The Crazy Among US

What do we do with the crazy among us?  The revelations about the recent shooter in Santa Monica and others reveals that they were primed to commit an egregious act.  "Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year.1 When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people.2 "  Of course, the numbers above apply to all disorders from Schizophrenia to Agoraphobia.  There is no number for the proportion of mental disorders in which the individual will go out and shoot people.  Medical conditions are private, as is their conversations with their care providers.  Adults have their own rights.  The Santa Monica shooter was given a mandatory psychological evaluation and released three days later.  If you are an adult, the standard is no incarceration unless you are an immediate danger to yourself or others.  Most aren't.  Most are, despite their condition, intelligent enough to tell the doctors what they want  to hear and save their rage until they are released.  Given the numbers, we should feel good about the number of crazy people who commit violent acts.  It is a very small percentage.  We should also realize that the numbers are overwhelming to any monitoring systems we might have in place.  Until we have an economic way of monitoring the most dangerous among us, we will always have Santa Monica scenarios.  

1. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.

2. U.S. Census Bureau Population Estimates by Demographic Characteristics. Table 2: Annual Estimates of the Population by Selected Age Groups and Sex for the United States: April 1, 2000 to July 1, 2004 (NC-EST2004-02) Source: Population Division, U.S. Census Bureau Release Date: June 9, 2005. http://www.census.gov/popest/national/asrh/