Continuing Coverage by:

COLUMN: How Far Should We Go to Prevent Catastrophes?

June 19, 2007

By A. Barton Hinkle

RICHMOND, Va. — Why aren't there more 9/11 scale attacks on American soil?

Partly because the system designed to stop them is working. Authorities have broken up several plots in the past few years, and have proudly publicized the results. It's a safe bet that some ter rorism-prevention measures are taking place with less publicity — the kind that involve special-forces teams sneaking into tents at night and strangling would-be hijackers with piano wire.

There also haven't been major terrorist attacks on American soil because such incidents are rare occurences by nature. Even in bloody places like Iraq and Palestine, most killings are done with small arms and satchel bombs. Not every nutcase with a grudge wants to set off a nuclear weapon — and those who do can't simply buy one off the shelf.

It might even be the case that some of the more controversial measures enacted by the Bush administration — such as warrantless wiretapping and detaining enemy combatants at Guantanamo Bay — have helped fend off another attack.

All of which brings us to Seung-Hui Cho's massacre at Virginia Tech, and what should be done to prevent another similarly rare but catastrophic event.

Virginia's inspector general for mental health, James Stewart III, has completed an accounting of Cho's involvement with the mental-health system. Like the 9/11 report, it notes tragically missed opportunities and stovepipe intelligence — a lack of communication between agencies. Stewart's report leads to an obvious conclusion: If the system had worked perfectly, then it might have prevented the massacre at Tech.

But then again, it also might not have. No one knows with certainty the answer to the question, "What if?"

What's more, it might be the case that the mental-health system as currently constituted already has prevented a number of Tech-like incidents. If they don't happen, then they don't become major news events, so nobody knows about them. It's foolish to assume that one single catastrophic failure means the entire system is broken.

Still, it's wise to make incremental improvements to reduce the possibility of catastrophic failure in the future.

The state's mental-health system requires particular attention in the areas of commitment equitability, outpatient care, transitional housing, and juvenile treatment. And there is a crying need to stop warehousing the mentally ill in jails and prisons. The deinstitutionali What if the gubernatorial election were held today? For more, go to the Barticles blog on inRich.com.zation movement of recent decades has, in large part, been simply a re-institutionalization movement as persons with severe problems are swept off the streets and into correctional facilities.

(As Bernard Harcourt, a professor of law and criminology at the University of Chicago, points out: "From 1935 to 1963 the United States consistently institutionalized [mentally ill persons in mental hospitals and psychiatric wards] at rates well above 700 per 100,000 adults." However, "over the past 40 years, the United States dismantled a colossal mental-health complex and rebuilt — bed by bed — an enormous prison . . . .[In 2002], our imprisonment rate rose above 600 inmates per 100,000 adults.")

As a result of the tragedy at Tech, Congress is tightening gun-control laws to ensure that people who have been judged a danger will show up on instant background checks. That's good. Virginia will almost surely make improvements to its mental-health system. That's good, too.

Yet since 9/11 there has been concern — richly justified, in some cases — about overreaction to the terrorist threat (overreaction through, e.g., the Patriot Act, warrantless wiretapping, extraordinary rendition, indefinite detention of enemy combatants at Guantanamo, the use of torture, and the war in Iraq). Likewise, there is a danger that state and federal authorities could pass measures in their haste to respond to Tech that they will repent in leisure later on.

Not that long ago, this newspaper was full of horror stories about people imprisoned in mental wards against their will for years on end — despite their seeming fitness to return to society. In fact: Stewart, who wrote the report released last week, occupies a position (inspector general) created by the Gilmore administration in response to articles such as this one: "Advocates say too many people are forgotten in state mental hospitals. The state itself says there are hundreds of people in its institutions who don't belong there." ("Left Behind: Some Patients Have Been Institutionalized for Years" — September 15, 1998.) Since then Virginia has implemented further deinstitutionalization of the sort Harcourt refers to. Virginia's mental hospitals, which once held roughly 6,000 patients, hold fewer than 1,500 now.

That's not necessarily a bad thing. Virginians should take care to remember that Cho is hardly representative of the typical person with mental issues. The mentally ill might commit a disproportionate share of violent acts — but the proportion of mentally ill persons who are violent is actually quite small.

Life is complicated. Striking just the right balance is tricky.

There are those who want to find someone to fault for the massacre at Tech — and who are eager to blame "the system" rather than the person ultimately responsible for it: Cho. Virginia should do its best to improve the state's procedures for helping the mentally ill, and not just because of the Tech massacre. But the state's residents should not think a better process necessarily would have prevented the tragedy — or that the current process has not stopped similar incidents, or that the lack of another such incident is automatically a direct result of any reforms that might come to pass.

As with the absence of a major terrorist attack, it might be impossible to pin down precisely why something that is quite rare by nature doesn't happen more often.

"My thoughts do not aim for your assent — just place them alongside your own reflections for a while." — Robert Nozick

Contact Michael Hardy at mhardy@timesdispatch.com or (804) 649-6810.