Prior to his dropout from the University of Colorado, Aurora theater-shooter James Holmes had been seeing a mental health specialist at the University. However, school specialists, trained mostly to treat academic anxiety, were ill equipped to address Holmes’s condition. New evidence indicates he may have also called his psychiatrist just minutes before he entered the theater, but was unable to reach a specialist.
While Virginia disallows gun ownership for five years by people who have been involuntarily hospitalized for psychiatric problems, Seung-Hui Cho never had inpatient psychiatric care before the shooting at Virginia Tech. This is because Virginians can only be involuntarily detained for presenting an “imminent threat,” which he was.
There is no evidence that the US Army’s Psychological Operations division required Wade Michael Page, the shooter of a Wisconsin Sikh temple, to receive mental health attention for his propensity to kill. They hired him for it.
And that may be the case with Terence Tyler, the ex-marine who ended three lives in New Jersey, early Friday morning.
While there has been much necessary focus on gun-control and security competence in the aftermath of these acts of terror, such reactionary approaches do not answer the infinitely more important question: what happens in an individual’s mind to make him or her want to kill?
Before cultural assumptions lead to accusations that someone with such a warped sense of reality needs to be locked in a mental institution with other “schizophrenics,” one must know that individuals with debilitating conditions such as schizophrenia are more often the victims than the perpetrators of assault.
However, delusions of grandeur, Narcissistic Personality Disorder (NPD), and sociopathy as displayed by many of the domestic terrorists of the past few years are also mental illnesses. Truly, any individual who premeditates the murder of a human being is nothing short of mentally ill.
In a country where we think of arms-bearing as a civil liberty, we must treat mental health as a right.
Still, limited resources and a culture of neglect leave tens of millions of Americans, including these killers, without appropriate mental health attention. In fact, more Americans live in mental health resource shortage areas than in any other medical service shortage area.
Further, the federal healthcare safety net, Medicaid, requires an individual be ill for a full year before qualifying for mental health coverage. Even if they fulfill that prerequisite, the person must fail to achieve “substantial gainful activity,” potentially disqualifying those with NPD, Anti-Social Personality Disorder (which, contrary to the name, is marked by manipulative behavior and a hyper-polarizing view of people), or delusions of grandeur.
If there is to be a comprehensive prevention plan for mass murders, the United States can no longer treat mental health as a privilege to be earned. In a country where we think of arms-bearing as a civil liberty, we must treat mental health as a right.
First, every American must have access to resources without condition, including documentation status. One path to achieve this would be to open Medicaid’s doors to anyone seeking psychiatric help. Another would be to require private insurers to offer and encourage mental health services without charge, to be reimbursed in part or whole by the government. Most likely, a combination of the two would be necessary.
The only reasonable argument against defining mental health resources as a human right is the expense associated with providing services to everyone who wants or needs them without restrictive costs. But as a nation we must ask ourselves: how much will the families of murder victims pay for their own therapy? How much would they have paid – in psychiatric, hospitalization, medication bills for a total stranger – to prevent the murders of their loved ones?
Second, legislation relating to mental health has to get serious. If Holmes had been in a psychiatric hospital, he wouldn’t have been at that theater. If hospital-groups felt an unconditional responsibility to their patients, he would have spoken with a professional just before committing the murders. In Virginia, a judicial officer had declared Cho an “imminent threat.” It was within the state’s capacity and responsibility to hospitalize Cho and deny his right to firearms.
Federal laws allowing courts, physicians, and police to detain individuals against their will for evidence of mental instability need to expand. States need to enforce these laws accordingly.
Involuntary detention, of course, is not something to be taken lightly. However, hospitalization is not imprisonment; these detentions are opportunities rather than punishment. Further, detentions end in freedom. Death does not.
Such a transformation in law and culture would not be an unnecessary, paternalistic obstruction of liberties. Nor would it be so simple as a universal entitlement program for people with mental and emotional instability. The redefinition of mental health as a basic and inalienable human right would improve the lives of nearly everyone with mental illness, and it would save tens of thousands of lives each year.
After the shooting on Friday, Mayor Owen Henry of Old Bridge, New Jersey told a local newspaper, “You can prepare for these things, but you can’t prevent them.” This defeatist perspective will see more massacres. It’s well past time to start preventing mass murders in the US by addressing the underlying mental health problems.
