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Health See other Health Articles Title: Madness, Deinstitutionalization & Murder For those of us who came of age in the 1970s, one of the most shocking aspects of the last three decades was the rise of mass public shootings: people who went into public places and murdered complete strangers. Such crimes had taken place before, such as the Texas Tower murders by Charles Whitman in 1966, but their rarity meant that they were shocking. Something changed in the 1980s: these senseless mass murders started to happen with increasing frequency. People were shocked when James Huberty killed twenty-one strangers in a McDonald’s in San Ysidro, California in 1984, and Patrick Purdy murdered five children in a Stockton, California schoolyard in 1989. Now, these crimes have become background noise, unless they involve an extraordinarily high body count (such as at Virginia Tech) or a prominent victim (such as Rep. Gabrielle Giffords). Why did these crimes go from extraordinarily rare to commonplace? For a while, it was fashionable to blame gun availability for this dramatic increase. But guns did not become more available before or during this change. Instead, federal law and many state laws became more restrictive on purchase and possession of firearms, sometimes in response to such crimes. Nor has the nature of the weapons available to Americans changed all that much. In 1965, Popular Science announced that Colt was selling the AR-15, a semiautomatic version of the M-16 for the civilian market. The Browning Hi-Power, a 9mm semiautomatic pistol with a thirteen-round magazine, was offered for sale in the United States starting in 1954, and advertised for civilians in both the U.S. and Canada at least as early as 1960. If gun availability does not explain the increase of mass public murders, what else might? At least half of these mass murderers (as well as many other murderers) have histories of mental illness. Many have already come to the attention of the criminal justice or mental health systems before they become headlines. In the early 1980s, there were about two million chronically mentally ill people in the United States, with 93 percent living outside mental hospitals. The largest diagnosis for the chronically mentally ill is schizophrenia, which afflicts about 1 percent of the population, or about 1.5 percent of adult Americans. A 1991 estimate was that schizophrenia costs the United States about $65 billion annually in direct and indirect costs. The $19 billion in direct costs (as of 1991) included the criminal justice system dealing with a few spectacular and terrifying crimes (such as mass public shootings), and millions of infractions, arrests, and short periods of observation. A 1999 study found that 16.2 percent of state prison inmates, 7.4 percent of federal prison inmates, and 16.3 percent of jail inmates, were mentally ill. As of 2002, about 13 percent of mentally ill state prison inmates nationwide had been convicted of murder. A detailed examination of Indiana murder convicts found that 18 percent were diagnosed with “schizophrenia or other psychotic disorder, major depression, mania, or bipolar disorder.” In the 1960s, the United States embarked on an innovative approach to caring for its mentally ill: deinstitutionalization. The intentions were quite humane: move patients from long-term commitment in state mental hospitals into community-based mental health treatment. Contrary to popular perception, California Governor Ronald Reagan’s signing of the Lanterman-Petris-Short Act of 1967 was only one small part of a broad-based movement, starting in the late 1950s. The Kennedy Administration optimistically described how the days of long-term treatment were now past; newly-developed drugs such as chlorpromazine meant that two-thirds of the mentally ill “could be treated and released within 6 months.” At about the same time, two different ideas came to the forefront of American progressive thinking: that there was a right to mental health treatment, and a right to a more substantive form of due process for those who were to be committed to a mental hospital. If there was a right to mental health treatment, then judges could use the threat of releasing patients as a way to force reluctant legislatures to increase funding for treatment. The notion of due process for the mentally ill was not radical. American courts have been wrestling with this question from the 1840s onward. While perhaps not up to the exacting standards of the American Civil Liberties Union, by the end of the nineteenth century, there was something recognizably like due process before the mentally ill were committed. What changed in the 1960s was the result of ACLU attorneys such as Bruce J. Ennis, who claimed that less than 5 percent of mental hospital patients “are dangerous to themselves or to others” and that the rest were improperly locked up “because they are useless, unproductive, ‘odd,’ or ‘different.’” Until the 1960s, courts used a medical model when considering commitment: the government’s actions were part of “the historic parens patriae power, including the duty to protect ‘persons under legal disabilities to act for themselves.’ . . . The classic example of this role is when a State undertakes to act as ‘the general guardian of all infants, idiots, and lunatics.’” Instead, public safety alone became the legitimate basis for commitment, and with it, a more exacting standard, a bit less than is required for convicting criminal defendants. Neither a right to treatment nor a more demanding application of due process alone was particularly destructive, but in combination they made hundreds of thousands of seriously mentally ill people homeless, where many died of exposure and violence. They fell through the cracks, living shorter, more miserable lives, and often greatly degrading the quality of urban life for everyone else. A fraction became something quite a bit more unsettling than the mentally ill person begging on the street or disrupting the public library: they became the mad mass murderers of the modern age. Post Comment Private Reply Ignore Thread
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