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Most mental health funding is not targeted to those who need help the most and we must overhaul our system of care, Doris A. Fuller tells Washington Journal host Steven Scully on C-SPAN.

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Shot by a man whose hallucinations were so serious he called police in terror barely a month ago, the 12 people killed Monday at the Navy Yard in Washington September 16 are the latest victims of America’s failed mental health policies and civil commitment laws that need to be improved

aaron-alexis“This is a classic example of the failure of our mental health system – and the price we all pay for that failure,” said Doris A. Fuller. “Aaron Alexis was clearly suffering an acute psychiatric crisis. He was like a man in the grip of a terrible heart attack. But because of our dysfunctional approach to mental illness treatment and weak civil commitment laws in the state where he was deteriorating, he wasn’t treated like the victim of a severe medical emergency in need of intervention. Now 13 people including Alexis are dead, eight more are injured, and the lives of innumerable others are forever changed.”


Passage of the Community Mental Health Centers Act of 1963 and the resulting wholesale closure of public psychiatric hospitals decimated the inpatient system that once provided care for the most acutely and chronically mentally ill individuals. Today, the nation has 5% the number of public beds it had in the late 1950s, and untreated mental illness is a factor in an estimated 50% of rampage killings and 10% of all homicides. It is also a major contributor to homelessness, jail and prison overcrowding, victimization of individuals with mental illness and suicide.

Research shows that individuals receiving effective mental illness treatment are no more likely to commit violent acts than the general public, but the system for providing timely and effective treatment to those most at risk for violence has been dismantled and nothing has replaced it.


At the same time we were emptying the nation’s psychiatric hospitals, civil commitment became increasingly limited to individuals demonstrating an imminent danger to themselves or others.

Rhode Island provides a case in point. Just over a month ago, Newport, Rhode Island, police responded to a call from shooter Aaron Alexis’s hotel room, where he told officers he was being followed by someone who “had sent three people to follow him and to keep him awake by talking to him and sending vibrations to his body” via a microwave. Alexis, 34, moved to three different hotels in a single night to elude the voices and the people he believed were sending the vibrations, according to a police report.

The responding officers told Alexis to stay away from the individuals he thought were following him and concluded, “No further action was required.”

“Under the laws of some states, Alexis could have been taken to a hospital for emergency evaluation,” said Fuller, “but in the absence of violent or suicidal acts or threats, it appears he was not considered committable in Rhode Island,” which requires that an individual with mental illness demonstrate “likelihood of serious harm” to qualify for involuntary treatment.

Read Dr. E. Fuller Torrey’s article on the most recent mass tragedy in the National Review Online.

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