A country gone insane ...

Now Dr Bennett was not actually trained in the US, nor in Europe, and there are a few question marks of an ethical nature hanging over this guy’s past. But the authorities did not mind, they want Maturana treated and killed, fast. The doctors of Arizona did mind. It was pointed out that if Dr Bennett wanted to treat Mr Maturana he would need to be licensed by the state of Arizona’s medical board. The Board isn’t too keen to let Bennett join their ranks for the unique Kevorkianate task of killing a patient. Furthermore, the AMA ethical policy specifically forbids treating a prisoner to restore mental competency unless the prisoner's sentence has already been commuted to life. The situation is now at an impasse and all sides are calling on the legislature to make sure this won’t happen again. Meanwhile, as all eyes are turned towards Arizona to see how the situation is resolved, another condemned man deemed incompetent is on his way to the state hospital with instructions to treat him until he is healthy enough to be killed.

The Arizona authorities may seem a bit blood thirsty but in their partial defense they do not actually believe that Maturana is actually mentally ill, they think he is faking it. This might be a bit unlikely given he has been diagnosed as seriously ill by so many doctors, even Dr Bennett, but authorities are wary of the mentally ill claim because it has become so common. One prosecutor in the Maturana case called it "the excuse of the month". This is not to say that the "excuse" actually succeeds on a regular basis but applications alleging mental illness or damage are constantly being made and the authorities are tired of reading the claims (and paying for the expert opinions). They are taking a stand with Maturana because they feel if he succeeds it could be the tip of the iceberg (with a slippery slope heading down to floodgates).

The thing is that these positions are not mutually exclusive. The excuse may be so prevalent because they are so many people on death row with serious mental damage or illness. This accords with common sense given that most sane people do not commit the kind of crimes these people are accused of. It also accords with a growing body of evidence. In one revealing study by two psychiatrists 15 death row inmates were examined. They were chosen not by any common traits but because they were those closest to being executed. The study discovered that ALL of them showed symptoms of serious mental injury or illness including delusions, memory loss and regular bouts of unconsciousness. They all also had a history of serious head injuries - not little bumps but being hit on the head by a horse kick, or a car, or an iron bar, or smashed against a wall, most more than once. Some had histories of head injuries like Homer Simpson’s. The inmates were not making it up, proof existed in medical histories, and in scars. But very few inmates had raised their mental issues at trial. Despite the perception of malingering, many serious sufferers of mental illness tell few people about their symptoms. Some like the Unabomber Ted Koconski, actively disguise their symptoms in order that people might think they are sane.

Rampage Killers

Another interesting study was recently conducted by the New York Times on rampage killers. Rampage killings are actually incredibly rare but after the Columbine shootings they have attracted an enormous amount of publicity and prompted various law enforcement proposals. The Times looked at 102 killers in 100 rampage attacks in a computer-assisted study looking back more than 50 years. The Times stated "425 people were killed and 510 people were injured in the attacks. The database, which primarily focused on cases in the last decade, is believed to be the largest ever compiled on this phenomenon in the United States." The results of the study are so fascinating they deserve separate treatment but some of the findings stand out in this discussion. The study discovered that the biggest link between the killers was not interest in violent video games or movies or dabbling in satanic cults but … you guessed it - mental illness.

More than half had histories of serious mental health problems - either a hospitalisation, a prescription for psychiatric drugs, a suicide attempt or evidence of psychosis. Many of the rest showed symptoms of mental illness before the killings. Now I am not suggesting that people with mental illness are all potential rampage killers. In fact, even people with very serious mental illness are usually no more dangerous than anyone else provided that they take medication and/or receive treatment. The tragedy in these cases was that the people had either stopped medication or treatment or had gone untreated despite constant warning signs. The two biggest trigger events were found to be the end of a relationship or being terminated from employment. These people didn’t just get fired, "snap" and "go postal". Many of them got fired because they were displaying erratic behavior as a symptom of mental illness One might assume similar problems contributed to some of them being dumped.

Conclusion - what can be done?

Obviously the studies of the 15 inmates or the rampage killers do not represent conclusive proof that most death row inmates are mentally ill or damaged. The subjects represent a tiny fraction of convicted murderers. But the studies raise so many important questions. If an almost random sample of 15 inmates finds that all are mentally damaged how many are really out there? Is there a link between head injuries and the commission of violent crime? Are most killers driven by mental forces we don’t properly understand? Could rampages have been prevented by identification of mental illness or by better treatment?

These questions are important and they suggest society has a responsibility to find out more about the reasons why people commit crime. Public safety could be improved if more effort was taken to understand the dimensions of mental illness and damage. Instead courts and prosecutors seem determined to dodge the tricky issues, dump all blame on the defendant, label the mentally ill as malingerers and execute them as quickly as possible.

Some changes seem obvious. Lisa Duy, 24, went to a gun store, bought a semi-automatic pistol, was taught how to shoot it by the gun store owner in the basement, walked out wearing the protective ear mufflers she has been lent and less than two hours later, still wearing the mufflers, opened fire at a TV station. She had a long history of psychiatric problems, was suffering from paranoid schizophrenia and only a year before had been committed to a mental hospital by a judge after threatening to kill an FBI Agent.

Does the bit about buying the gun stick out to anyone else? There is a debate right now about whether background checks for gun buyers can access mental health records. The mental health lobby has curiously joined forces with the NRA - arguing about privacy rights and the stigma already attached to people with mental illness. I understand the danger of stigma - especially when it is facing insane people on death row - but I am pretty indifferent to the rights of anyone to buy semi-automatic weapons. It is much harder to go on a murderous rampage with a knife - the recent increase in rampage killings has coincided with easier access to semi-automatic "spray and pray" weapons.

But then that is the US: the state allows the mentally ill to purchase guns to reduce stigma and then kills the mentally ill when they use them, to demonstrate killing is unacceptable - provided the mentally ill can discuss guns which proves that they are a genius. The problem all stems from the same fundamental ignorance about mental illness (and guns) but the US authorities resist finding out more in favor of quick, and brutal, solutions. Perhaps they should just propose that all those with head injuries or mental illness be killed at birth - preventative policing meets zero tolerance. But then what do you expect? It is hard to advocate better understanding and treatment of mental illness in a country where the law makers and judges show the biggest sign of insanity. The lunatics have taken over the asylum.