[acb-hsp] Looking for Loughners

[peter altschul]

Looking for Loughners: Would Laxer Commitment Rules Make Us 
Safer?
  Jacob Sullum
  After the recent shooting rampage in Tucson, Ariz., the 
psychiatrist E.  Fuller Torrey, writing in The Wall Street 
Journal, said such crimes are "the inevitable outcome of five 
decades of failed mental-health policies." Time blogger Joe Klein 
regretted that "we no longer lock up the mentally ill." 
Syndicated columnist Mona Charen faulted "laws that require proof 
of dangerousness before a person can be involuntarily subjected 
to treatment." These and other critics argue that innocent people 
could be saved if it were easier to imprison lunatics like Jared 
Lee Loughner before they commit crimes.
  But the champions of involuntary psychiatric treatment rarely 
consider the innocent people who would be stripped of their 
freedom under a legal regime that allowed the government to lock 
up potential Loughners based on little more than their wacky 
beliefs and off-putting behavior.
  Blogging at The New Republic's website last week, University of 
Maryland political scientist William Galston argued that "a 
delusional loss of contact with reality" should be enough to 
justify involuntary treatment.  He wrote, "Those who acquire 
credible evidence of an individual's mental disturbance" -- 
including "parents, school authorities and other involved 
parties" -- "should be required to report it to both law 
enforcement authorities and the courts," under penalties "tough 
enough to ensure compliance." In short, Galston wants a system 
that compels Americans to keep a close eye on their odd 
relatives, friends, neighbors, students and employees, reporting 
them to the authorities when their strange ideas escalate into "a 
delusional loss of contact with reality." That distinction may 
prove hard to draw.
  Many of the things Loughner said on subjects such as grammar, 
mathematics, lucid dreaming and monetary policy were inscrutable 
or demonstrably false.  But if that were enough to signal a break 
with reality justifying involuntary commitment, our mental 
hospitals would be overrun.
  The fuzzy line between Loughner's opinions and his "mental 
disturbance" is apparent in a remark one of his friends made to 
The New York Times: "He was a nihilist and loves causing chaos, 
and that is probably why he did the shooting, along with the fact 
he was sick in the head."
  Was Loughner's nihilism a symptom of his illness, a cause of 
it, or an independent motivation for his crime? As difficult as 
such matters are to disentangle after the fact, it is even harder 
to say ahead of time which deluded malcontents will become 
cold-blooded murderers.  In retrospect, every strange thing 
Loughner did or said marked him as a dangerous madman, including 
not just overtly crazy stuff like his video linking Pima 
Community College to genocide, but borderline behavior such as 
singing to himself, talking out of turn, pestering teachers about 
grades, smiling and laughing inappropriately, and making weird 
comments in class.  But it is not hard to see why administrators 
and police officers might have considered him a nuisance rather 
than a menace.
  Even among people diagnosed as schizophrenics, Torrey says, 
only 10 percent become violent.  So assuming that Loughner 
qualifies for that label, a policy of detaining people with 
similar symptoms would sweep up nine harmless individuals for 
each future criminal.
  Although they are routinely called upon to say whether people 
pose a danger to themselves or others, psychiatrists are 
notoriously bad at it.  "Over 30 years of commentary, judicial 
opinion and scientific review argue that predictions of danger 
lack scientific rigor," notes University of Georgia law professor 
Alexander Scherr in a 2003 Hastings Law Journal article.  
"Scientific studies indicate that some predictions do little 
better than chance or lay speculation, and even the best 
predictions leave substantial room for error about individual 
cases.  The sharpest critique finds that mental health 
professionals perform no better than chance at predicting 
violence, and perhaps perform even worse."
  The current system of involuntary commitment rests on 
predictions of dangerousness that are appallingly inaccurate.  
Abolishing the requirement of dangerousness would avoid that 
embarrassment at the cost of imprisoning even more people who 
pose no threat to others.
  Jacob Sullum is a senior editor at Reason magazine and a 
contributing columnist on Townhallddcom.