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Date published: 9/22/2013

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If I thought he could be sufficiently cared for by family or friends to receive regular oral medication, therapy, and follow-up, I would have discharged him. Otherwise, I'd have admitted him. And if he refused, I'd have ordered a 14-day involuntary commitment.

Sounds cruel? On the contrary. For many people living on park benches, commitment means a warm bed, shelter, and three hot meals a day. For Alexis, it would have meant the beginning of a treatment regimen designed to bring him back to himself before discharging him to a world heretofore madly radioactive.

That's what a compassionate society does. It would no more abandon this man to fend for himself than it would a man suffering a stroke. And as a side effect, that compassion might even extend to potential victims of his psychosis--in the event, remote but real, that he might someday burst into some place of work and kill 12 innocent people.

Instead, what happened? The Newport police sent their report to the local naval station, where it promptly disappeared into the ether. Alexis subsequently twice visited VA hospital ERs, but without any florid symptoms of psychosis and complaining only of sleeplessness, the diagnosis was missed. (He was given a sleep medication.) He fell back through the cracks.

True, psychiatric care is underfunded and often scarce. But Alexis had full access to the VA system. The problem here was not fiscal but political and, yes, even moral.

I know the civil libertarian arguments. I know that involuntary commitment is outright paternalism. But paternalism is essential for children because they don't have a fully developed rational will. Do you think Alexis was in command of his will that night in Newport?

We cannot, of course, be cavalier about commitment. We should have layers of review, albeit rapid. But it's both cruel and reckless to turn loose people as lost and profoundly suffering as Alexis, even apart from any potential dangerousness.

More than half of those you see sleeping on grates have suffered mental illness. It's a national scandal. It's time we recalibrated the pendulum that today allows the mentally ill to die with their rights on--and, rarely but unforgivably, take a dozen innocents with them.

Charles Krauthammer is a columnist for the Washington Post Writers Group.


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