Bedlam revisited

By Jonathan Kellerman

Excerpted from The Wall Street Journal

Diagnosis from afar is the purview of talk-shows hosts and other charlatans, and I will not attempt to detail the psyche of the Virginia Tech slaughterer. But I will hazard that much of what has been reported about his pre-massacre behavior -- prolonged periods of asocial mutism and withdrawal, irrational anger and hatred, bizarre writing and speech -- is not at odds with the picture of a fulminating, serious mental disease. And his age falls squarely within the most common period when psychosis blossoms.

No one who knew him seems surprised by what he did. On the contrary, dorm chatter characterized him explicitly as a future school-shooter. One of his professors, the poet Nikki Giovanni, saw him as a disruptive bully and kicked him out of her class. Other teachers viewed him as disturbed and referred him for the ubiquitous "counseling" -- an outcome that is ambiguous to the point of meaninglessness and akin to "treatment" for a patient with metastasized cancer.

But even that minimal care wasn't given. The shooter didn't want it and no one tried to force him to get it. While it's been reported that he was involuntarily committed to a "Behavioral Health Center" in December 2005, those reports also say he was released the very next morning. Even if the will to segregate an obvious menace had been in place, the legal mechanisms to provide even temporary "warehousing" were absent. The rest is terrible history.

That is not to say that anyone who pens violence-laden poetry or lets slip the occasional hostile remark should be protectively incarcerated. But when the level of threat rises to college freshmen and faculty prophesying accurately, perhaps we should err on the side of public safety rather than protect individual liberty at all costs.

If the Virginia Tech shooter had been locked up for careful observation in a humane mental hospital, the worst-case scenario would've been a minor league civil liberties goof: an unpleasant semester break for an odd and hostile young misanthrope who might've even have learned to be more polite. Yes, it's possible confinement would've been futile or even stoked his rage.

But a third outcome is also possible: Simply getting a patient through a crisis point can prevent disaster, as happens with suicidal people restrained from self-destruction who lose their enthusiasm for repeat performances.

At the very least, in a better world, time spent on psychiatric watch could've been used to justify placing the Virginia killer on a no-buy gun list. I'm not naive enough to believe that illegal firearms aren't within reach for anyone who really wants them, but just as loud dogs deter burglars and crime rates drop during harsh weather, sometimes making life difficult for a would-be criminal is enough.

But all this remains in the realm of fantasy. Penning up and carefully scrutinizing the killer was never an option. Not in Virginia or California or any other state in the union. Because in our well-intentioned quest to maximize personal liberty, we've moved conceptual eons away from taking the concept of dangerousness seriously.

The best predictor of future violent behavior is past violent behavior, yet we regularly grant parole to murderers, serial rapists, chronically assaultive individuals and habitual pedophiles. Even when we do attempt to segregate low-impulse multiple offenders with effective tools such as with three-strikes laws, liberationist clamor never ceases.

Talk to anyone who's tried to commit a dangerously violent child or parent for even a few days: A stranger with a law degree will show up at the hearing and paint you as a fascist. So it's far too much to expect anything resembling a decisive approach to those whose level of threat remains at the verbal level.

Given the excesses of the past -- husbands committing troublesome wives, involuntary sterilization of those judged defective -- extreme caution is warranted. But like drunk drivers, we sway from one side of the legal road to the other and find the sensible center lane elusive.

Unless we confront the unpleasant fact that the brains of a small percentage of our citizens incubate dark, disturbed thoughts that can blossom into vicious behavior, we can look forward to repeats of last week's outrage.

Dr. Jonathan Kellerman is clinical professor of pediatrics and psychology at University of Southern California's Keck School of Medicine and the author of 27 crime novels and three books on psychology.