Deinstitutionalization and Mass Murder

Clayton Cramer has an interesting article in the Federalist Society publication that looks at the rise in mass shootings, and how they coincided with mass deinstitutionalization. I actually think it should be pretty difficult to commit someone to an institution against their will, but it’s pretty clear that complete deinstitutionalization of the mentally ill hasn’t served either the public, or the mentally ill, as well as many proponents of it had hoped.

Patrick Purdy, a mentally ill drifter, used his Social Security Disability payments to buy guns, while having a series of run-ins with the law. After one suicide attempt in jail in 1987, a mental health evaluation concluded that he was “a danger to his health and others.”27 In January 1989, Purdy went onto a schoolyard in Stockton, California with an AK-47 rifle, murdered five children and wounded twenty-nine others, before taking his own life.

And you can see how this issue affects ours. Californians now live under their assault weapons regime because the State of California, rather than ensure that the clinically insane were institutionalized, decided to, every so slightly, institutionalize everyone else in the state by limiting everyone else’s freedom.

53 Responses to “Deinstitutionalization and Mass Murder”

  1. Welcome to the Hotel California …

    • persiflage says:

      The feeling, Progressive way – empty the jails of society’s victims, make the entire country one big jail…

      • Yup. I found an article published in the mid-1970s when the consequences of California’s Lanterman-Petris-Short Act (which largely scrapped the old institutionalization system) were becoming apparent. The response of one of the defenders of the new system was that while it would certainly be less humane to the mentally ill, it would force the society to confront its hypocrisy about marijuana, homosexuality, and extramarital sex. “You have to break a few eggs to make an omelette,” to quote Berthold Brecht.

    • And not just California, although that was a leader with passage of Lanterman-Petris-Short Act in 1967. This was a nationwide movement, driven by ACLU lawsuits, a general hostility towards state mental hospitals which were considered inhumane and uncaring, and radical opposition to the notion of sanity as a bourgeois institution. Part of my book examines how the Socialist Patients Collective (a group of deinstitutionalized German mental patients) became the Baader-Meinhof Gang (also known as the Red Army Faction).

  2. DevsAdvocate says:

    I guess we can thank the small gov’t crowd eh?

    • Alpheus says:

      This isn’t so much as a “small gov’t” issue, as it is a “we can’t do anything against anyone’s will for any reason if they haven’t done anything illegal” issue.

      As someone who has strong inclinations towards so-called “anarcho-capitalism”, this is one of the unaddressed issues I have towards that particular system of government. (Another issue is that I’m pro-life–although being pro-life isn’t as nearly a huge issue as to what to do about the mentally ill, because technically, in “anarcho-capitalism”, even murder would be “legal”, in the sense that the only recourse to “punish” someone would be to sue them.)

    • Patrick H says:

      How so? Unless you are being sarcastic, its the big gov’t crowd we have to “thank”.

    • SPQR says:

      Actually, it was an initiative of the ACLU to make it more difficult to involuntarily commit people.

    • Not really. This was a mixture of civil libertarian, progressive hostility to state mental hospitals, and soft-headed liberalism.

  3. I think that a better argument against deinstitutionalization can be made when you look at the problem of chronic homelessness. The majority of the chronically homeless (90% if I remember correctly) suffer from mental health problems. And, they are the type who routinely go off their meds because they don’t like how the meds make them feel. These are people who, for the good of everyone, need to be institutionalized.

    • Mental illness rates among the homeless vary substantially from region to region, with the percentage much higher on the coasts (perhaps because mentally ill homeless people freeze to death in more severe climates).

  4. MicroBalrog says:

    Mr. Cramer fails to provide one answer: whom does he think should be institutionalized?

    Given he believes (and has stated so in the past) people like transsexuals should be institutionalized against their will, I’m continuing to doubt his policy solutions.

