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Mass murders and mental illness

The Daily Reflector - 10/16/2017

I have a confession to make. After seeing thousands of patients with mental health problems over the years, I know that some of them have committed suicide or serious violent crimes and I always have regrets because, in retrospect, I did not take hold of the patient as much as I should have.

However, every patient that I see with depression, anxiety, mood disorders or even schizophrenia is told at the start that injury to themselves or to someone else can happen and therefore they must do exactly what I tell them or I’m not going to give them medications and I will refuse to treat them.

Often it means they must have someone move in with them. In the small cities and towns where I worked, word gets around and the families wanted me to do exactly what I just explained.

In general there is little difference between patients with the same mental illness and the outcome of their treatment depends on how completely patients are followed up. If necessary it must be free.

Mental illness, unlike most physical illnesses, can always turn into a matter of life and death. It seems to me in the case of James Holmes, the “Batman” mass killer, and Stephen Paddock, the “machine gun” mass killer, that somewhere along the line some doctor may have missed the boat.

In the case of Stephen Paddock, I know the police are doing everything possible to determine what the motive was for the mass murders. Unfortunately there is usually no rhyme or reason why schizophrenics who hear voices, see things and believe people are trying to kill them commit murder. Scientists have noted chemical and physical changes in their brains as well as changes in the ventricles and cortex at autopsy.

Like most Americans, I am in favor of gun control, but we also have to improve the diagnosis and treatment of mental health patients.

Robert Piat



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