For some time, I've complained that mentally ill people in obvious need of treatment roam the streets at will. But what is mental illness? What should be the treatment for what?

Right now, a lot of attention is being focused on Cho Seung-Hui, who, as Dr. Helen observes, is considered a "text book case of a school shooter." Yet nothing was done:

What I am amazed by is that in many school shootings, especially in universities, school authorities and others were told that there were problems or in some cases, the eventual killer had already made threats but no one did anything. The schools deny any responsibility at all in most of these cases although, sometimes they end up being sued for it. But what is money when people's lives are at stake? It's often the case that when the killer finally lashes out, the people who knew him aren't surprised -- they'd been predicting something like this for weeks or months, but no action was taken.

In my opinion, if we have mentally unstable students who have made threats, have behavioral problems, etc. in universities and schools who do not hold themselves or the student accountable for their behavior, there is no other alternative than to extend the civil right to concealed carry to the potential innocent staff and students who may encounter the wrath of such a person. If universities and schools won't take responsibility -- and they won't -- then someone has to.

Dr. Helen links Neo-neocon, also an expert in these matters:

The shooter's profile could have been written by almost anyone beforehand, so precisely does it fit what we've come to expect of people who end up as mass murderers. And if he did in fact go to counselors for some therapy sessions, I'd hate to be one of those counselors today. Evaluating potentially violent patients and deciding when to alert authorities about their dangerousness is one of the especially knotty and heavy responsibilities of therapists, and an almost impossible task.

Not every loner with a beef, an oeuvre of angry essays, and a love of guns wids up blasting away thirty-two people--or even one, himself. But many of those who do so were loners with just those characteristics. To differentiate the first group from the second is fiendishly difficult, although in our desire to protect ourselves we like to think we can predict better than we can.

However, if this young man had voiced specific and credible threats against others, his counselor would have had a duty to seriously consider voluntary or even involuntary commitment, a controversial and imprecise instrument for attempting to evaluate and treat such an individual and prevent him (and it's almost always a "him") from exploding into murder.

The details will emerge with time. But so far, no real surprises on that score.

Clayton Cramer thinks the deinstititutionalization of the mentally ill is contributory factor and says it has gone too far:

....over the last forty years, one of the consequences of the deinstitutionalizaton of the mentally ill has been not the release of those who were hospitalized, but the reluctance to hospitalize those whose behavior was peculiar or worrisome.

[...]

American society was too willing, not that many years ago, to lock someone up in a mental hospital on the say-so of an authority figure. But we have clearly gone too far the other direction--and the consequences of this unwillingness to hospitalize those who are deeply troubled sometimes gives a bitter and bloody harvest.

But whether Mr. Cho could have been hospitalized I don't know. He would have to be considered a threat to himself or others, and it's a tough standard. If they had tried to commit him, he'd have been entitled to legal representation, and there's always the possibility that he or his family might sue the university (a possibility of which I'm sure the latter is aware).

I think if standards are toughened as a result of this, it will be more along the lines of making it impossible for anyone who has ever sought treatment for mental illness to ever buy a gun. Couple that with the notion that nearly all of us are all mentally ill (whether from depression, neurosis, OCD, ADHD, "codependency" etc.) and I don't think it's much of a stretch to see a movement to use mental illness as grounds for disarming a lot of people who, while they might arguably need treatment for one thing or another would never shoot anyone.

Easy answers are not staring me in the face. In the old days, people either were clearly insane or they were not. It was a definition based on common sense. A neurotic who counts cracks in the sidewalk or an agoraphobe who can't stand to leave his house -- these people are not insane.

I think there's a hesitancy to say that anyone is insane, though. Terms like "insane" or "crazy" are seen as hurtful. Yet it seems the more the definition of mental illness is expanded, the fewer people there are who can actually be considered crazy.

The worst aspect of trying to spot a guy like Cho is that there are probably lots of loners who fit his profile (hating rich kids, debauchery, writing bizarre screeds, etc.) but the vast majority of them will never kill.

Obviously, if the man truly was criminally insane, it would have been wise to lock him up.

Wisdom always seems to work better in retrospect.

MORE: The Cho situation gets more complicated. Clayton Cramer links this ABC report that Cho had previously been hospitalized against his will in December 2005, "after two female schoolmates said they received threatening messages from him and school officials became concerned that he might be suicidal." Cramer noted that the Brady Law background check seems to have failed. It's not surprising. Another gun law which failed to stop him was the one making it illegal to file off serial numbers.

UPDATE (04/19/07): Sean Kinsell links this post and rebuts the ridiculous notion that "Seung-hui's Korean-ness relates to his having shot at several classrooms full of college students." (It came as news to me that anyone would think such a thing, but I guess it shouldn't have.)