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The Gabrielle Giffords Shooting: Why Don't We Just Force People to Be Treated?

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Gabrielle Giffords' shooter Jared Loughner was a troubled man -- everyone agrees.

Commentators lament that Loughner's problems weren't identified earlier so that what? He could have been arrested? institutionalized? Treated?

First, let's review the ample warning signs. Loughner had an extensive police dossier, his community college file was replete with indicators of his instability and anger, his old friends describe his growing paranoia and hostility.

So then what?

In the first place, guaranteeing the privacy of mental health records has been a hard-fought battle -- seemingly fought by some of the same people and interests who say that more should have been done to prevent Loughner's actions.

But Loughner had done nothing to be arrested. And we have moved as a society away from involuntary institutionalization. Does anyone seriously propose to reverse this mental health policy? Where would that leave the millions of people who don't endanger themselves and others despite having a mental disorder?

That leaves treatment of some kind. Pundit after pundit (Patrick Kennedy for instance) speaks about the need to eliminate the onus surrounding emotional problems, so that people will more readily seek and receive psychiatric treatment -- as he has. (Kennedy, of course, is rich, well-connected and has had repeated treatment -- he had already received the best treatment money can buy when he was arrested driving an automobile into a Capitol Hill protective barrier in the middle of the night.)

While people like Kennedy and others call for greater acceptance and tolerance for mental disorders, Americans are in fact less tolerant than people in any other Western society of deviant behavior -- consider drug use and gay marriage as examples. And, in fact, the people of no Western nation are made more uncomfortable by individuals who behave in unusual or aberrant ways.

This is one reason that Loughner was so ostracized and isolated in the first place. It is also the reason that Americans adopt a policy of passing off disturbed people to medical authorities: to get them out of sight and off their hands.

Contrary to Kennedy's idea, the United States has gone as far as any modern society in terms of actively identifying and treating its citizens' mental disorders. Can anyone name a country, past or present, that has diagnosed and treated more people? Is America's problem really that many more Americans need to be swept into the mental health system?

Critics of the political climate in the United States say that each side is incapable of self-reflection and taking responsibility for their own role, so that they can only look outside themselves for the sources of our country's problems.

Exactly the same thing can be said about America's way of dealing with its mental health issues -- and the crucial factors underlying mental illness and acting out are exactly as unlikely as political polarization to be addressed. These problems include the following:

  • The absence of communities to identify, insulate and support troubled individuals;
  • A vast oversubscription to medical ideas of causality and treatment (expressed by Patrick Kennedy, but evident at PT Blogs, although somewhat less so than many places);
  • A society that is hopelessly conflicted over belief in personal achievement and responsibility and the need for initiative, on the one hand, and in victimization and powerlessness and the need for protection, on the other.

The Tucson tragedy will have no beneficial impact on the mental health of Americans, or on the protection of and from those with problems like Loughner's. We might look with better effect at preventing disturbed and aggressive people from having powerful guns - but we don't have the will in America to do that, and focusing on Loughner's emotional problems is actually one societal alibi for avoiding doing so.

Next question: Will finding, helping, and now treating Ted Williams resolve -- or even improve -- his problems?

P.S. As an indicator of this conundrum, consider this analysis in The New York Times by Robert Gallagher, the former Vice Chancellor for Student Affairs at the University of Pittsburgh and director of the counseling center for 25 years.

For a number of years now, our research studies have shown that the incidence of college students with serious mental health problems has risen significantly ...

Other survey data indicate that many more students have problems that could be helped through counseling, but never seek such help. For example, in my 2010 survey of counseling center directors, 87 percent of the students who committed suicide had never sought out mental health services on campus.

Given this reality, it is unrealistic to think that any school could monitor the psychological needs of all its students nor, in my opinion, should they. Even if it were possible to do a clinical assessment of every student who arrives on a college campus our abilities to predict who is likely to harm themselves or others is very low. To mandate mental health services for all those who exhibit eccentric behavior would create a society we would not want to live in.