Good article by psychiatrist Paul Steinberg (http://www.paulsteinbergmd.com/) in The New York Times (“Our Failed Approach to Schizophrenia,” http://www.nytimes.com/2012/12/26/opinion/our-failed-approach-to-schizophrenia.html?_r=012/25/12). He writes bravely about the way in which the rights of mentally ill American citizens wind up encroaching upon the rights of other citizens to feel decently safe in public from the more malignant expressions of violence and irrational thinking.
I say bravely because Steinberg makes reference to his unorthodox choice to discuss schizophrenia and Adam Lanza and other mass murderers in the same piece in spite of the “Goldwater Rule,” an ethical standard of American psychiatry preventing psychiatrists from commenting on the mental state of someone they have not evaluated. That’s how, in the aftermath of horrific crimes in which a mental disorder of some kind played a role, there is surprisingly little commentary from the vast number of mental health professionals who could be among those offering the most useful insights.
I particularly liked the author’s mention, if obliquely, of some of the missing pieces in our current mental health service delivery that could account for how individuals about whom parents or classmates or their school counselors believe something to be very wrong are able to continue on their dark paths wholly unattended. Our hands-off policy is admirable in theory, but may not be very practical—or just—in a national community where ready access to powerful weapons abounds.
There is an uncomfortable parallel here, too, in American family life. The same argument for the sanctity of privacy rights that we see in public is made millions of times every day on the parts of adolescents who astutely exploit their parents’ wishes to never be seen as overly-intrusive, or worse—“controlling.” That’s how so many moms and dads end up on the far margins of their teenager’s lives, wondering just what it is they’re doing with their time, and with whom. In these situations the more endangered party is the one whose privacy is being “protected”—small consolation though to the parent who (more often than not) wants only to remain a relevant and credible figure in their son or daughter’s life.