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One Fell Out of the Cuckoo's Nest

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E. Fuller Torrey gives us a different perspective on the Tucson shooting in this WSJ op-ed.

The killing of six people in Tucson is one more sad episode in an ongoing series of tragedies that should not be happening. The alleged shooter, Jared Lee Loughner, is reported to have had symptoms associated with schizophrenia--incoherent thought processes, delusional ideas, erratic behavior--and almost certainly was seriously mentally ill and untreated. The fact that he was barred from his college until he was evaluated by a psychiatrist would appear to confirm the nature of the problem.
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These tragedies are the inevitable outcome of five decades of failed mental-health policies. During the 1960s, we began to empty the state mental hospitals but failed to put in place programs to ensure that the released patients received treatment after they left. By the 1980s, the results were evident--increasing numbers of seriously mentally ill persons among the homeless population and in the nation's jails and prisons.
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The solution to this situation is obvious--make sure individuals with serious mental illnesses are receiving treatment. The mistake was not in emptying the nation's hospitals but rather in ignoring the treatment needs of the patients being released. Many such patients will take medication voluntarily if it is made available to them. Others are unaware they are sick and should be required by law to receive assisted outpatient treatment, including medication and counseling, as is the case in New York under Kendra's Law. If they do not comply with the court-ordered treatment plan, they can and should be involuntarily admitted to a hospital. Arizona has such a provision in its laws, but it is almost never used.

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The solution to de-institutionalization is neither obvious nor facile.

Individuals with serious mental illness were institutionalized in the first instance because they were a danger to themselves or others and could not be relied upon to voluntarily take their psychotropic medication. Non-compliance with out-patient programs is rarely met with swift and sure consequences.Much like the jurists on the criminal side, judges dawdle and recalcitrant patients are left "on the street' while advocates reformulate conditions and treatment modalities.

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