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Medical reluctance to call in the police is rooted both in therapeutic practice and the practicality of the law. Successful treatment of mental illness depends on the confidence of the patient in the therapist. If doctors were expected by the public and their patients to report every threatening remark, they would soon have few patients. Moreover, as New York's Deputy Police Commissioner Sylvan Fox noted last week, "we can't arrest people because they are ill." Adds New Jersey Psychiatrist Henry A. Davidson: "We are in a situation now where there is enormous pressure for civil rights. The idea of locking someone up on the basis of a psychiatrist's opinion that he might in the future be violent could be repugnant." It would also be a very poor way to help the vast majority of disturbed people who make threats that they will never carry out.
Some states empower a doctor to order commitment to a mental hospital when he thinks a patient dangerous—at least long enough to subject him to a thorough examination by psychiatrists. Other states insist that the individual commit himself voluntarily, that his family commit him or that the courts remand him into hospital care. In such situations, the doctor can only try to persuade, though the psychotic is not notably amenable to having himself locked up. Nor, often, is his family, who may still regard mental illness as a shameful smirch and resist formal commitment to an institution until it is too late.
Study v. Punishment
For this reason, most medical men believe that the best way to catch psychotics before they begin shooting is a long-term program of education in mental hygiene, more psychological testing in schools and colleges, and the spread of community clinics that can make instant help available to all. Necessary, too, is more money and manpower for research. Far too little is known about the mass murderer because he erupts infrequently—and even less frequently survives to be examined. Psychiatrists firmly believe that Richard Speck, accused of the nurse killings, ought to be studied intensively rather than punished by society, if found guilty. Pilot studies in Massachusetts and Illinois of juvenile offenders indicate that many potential psychotics may be identifiable and curable while in their teens, and an important segment of the medical profession has not given up hope of finding the cure to psychosis in the chemistry of the brain. While science may never develop a foolproof psychiatric Geiger counter or a cerebral "Pap smear" for spotting every psychotic in advance, there is no doubt that far more can be done within the resources of the Great Society to pare the danger of sudden, irrational murder.