The real Navy Yard scandal

by Charles Krauthammer
September 19, 2013

Excerpt:
Delusions, paranoid ideation, auditory (and somatic) hallucinations: the classic symptoms of schizophrenia.

So here is this panic-stricken soul, psychotic and in terrible distress. And what does modern policing do for him? The cops tell him to “stay away from the individuals that are following him.” Then they leave.

But the three “individuals” were imaginary, for God’s sake. This is how a civilized society deals with a man in such a state of terror?

Had this happened 35 years ago in Boston, Alexis would have been brought to me as the psychiatrist on duty at the emergency room of the Massachusetts General Hospital. Were he as agitated and distressed as in the police report, I probably would have administered an immediate dose of Haldol, the most powerful fast-acting antipsychotic of the time.

This would generally have relieved the hallucinations and delusions, a blessing not only in itself, but also for the lucidity brought on that would have allowed him to give us important diagnostic details — psychiatric history, family history, social history, medical history, etc. If I had thought he could be sufficiently cared for by family or friends to receive regular oral medication, therapy and follow-up, I would have discharged him. Otherwise, I’d have admitted him. And if he refused, I’d have ordered a 14-day involuntary commitment.

Sounds cruel? On the contrary. For many people living on park benches, commitment means a warm bed, shelter and three hot meals a day. For Alexis, it would have meant the beginning of a treatment regimen designed to bring him back to himself before discharging him to a world heretofore madly radioactive.

That’s what a compassionate society does. It would no more abandon this man to fend for himself than it would a man suffering a stroke. And as a side effect, that compassion might even extend to potential victims of his psychosis — in the event, remote but real, that he might someday burst into some place of work and kill 12 innocent people. 
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(Raymond practices in the area of psychiatric legal matters and is a guardian for several veterans.  He describes it this way: " This area of the law is quite literally insane. Our rights-oriented approach toward mentally ill people allows them to wander around, harm themselves and others, and destroy both families and strangers around them. This was just one example of that [Navy Yard] but there are a thousand smaller examples that I have seen. I hope the Liberals who have such a rights notion of mentally ill people will take notice that this is the root of the cause, and not AR-15s, shotguns, or any other weapons. Mentally ill people shoot large numbers of people with guns; sane people do not."  -PD)