There are many reasons why people who are referred for treatment ultimately fail to receive it. In addition to their own lack of will or insight about the need for treatment, there are structural barriers in society that prevent follow-up among people who do want treatment; one of the most significant barriers is the managed health insurance system (Hersen & Kent 5). In the case of Cho Seung Hui, it is not yet known whether he received follow up, and if he did not, what the reasons might be. He was evaluated at a clinic and was referred for outpatient treatment rather than mandated to an inpatient facility for observation and acute care (Kleinfield A1), but after he left the clinic, the paper trail on Cho Seung Hui’s mental health treatment seems to end.

Cho Seung Hui is but one recent example of a persistent problem in American society, however. One of the most memorable and heart-wrenching cases was that of Andrew Goldstein, a man who had been diagnosed as paranoid schizophrenic and who was “tried twice for the murder of a woman he had pushed in front of a subway train” (Pustilnik 17). Another case, almost exactly the same in nature and circumstance, was that of Julio Perez, also diagnosed as schizophrenic and who also pushed a woman to her death in the subway (Bernstein np). Both Goldstein’s and Perez’s cases provoked stringent “criticism of New York State’s mental health system” (Bernstein np), as both men had repeatedly presented at New York City hospitals to seek treatment for their acute systems, but were just as often turned away. As Bernstein reported, “it appears…that people with only scraps of information…listened briefly and sent him on his way, to another part of the same disjointed system that had been shuttling him between hospitals, jails, shelters and the streets of New York since 1995” (np).

With this observation, Bernstein raises an issue that is at the heart of the case of Cho Seung Hui, and that is accountability. All three men had numerous contacts with the criminal justice and legal systems, and were recognized—indeed, were diagnosed—as mentally ill by professional experts. Nonetheless, all three men fell through cracks in the system, which is riddled with inadequacies, inefficiencies, and a lack of oversight that can ultimately lead to tragedies such as those that have been described here. While it is incorrect and even dangerous to say that individuals with mental illnesses are dangerous (Wahl 10), it is not inaccurate to say that the presence of active symptoms of psychosis compromise a mentally ill person’s insight, ability to reason, and judgment substantially. A person who might, under normal circumstances and functioning, avoid violence, can become aggressive and even homicidal during a psychotic episode.

Another aspect that should have entered this discussion on gun control as it relates to the events at Virginia Tech and in the case of the clearly mentally ill Cho Seung Hui is the matter of medication and how this should influence who is granted to the right to own a gun and who is a considered a risk under current gun control legislation. The risk of aggression and violence increases exponentially when a person who is diagnosed with a mental illness is not treated with medications (Wahl 49), as apparently was true of Cho Seung Hui. With no psychopharmacological intervention, no counseling, and apparently no one who was responsible for overseeing Cho Seung Hui’s care and mental state once he was discharged from the clinic where he was evaluated, it is not hard to understand how or why he initiated a psychosis-driven rampage in which he took the lives of 33 innocent people.

Rather than focus on the argument on gun control as the central problem in the case of Cho Seung Hui, the public should be directing their energies, both in conversation and in deed, towards advocating for improved treatment of the mentally ill in the United States. Although the U.S. is one of the most developed countries in the world, it seems to have persistent difficulties sealing the cracks in the mental health system, putting both mentally ill people and the public at large in great danger. Part of the advocacy for an overhauled system should address the need to link criminal justice and mental health systems in a more effective manner so that information can be exchanged for the benefit of everyone. Such a proposal does not posit that mentally ill people are criminals or that they should be monitored more than anyone else for potential violence. What it does mean, however, is that mentally ill people who have had episodes of violence must be made known to the criminal justice system so that information sharing can occur and appropriate referrals for treatment and care can be made.

The gun control argument and debate in the United States is not likely to disappear anytime soon; it is a persistent and divisive feature of American life, especially in the wake of numerous senseless and violent events that have reinvigorated the debate about gun control and how we dole out guns. Given that gun control laws are unlikely to change, we should not advocate gun reform as a means of responding to the Virginia Tech tragedy. Instead, we should direct our attention and energy towards helping people with mental illness to get the care that they need and deserve. Treatment through counseling and medicine will benefit them, but it will also benefit all of society and potentially make our country a safer place to live.

Other essays and articles in the Arguments Archives related to this topic include : Police, Harassment and the Criminal Justice System •   An Argument in Favor of Capital Punishment   •  Argument in Favor of Legalizing Marijuana for Medical Use  •   Capital Punishment, Ethics, and Public Opinion   • Argumentative Analysis of the Essay “First Amendment Junkie” by Susan Jacoby

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