    Also, the amount of prisoners in the U.S. prison system is currently in decline – and so is the crime rate, which does not jive well with his prediction.;

    • Harold says:

      Given he believes (and has stated so in the past) people like transsexuals should be institutionalized against their will….

      Citation, please? I’ve read his blog for years, and recently when the self-defense incident blog he ran with another guy was targeted by that notorious copyright troll I helped check the contents of his personal blog for potential vulnerabilities. I don’t recall him ever saying anything even remotely like that.

      As for your last sentence, unless you normalize against the younger male population most likely to commit crimes those two statistics are of little use together. If that population is declining you’d expect both to decline as well. And there can be other reasons; not many are getting shot and crippled or killed, but certainly more … and certainly more criminal types know their risks have gone WAY up. Even for home invasions, since gun ownership has been going up since at least 9/11.

      • MicroBalrog says:

        Sorry, no citation. It was on his old, blog, I think, which he closed… but if I’m wrong, I’m wrong.

        Cramer is a very strong proponent about institutionalizing lots more people.

        • Harold says:

          His old blog is here, as referenced on the right side of his current blog. You can limit Google searches to it by including this in your search terms “”.

          If he’s as strong a proponent of “institutionalizing lots more people” as you say, you won’t have any trouble finding examples with a few minutes of quality time with Google.

        • I am certainly a proponent of returning to the traditional model on this–which did not involve institutionalizing people for being sexual deviants unless they were victimizing people.

    • I have never argued for institutionalization of transsexuals. EVER. Why? I have argued against funding sex changes.

    • Crime rates declined for a number of reasons, but as the article points out, Bernard Harcourt’s work demonstrates a statistically significant correlation between total institutionalization rate (prisons plus mental hospitals) and murder. Harcourt also claims that this is a better correlation than the other models used to explain the decline in murder rates in the 1990s.

    • Who should be hospitalized against their will? Persons who demonstrate that they are unable to care for themselves (by providing themselves shelter, food, or clothing) or whose actions demonstrate that they have lost contact with reality and are a danger to themselves or others. The Portland Oregonian ran a series of articles some years ago about people who starved or dehydrated themselves to death because of mental illness while family, friends, and police, looked on helplessly. By law, they could not intervene, because the danger was not “imminent.” By the time the danger was imminent, they had not been seen for some days.

    • You need to either retract this claim, or back it up. I have NEVER supported locking up sexual deviants of any type simply for deviance, and I have frequently blogged about the absurdity of imprisoning homosexuals in sex-segregated institutions.

    • MicroBalrog, I just searched the old blog for every use of the term “transgender.” (I don’t normally use the term “transsexual.”) I found a total of 32 posts from the roughly seven years the old blog covered. There is not a single reference to the idea that transgendered people should be institutionalized.

      There are several posts about prisoners filing suit to get the state to pay for their sex changes. And I have made it clear that sex-change surgery is really sick, a form of mental illness–it makes homosexuality seem downright normal by comparison. But I have never argued that someone should be locked up simply for this.

      • MicroBalrog says:

        Good to know. I apologize for misunderstanding, and misrepresenting, your position.

  5. Sage Thrasher says:

    I’ve read that a significant portion of those in prison ought to be in institutions. The typical pattern seems to be to ignore mental health issues until they become bad enough to harm someone. The gunman in AZ last year certainly had shown plenty of signs to everyone around him that he was dangerously insane, but neither the cops, his college or his family appear to have done anything about it. Part of it is the “not my problem” syndrome, but a bigger part of it is people not being willing to fund mental health treatment–obviously the homeless don’t have jobs, health insurance, etc., so it either goes on the public dime or, more often, nothing happens until it’s too late.

    • Yup. That’s the essence of the book that I am trying to find a publisher for. We wait until a mentally ill person kills someone, or darn close to it, and then they usually end up in a prison, which is bad for the patient, bad for the prison, bad for the other prisoners, and bad for the taxpayers.

