Thinking the unthinkable

In a population of about 800,000 people there are about 4,000 people on the books of specialist MH treatment services at any time.

There are about 2,000 people with a diagnosis of psychotic illness (eg, schizophrenia). There are about 3,000 people with a diagnosis of mood disorder (eg, depression).

There are about 60 beds for 'adults of working age'[1] with a MH problem. Most treatment is successfully provided in the community by community and home treatment teams. Staff visit people in their homes daily, weekly, fortnightly, monthly, whatever. Treatment is not just medical and drugs, it involves therapy, but it also involves occupational stuff. (Occupational stuff does not just mean 'work' (although that's important and there are specialist teams focussed on 'place and train' return to work) but includes meaningful social activity, education, exercise, family and friend networks, etc.)

There are no beds in county for children. Children with a need for a psychiatric in-patient stay are sent out of county. (Apart from a short time each year when adult drug and alcohol re-hab is used for children.)

There are a small number of beds in a low-secure forensic unit.

There is an estimated 30,000 (thirty thousand) (high end) or 22,000 (twenty two thousand) (low end) people with a probable diagnosis of one of the personality disorders.

PD is a difficult diagnosis. It used to be a diagnosis of exclusion. Someone with a diagnosis of PD would not be committed to MH hospital, because PD was thought to be not treatable. PD is no longer a diagnosis of exclusion. Someone with a diagnosis can be committed to a MH hospital. But they are much more likely to find themselves involved in the criminal justice system.

Gloucestershire has had a well known incident where someone with a mental illness has killed - (http://news.bbc.co.uk/1/hi/uk/1182902.stm) (etc).

The serial killers Fred and Rosemary West lived in Gloucestershire. They killed maybe 13 people. (https://en.wikipedia.org/wiki/Fred_West)

We hear a great deal about these significant murders. We hear very little about the every day murders - the murders by the sane. Very many children are raped or abused or murdered by their sane parents; very many people are murdered by their sane spouses; very many sane people commit acts of violence every day. We don't hear too much about the number of ill people killing themselves. (UK: about 1000 murders a year, about 4000 suicides per year.)

People with a mental illness are far more likely to be the victims of violent crime than to be the perpetrators of violent crime.

The US does have serious problem with terrible care for people with mental illness. Do you really need a spree killing to start that discussion? Do you walk past the homeless and think it's okay so long as they're not killing anyone?

[1] Historically services have been split between "old people"; "adults of working age"; "children and adolescents"; and "people with an IQ < X". There are problems with these arbitrary divisions, and modern services are moving away from them.

In the 12 years since we've only had one incident. In 2002, a member of a sport shooting club (one of the few categories of people allowed to own handguns) opened fire in a Monash classroom. He killed two people and wounded five others, but since he could only manage to acquire handguns he had to switch weapons and was tackled to the ground. No doubt things would have been a lot worse if he'd had access to something with a larger magazine. We tightened laws on handguns after that as well.

I find myself surprised that an otherwise relatively pragmatic people get so blind to the consequences of readily available firearms. I don't have any ideological opposition to guns - in fact, I quite like them - but if someone told me that yoga was involved in every killing spree in the last decade it would be pretty silly not to take a serious look at whether ready access to yoga is worth the cost.

There are nations on this earth where people consider themselves fortunate if they can just eat 2-3 times a day. Probably send their kids to their school(Where education is just for names'sake), have some clothes to wear, not fall ill and live with minimal dignity.

The situation is far better in US, people is US probably don't even have an idea how bad things are for people outside. Most US citizens aren't even remotely likely to face such situations.

I guess at the end its too much luxury, and law of diminishing utility kicking in.

I think people in US should face some real hardships in their lives, what people else where face. May be when they see for themselves how fortunate they were with what they had before. They will learn the importance of things the hard way.

When you are learning how to write as a small child, it's a big deal to write clearly (for obvious reason). Then you are forced to learn cursive, and its a big deal to write cursive clearly.

Then it doesn't matter anymore. Literally everyone stops caring as long as it is legible. It's a weird system. While you are learning to read and write, there is an emphasis on penmanship. But once you are literate...no one cares anymore. Most people (like myself) degenerate back to chicken scratch. Especially as typing became more prevalent. I would hazard a guess that children in the States have even worse handwriting nowadays.

If you watch that video, you will understand how scary the situation is. If someone could easily get hold of such things, I'm not sure how they react on a moment of anger...