It's obvious now that Jared Lee Loughner should have been stopped. In accounts by news organizations, his madness escalated so clearly: the classroom outburst about strapping bombs to babies, the government conspiracy talk, the eerie, miscued smiling.
But for those of us with a schizophrenic in the family, the progress can look a lot like a rebellious teenager dabbling in drugs and struggling to cross into manhood - not ideal, but in a word, normal.
People ask, why didn't Loughner's parents stop him? We may never know what other steps the family took - nor do we know whether the suspect is mentally ill, though he displays all the signs. But his father was alarmed enough to chase Jared into the desert - ultimately losing him - the morning of the shootings at the Safeway meet-and-greet in Tucson. To me, as the sister of a schizophrenic man, this is the quintessential family face of mental illness: chasing, and powerless.
Families, and other authorities, have too few tools for this disease that sickens men on average at 18 and women at 25. In Arizona, like more than half the states, in the absence of specific threats, it's impossible to force someone into treatment. The law requires that individuals constitute a danger to themselves or others. That means, in most cases, a suicide attempt or a crime. As we know from Tucson, waiting for such evidence can be fatal.
Since the 1970s, Americans have moved firmly away from forced treatment, horrified by stories of brutish conditions, lobotomies and traitorous relatives signing away a poor soul's freedom. But we have journeyed so far in the opposite direction, in our concern for the civil rights of the mentally ill, that they are too often going without the medical care they need.
Like other illnesses, this disease can worsen when left untreated. The consequences can be catastrophic.
Postponing help until after a crime has packed this country's jails and prisons with the mentally ill: The Treatment Advocacy Center, a national organization that wants stronger involuntary-treatment laws, estimates there are 280,000 mentally ill locked in correction facilities today, up from 170,000 a decade ago. These people are often not receiving the care they need to get well and live lives outside of a cell.
In September, Pima Community College, where Jared Loughner was enrolled, was sufficiently unnerved after several incidents that it sent two campus police to tell Loughner and his parents that he had been suspended - and those officers had backup waiting in the neighborhood, just in case. The school wanted him to be cleared by a mental health professional before he could return.
The school protected its students. But didn't college officials also have an obligation to the greater community? William Galston, who advised the Clinton administration on domestic policy, argued in The New Republic last week that college personnel, Loughner's parents and other adults should have been required to report his actions to the police and the courts.
One result, at least in New York, might have been a judge's order for a temporary commitment and medication. The threshhold here is "need for treatment," not just a person's likelihood of being dangerous. Nearly half use this standard, and 44 permit court-ordered medication. But the laws are rarely used. California, for example, recently passed Laura's Law but has not enforced it, lacking money and treatment resources, and fearful of violating patients' freedoms.
It's the nature of mental illness that nearly half of those suffering do not realize they are sick. That's why those of us around them need to give chase - and persist until we help them.
Originally published in Newsday