  6. mobo says:

    I think that more than any other factor, media coverage of these mass shootings breeds copycat shootings. I have no data to back this idea up, but I suspect that the more national nature of media coverage that has been ramping up since the ’90s will correlate very strongly with the increase in the frequency of mass shootings.

    • Sage Thrasher says:

      Mass shootings may be en vogue in the US these days, but mass murder events (as distinct from serial killers) have deep roots in American society (Google “Bath School Disaster, for example.) The famous comparison is between us and the Swiss, who are generally better armed but tend not to think the ending scene in “The Wild Bunch” is a good primer on how to deal with getting fired.

      It’s interesting to look at which countries do & don’t tend to suffer these kind of events–China certainly does, usually with explosives; Turks seem to go in for mass murder by arson. Your guess is as good as mine as to why it is how it is.

      • jake says:

        true, true…
        i have to throw in my two cents that the problem isn’t guns, it’s narcissism. pure and simple… when a narcissist is combined with an ego injury it can take an eventually take an ugly turn…e.g. Purdy (the example cited above) being a half-retarded alcoholic drifter, unemployed and outshined by supposed inferiors (he was a neonazi and blamed south asians for taking white american male jobs). i think essentially most spree killings are more like Purdy; angry, hurt and ineffectual men protesting their own obsolescence. virginia tech, columbine, norway… very rare are they truly schizophrenics like Jared Loughner. i can’t even think of an actual schizophrenic (e.g. lost reality) among the ones I know about. i’m not sure this helps the discussion or not, as we take it as a fact that someone who would kill lots of people is mentally ill. i’m just saying that sometimes that choice is not because the voices told them to.

        • Virginia Tech was definitely schizophrenic. Not all the mass murderers are mentally ill, but the New York Times survey found that about half had clearly demonstrated evidence of severe mental illness. Purdy was actually diagnosed as paranoid schizophrenic; that’s why the government gave him money every month which he used to buy guns and ammo. The guy with the samurai sword on the Staten Island Ferry? Schizophrenic. The guy who murdered four people, with Jeanne Assam shot him in the lobby of the church in Colorado Springs? Schizophrenic. And that was the diagnosis of many of the examples in the article linked above.

          • jake says:

            i appreciate the condescending authority with which you say what you’re saying, but if i may defend myself for a second… virginia tech shooter Seung-Hui Cho was not diagnosed with schizophrenia, the reference in that article is from abcnews. but he was never formally diagnosed with schizophrenia. neither (from what I could tell, but I’ll look more into it) was Purdy. a mentally retarded misanthropic drifter, disgruntled, but reading his story he did not sound to be schizophrenic.. (hallucinations, delusions, disorganized thinking et al define this diagnosis). guy with a samurai sword… i’ll take your word for it. in order to finger point where I’m wrong, i worry you may have missed my point … people are depressed and psychotic and schizophrenic en masse every single day of the year, it is often the anger from an ego injury that is intolerable that leads to a spree killer. the pseudocommandos really end up getting lumped into this debate.

            • jake says:

              after re-reading my post (but after time I could edit_ i apologize for my own tone in this comment. you are the expert Clayton and I am not.

      • Oddly enough, European countries have even more mass murder events with guns than the U.S. I mention some of those incidents in the paper linked above.

    • “Ethical Problems of Mass Murder Coverage in the Mass Media,” Journal of Mass Media Ethics 9:1 [Winter, 1993-94] 26-42.

      An examination of the way in which statistically disproportionate coverage of mass murders by Newsweek and Time encouraged at least one copycat crime, and may have caused others. First Place, Association for Education in Journalism and Mass Communication Ethics Prize, 1993.

  7. brian says:

    I always seem to see a footnote on the mass murder stories that he had “just stopped taking his anti-deppreseant meds. just food for thought.

    • A more common relationship is that anti-depressants sometimes give severely depressed people enough energy to plan and carry out suicides. Sometimes these involve mass murder first.

  8. Tam says:

    So, we’re willing to gamble with freedoms in favor of safety, then?

