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Welcome to The Journal Editorial Report I'm -- if you go as the nation copes with the shooting deaths of six adults and twenty children and an elementary school in Newtown Connecticut efforts turn now.
To preventing the next tragedy with President Obama appointing a task force to study gun violence.
And members of congress calling for stricter gun control measures but my guess this week says the -- of the problem is not.
The availability of weapons but the abundance of individuals with severe mental disorders who are not being treated.
How America's failure to treat the seriously mentally ill is endangering.
Its citizens -- doctor -- welcome glad to have you here.
All my pleasure you would have said -- broke written for us -- you're not opposed to gun control but the access.
Mentally ill people to guns is is a bigger.
Threat how many people are we talking about here across the United States.
Both of both the gun problem at a -- as problem we have about seven million severely mentally ill people in the United States at any given time.
Of these half we're not being treated at any given time in about 1% or 70000.
Are potentially dangerous at any given time and we're not treating those people.
How do we get around to treating them.
We don't know for example that at a glance -- really was mentally we haven't seen if they're we don't know if there was a formal diagnosis.
So how do we identify those people and then make sure they get treatment.
Most of the potentially dangerous people we can identify you can walk into the police station in any small town in the United States.
-- who are the potentially dangerous people you know above.
Let's say well you know John over on fourth street we have to go and visit every two weeks because.
He gets a -- out threatens to kill as neighbors we know basically who the potentially dangerous people are.
But we often because the way the laws are written in most states.
We can't do anything until you actually act until it actually committed a crime will explain that why do we have to why do we have to -- -- police departments and others know when you say the laws the way the laws are written.
How how does that work.
Or in -- all that work.
Police or state law so they vary from state to state state Connecticut is an example -- among the most stringent the most restrictive.
Commitment laws so that the only way you can get somebody treated in Connecticut is if they are overtly a danger to themselves or others.
You can't treat them because they are potentially because they have exhibited dangerous.
Dangerous behavior in the past you have to wait until it actually do something.
They also Connecticut's a good example of what it will only six states that does not -- -- assisted outpatient treatment.
Which means you can treat the person living in the community on the condition they can live in the community -- condition that they take the medication.
Connecticut doesn't even have a law like that.
So what who makes that decision when you say assists -- outpatient treatment for example in the case of an atom Lanza who would make that decision about the fact -- saying look you would need to take this.
This treatment otherwise you're going to have to be incarcerated.
The petition could be filed by the mother or by another family member or by a member of the police for example if they thought the -- was dangerous.
They that would have to be examined I'm talking about a typical state right up -- have to big they that would have to be examined they would have to have a court hearing.
They would be defended by a lawyer.
So it's a judicial process.
That then says yes you have exhibited dangerous news.
We think you may be dangerous and remember Paul -- these people don't know they're sick they won't take medication -- terribly.
Because they don't think there's anything wrong with a so they then are basically adjudicated by a judge and said yes you can continue to live at home or wherever your living.
On the condition that you take medication if you don't take medication.
We have the legal right to put -- in the hospital in stable life.
-- these laws seem reasonable -- on its face -- you explain it so why what is the opposition to this kind of assisted outpatient treatment.
Very strong opposition and civil liberties union from the American ACLU the American Civil Liberties Union.
ACLU best -- -- here in Washington has been a major impediment.
And a lot of people just believe that nobody should ever be treated in voluntarily.
Now that gets that that that.
Flies in the face the fact that we treat people with active tuberculosis and voluntarily what they won't take medicine.
We also restrict people who have alzheimer's disease and don't know they're sick.
So we do this for other conditions but we have a lot of trouble thinking through this clearly for people with severe mental illnesses will -- well.
Mentioned in your op Ed stressed that the number of actual psychiatric hospital beds for severely -- -- -- patience patience has really declined in the last fifty years to more than half a million from more than -- into fewer than fifty.
Thousand I guess this is part of that movement you're describing.
-- Against incarcerating them mentally -- but you're saying that that decline in those beds -- has endangered the American public.
It has because if you try to get somebody.
Who needs hospitalization and to a hospital today it is virtually impossible as one of my colleague says is much easier to get somebody at Harvard than it is to get him at a mental hospital.
We have really only one out of the twenty -- that we had 5060 years ago.
Given the increase in population.
Of the -- that we used to -- for treating people with severe mental illnesses are now closed.
What are the states that do this well he said Connecticut doesn't do well but what -- do and what's the evidence that they're succeeding.
The states that are using assisted outpatient treatment New York is a good example they are using it.
Not widely but they're using it in the studies have shown that assisted outpatient treatment decreases re hospitalization.
-- is -- risk decreases time people spent in jail.
And there are studies from both North Carolina and New York showing that this kind of treatment will decrease episodes of violence as well.
Is now a recent study for -- California.
Showing it's also cost effective for every dollar you spend on this program.
You save up to two dollars and you can do this you say the evidence is that you can do this without really abusing the civil liberties of people and and incarcerating them for months there.
-- years on an -- or treating them against their will for months and years on end.
Well you're treating people against their will.
Sometimes for long periods of time all older living in the community if they have no awareness of their illness OK if they if they really think the CIA is sending those voices and their head.
And they have no awareness of their illness in the CIA is telling him to do various things these people need to be treated for long periods of time.
But they can be done so while they live in the community.
OK doctor -- thanks so much for being -- fascinating.
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