Back to Bedlam: Jonathan Kellerman, Community Mental Health and the Virginia Tech Massacre

It’s human nature to try to explain the inexplicable. When we are hit with a shocking tragedy, the community tries to make sense of it. So now we find ourselves struggling to understand what turned a seething young outcast into a mass murderer.

It’s easy to get lost in the “why?” Andy and I have spent a lot of time over the past week retracing the killer’s steps, writing our own profile of his last hours. We want to understand what set him off just as much as anyone. But the reality is that we will never fully understand.

But as we overcome our shock and devastation, we must move on from asking unanswerable questions. As a society, we must turn our attention to how we can prevent the next Virginia Tech.

This is the subject of Jonathan Kellerman’s excellent editorial in today’s Wall Street Journal. The piece explains the “liberationist” sentiment of the early 1970’s and walks us through the shutdown of our national system of mental institutions in favor of ineffectual community mental health centers.

He argues that if an infrastructure for mental health-based incarceration had remained in place, Seung Cho would have been involuntarily committed for the long-term in the fall of 2005 when he became suicidal after two separate women rejected his romantic advances as stalking. At the very least, he might have been placed on a list that would have made it impossible for him to buy a gun legally.

Writes Kellerman:

No one who knew him seems surprised by what he did. On the contrary, dorm chatter characterized him explicitly as a future school-shooter. One of his professors, the poet Nikki Giovanni, saw him as a disruptive bully and kicked him out of her class. Other teachers viewed him as disturbed and referred him for the ubiquitous “counseling” — an outcome that is ambiguous to the point of meaninglessness and akin to “treatment” for a patient with metastasized cancer.

But even that minimal care wasn’t given. The shooter didn’t want it and no one tried to force him to get it. While it’s been reported that he was involuntarily committed to a “Behavioral Health Center” in December 2005, those reports also say he was released the very next morning. Even if the will to segregate an obvious menace had been in place, the legal mechanisms to provide even temporary “warehousing” were absent. The rest is terrible history.

That is not to say that anyone who pens violence-laden poetry or lets slip the occasional hostile remark should be protectively incarcerated. But when the level of threat rises to college freshmen and faculty prophesying accurately, perhaps we should err on the side of public safety rather than protect individual liberty at all costs.

If the Virginia Tech shooter had been locked up for careful observation in a humane mental hospital, the worst-case scenario would’ve been a minor league civil liberties goof: an unpleasant semester break for an odd and hostile young misanthrope who might’ve even have learned to be more polite. Yes, it’s possible confinement would’ve been futile or even stoked his rage. But a third outcome is also possible: Simply getting a patient through a crisis point can prevent disaster, as happens with suicidal people restrained from self-destruction who lose their enthusiasm for repeat performances.

At the very least, in a better world, time spent on psychiatric watch could’ve been used to justify placing the Virginia killer on a no-buy gun list. I’m not naïve enough to believe that illegal firearms aren’t within reach for anyone who really wants them, but just as loud dogs deter burglars and crime rates drop during harsh weather, sometimes making life difficult for a would-be criminal is enough.

So as we overcome our national grief and dry our eyes, how do we use the momentum of this senseless tragedy to move forward nationally? After reading Kellerman’s article, I think we have a mandate to re-start our national mental health care system. Community mental health care and voluntary outpatient treatment don’t help everyone. And when we combine permanent, residential mental health facilities with the profound advances we’ve made in psychopharmacology since the 1970’s, perhaps we can do better to effectively treat our nation’s mentally ill.

This is not about being a tax-and-spend, bleeding heart liberal. Kellerman is right when he says that some people are just plain dangerous to themselves and others. For the sake of the next Seung Cho and the many people whose lives he will eventually snuff out, I hope that we are able to transform the national grief into action.