    I’d suggest that this is a tree up which Team Liberty doesn’t want to bark.

    • Sebastian says:

      I don’t think too many people here are, and I am certainly not, arguing for a return to the good old days when you could more easily get someone institutionalized without any kind of reasonable due process. But in many states, it’s practically impossible to get adjudications, even for people who are clearly and plainly a danger to themselves and others.

      In truth, I’d be OK with letting someone walk the streets that’s just a danger to themselves. But I’m not sure with someone seriously mentally ill, that there’s much of a distinction to be drawn there.

      • There actually was due process for long-term institutionalization before the ACLU stuck its nose into this. I won’t claim that the system was perfect, but the notion that people were being commonly hospitalized for merely being eccentric does not seem to be the case. Even the ACLU, as late as 1963, when their representative testified before Congress about reforms to the process in D.C., could not point to a single example of an inappropriate hospitalization. There has been a long history of court struggles over this question, starting in the 1840s.

      • Good example: Jason Hamilton went on a rampage in Moscow, Idaho several years ago. He murdered three police officers. By some accounts, he was using a legally registered full automatic AK-47. A reporter I spoke to indicated that the bullet holes in vehicles were evenly spaced–suggesting that it was indeed a full auto. Hamilton had a carry permit, too.

        What made this weird is that:

        1. He had a domestic violence misdemeanor conviction, which should have caused revocation of permit and removal of the full auto.

        2. He had made a suicide attempt some months before, and told the psychologists doing the evaluation that the next time he was going to use guns or bombs, and take a lot of people with him. So instead of hospitalizing him (as Idaho statute allows), they released him. Why? Probably fear of suit. There’s a history on this that the ACLU caused.

    • An ounce of experience is worth a pound of theory.

      • David Green says:

        Clayton: Absolutely agree that “an ounce of experience is worth a pound of theory.” I read your article, and I think it makes a lot of sense. Just one thing concerns me, though, and that’s how to avoid going back to some of the problems that prompted de-institutionalization in the first place.

        For an example, see 995 F. Supp. at 536 (“Pennhurst was typical of large, isolated state residential institutions for persons with mental retardation. Forty-three percent of Pennhurst residents had no family contact within the past three years. Residents slept in large, overcrowded wards, spent their days in large day rooms, and ate in large group settings. There were few programs designed to increase their skills.”

        I agree that the solution (mass de-institutionalization) seems to have given rise to a new problem (mass shootings by people with mental illness). But how do we avoid going back to, basically, “warehousing” most people with a mental illness?

        • Note that retardation and mental illness, while at first glance quite similar, were actually rather different cases. The severely mentally retarded had no hope of recovery, and it is not surprising that warehousing (and often inhumane warehousing) was common.

          The mentally ill were another matter. Many were successfully treated, and if not cured, at least stabilized. Average stays in many states were about a year by the time the movement got under way. But there had been a long and ugly history to the state mental hospitals because of funding problems during the Great Depression and World War II, and much of this ugly history dominated the debate.

          Complicating this matter was into the 1960s, a large number of state mental hospital patients were senile (not mentally ill in the conventional sense) but were hospitalized because there was no other facility. Medicare’s arrival in the 1960s paid for nursing homes for the elderly senile, and this caused a massive movement of this population into private nursing homes (along with a significant increase in death rates).

          Additionally, into the late 1950s, much of the state mental hospital population was there because of tertiary syphilis mental illness. They were locked up because they were crazy and mentally dangerous because of the risk of spreading the disease. The introduction of penicillin pretty well wiped out this problem by the 1960s.

          Some opponents of deinstitutionalization like to point out the dramatic reduction in the number of patients in state mental hospitals (from about 550,000 in the mid-1950s to about 110,000 today) as a sign of how radical the change was. But as my book points out, this is misleading, because it fails to account for how much of this reduction was transinstitutionalization of the elderly senile, and reductions in syphilitic insanity.

