Yesterday, New York Mayor Michael Bloomberg made the appalling recommendation that police officers walk off their jobs until the politicians get the guns off the streets.
In Bloomberg’s New York, a city with draconian gun control laws, gun violence has recently been on the upswing.
Other cities that have strict gun control laws also have the most gun violence. Think Chicago and Washington, D.C.
As of now, Americans own some 200 million guns. The notion that we are going to eliminate guns is wildly impracticable.
This morning David Brooks is more on point when he suggests that we need to have more treatment programs for undiagnosed psychotics like James Holmes.
In his words:
The best way to prevent killing sprees is with relationships — when one person notices that a relative or neighbor is going off the rails and gets that person treatment before the barbarism takes control. But there also has to be a more aggressive system of treatment options, especially for men in their 20s. The truly disturbed have always been with us, but their outbursts are now taking more malevolent forms.
Brooks is right to focus our attention on the killer, not the culture or the politics.
He is slightly off the mark when he prescribes “relationships.”
Keep in mind that Holmes was studying graduate level cognitive level neuroscience. Thus, he was surrounded by people who are especially aware of the signs of mental illness.
He must have known that if he had shared his megalomaniacal delusions they would have tried to have him committed.
So, he dropped out of the program and took the kind of action that, as I mentioned in a previous post, and as Brooks points out, would have affirmed that he was not crazy—that is, that his voices were telling him the truth. He did something that made him as important and famous as they said he was.
Brooks is correct to say that we need “a more aggressive system of treatment options.”
The problem is not the availability or accessibility of programs. Psychiatry is perfectly capable of treating such people with its current programs. There are relatively few undiagnosed paranoid schizophrenics out there.
When Brooks talks of “aggressive” treatment, he is hinting that such patients should be subjected to forced hospitalization and forced treatment.
I suspect that the people who believe that gun control is the solution would fight to the bitter end to prevent the state from forcing treatment on a psychotic who does not want to be treated.
Some patients are treated against their will because they are deemed dangerous to themselves and to society. And yet, it is more difficult, from a legal perspective, to force treatment on someone before the fact, before he has committed murder and mayhem or before he has tried to commit suicide.
Like James Holmes many paranoid schizophrenics understand the system well enough to hide their delusions from those who would see them as crazy.
Some psychiatrists know how to engage a potential psychotic in a conversation that will reveal the extent of his problem. Too many psychiatrists do not know how to converse with patients and simply recite a checklist of questions.
It would also be good if there were a clearer psychiatric consensus that psychosis is a brain disease, not a psychogenic mental illness.
By that I mean that the psychiatrists who went on television to explain that James Holmes became psychotic because of bad parenting or unresolved childhood traumas are misleading us.
No reputable psychiatrist believes that psychosis can be treated by uncovering its infantile antecedents. It is irresponsible even to suggest otherwise.
When James Holmes was studying cognitive neuroscience he was most interested in the biological causes of mental illness. Doesn’t that alert us to the fact that Holmes knew that something was seriously wrong, that he did not know whether it was biological or psychological, and that he finally refused to believe that he was just suffering from a disease?