angeles County Jail, Rikers Island Jail in New York City, and the Cook County Jail in Illinois make up the three largest inpatient psychiatric facilities in the country.
Families have born the brunt of the burden, and they have very little help. The criteria for commitment are subjective at best. Few judges or law enforcement agents want to get involved with these cases since the resources for commitment are scarce. The best available options are visits to the emergency room, providing temporary relief, or prison, and many families are understandable hesitant to press charges.
Involuntary commitment tends to be easier to achieve in most First World countries. European countries, Australia and New Zealand all make involuntary commitment much easier.
In the UK “Sectioning” allows people with mental problems to be involuntarily committed under the 1983 Mental Health Act. There are similar laws around the world that allow for temporary or even indefinite detention. And while I’m not necessarily in favor of such laws, it is worth wondering whether they have saved lives.
In Britain, the 1983 Mental Health Act modified the procedures for involuntary admission to hospital. The Act provides for compulsory admission on an emergency (up to 72 hours) and non-emergency (longer periods of time) basis. The criteria for compulsory admission for assessment for a period of up to 28 days (section 2) or compulsory admission and detention for treatment for an initial period of up to six months (section 3) include “health or safety of the patient or for the protection of other persons” (Roberts, 1991). This criterion is wider than that of the dangerousness criterion applied in the U.S. As Gostin (1986) points out, the British law does not limit its scope to protect from physical harm.
The trouble with both sides of the argument is that it comes down to the issue of taking away the freedom of some, on limited grounds or no grounds at all, to protect the general public, and that’s a dangerous line.
Involuntary commitment deprives fewer people of their freedom than banning guns, but in a more severe way. The question as always is how do we balance the freedom of some or all against the lives of some.
There are cynical ways to make that argument. Obama surrounding himself with kiddie human shields is a classic example of the most egregiously shameless and dishonest way of making that argument.
But if as a practical matter we can’t do much to keep dangerous weapons out of the country, we can do something about keeping dangerous people away from them. This is not just a question of background checks; it is also a question of rebuilding our ability to protect society from people whose mental state makes them a threat to society at large. In dealing with the potentially violent mentally ill, we need to balance the potential danger to society more effectively against the loss of individual freedom. Building better facilities for the mentally ill and being more proactive about putting dangerous people in them is a necessary precaution given the abundance of weapons in these United States.
And what applies to mental illness, also applies to immigration from some of the more violent parts of the world.