          We spend public money on the homeless. As an example, the mental hospital at Creedmoor in New York has been reopened as a temporary homeless shelter–for many of the people who 40 years ago would have been hospitalized there. We spend a lot of money operating the criminal justice system for the small number of major crimes, and the swarm of minor crimes involving the mentally ill. It isn’t clear that restoring the state mental hospital system would be more expensive than what we do now.

  9. terraformer says:

    I am very late to this party but here goes. I disagree with the premise that single event mass murder is not rare any longer nor is it a modern phenomenon. Cowards have been choosing soft targets to kill en masse for millennia and in this country since at least the 1700s. School shootings (and bombings) have a long history in this country.

    I definitely don’t disagree that public policy decisions on mental illness have enabled mass shootings (as well as prohibition enabling gun violence) including making it easier for obviously disturbed individuals to enact such acts and other violence upon the public. But fixing mental health commitments won’t prevent en toto the mass murder. The perpetrators will change, but they will always occur.

    As for rarity, we are 4x the size population than we were in 1900. That means for every mass murder event back then, we get 4 now.

    • How many random mass murders (the killer wasn’t going after a particular person) can you identify in the U.S. before 1970? How many mass murders can you identify from the 1700s? Even then, they were not particularly random, and usually associated with mental illness.

      • terraformer says:

        So first off, you have just narrowed the scope down significantly by requiring “(the killer wasn’t going after a particular person)”. This doesn’t fit Reagan’s attempted assignation nor does it include Jarrod Lochner and a host of other mass murders by deranged lunatics which would fit into the rubric of mass murder.

        But even then, a good quarter of these fit the bill, including ones where the target wasn’t there so they shot up the place anyhow.

        And this one does big time.

        And this is only school related incidents. If I had unlimited free time I would find others.

        • Alpheus says:

          I would point out that Reagan’s attempted assassination doesn’t count as a mass-murder attempt, because Hinkley was specifically going after Reagan, and any other person who was shot, was shot incidentally to that. Of course, I’m not going to look into the details, but if I recall correctly, Hinkley was only armed with a six-round .22LR revolver–he wasn’t prepared for shooting a lot of people.

          On the other hand, Lochner walked up to Representative Giffords, shot her, and then started shooting everyone else around him. He had a magazine with over thirty rounds, and he had a second magazine that he couldn’t load, because the first one was stuck in the gun. While Lochner specifically targeted Giffords, he was also clearly planning on attempting to kill as many people as possible. I would thus think Clayton’s limitation is just.

          I would even go so far as to say that massacres, like Haun’s Mill (of Latter-day Saint history), should be excluded–where a lot of people were murdered, but they were murdered at the hands of a mob, rather than an individual. Mob violence has an entirely different dynamic than individual killing-spree type murders.

          Having said that, if we’re going to collect data on this, I think we ought to collect as many data points as possible, and then worry about the classifications later. :-)

      • terraformer says:

        So I figured I would look for some non school ones.

        Howard Unruh in 1949. The wiki for it references a CNN article which calls him the first US mass murderer. The bath incident basically putts that claim to rest as false but it’s typical moonbat to think the world went to hell after semi-auto firearms could be owned by civilians.

        You have already covered Chapman in TX but between Unruh and Kehoe (bath) that is at least two.

      • terraformer says:

        So with the addition of this “How many mass murders can you identify from the 1700s? Even then, they were not particularly random, and usually associated with mental illness.” which was an edit as it wasn’t there when I read it in my email, you are now asking for mass killers that don’t even fit the profile of your article.

        No problem though. Pontiac School Massacre in 1700s. One could argue that was an act of war but you didn’t preclude that.

        Point being, mass murder is not a new creation of humanity. And remember, I agree with the premise of your article. Our public policy on mental illness and prohibition is to blame for a lot of the violence we see as a society.

      • MicroBalrog says:

        How many mass murders can you identify, then and now, *per capita*? Does it even matter?