Blame De-Institutionalization for School Massacres

Dr. Jonathan Kellerman tells it like it is about the Virginia Tech massacre, in today's Wall Street Journal:

The basic premise of Community Psych--that severely mentally ill people could be depended on to show up for treatment voluntarily--never made sense to me. The core of the most common and debilitating psychosis, schizophrenia, is degradation of thought and reason. So the idea that people with fractured minds could and would make rational, often complex decisions about self-care seemed preposterous.

One day, I voiced that opinion in class, questioning if any mechanisms were being set in place to prevent a flood of schizophrenics from ending up on the streets, homeless, helpless, victims of crime and, in some cases, victimizers. The Community Psych professor--one of the liberationists--responded with a patronizing smile and a folksy account of the success of a program in rural Belgium or some such place, where humble working folk created a therapeutic milieu by volunteering to house psychotics in their humble homes and everything ended up peachy.

I didn't challenge what amounted to flimsy anecdotal data, but I did question its relevance to the plight of thousands of severely mentally disabled individuals set loose in vast urban centers. The professor's smile tightened and he changed the subject; and I resolved to get through this joke of a prerequisite and concentrate on becoming the best psychologist possible.

By the time I received my doctorate in 1974, the doors to many of the locked wards had been flung open and the much vaunted community mental health centers were being built--predominately in low-rent neighborhoods. A few years later, government funding for these allegedly humane treatment outposts had been cut, as yet more fiscal belt-tightening was inspired by findings that they didn't work.

Because crazy people rarely showed up for treatment voluntarily, and when they did, the treatment milieu consisted of queuing up interminably at Thorazine Kiosks.