How to Halt the Violence

by Jeffrey A. Lieberman

August 28, 2015

When Vester Lee Flanagan II fatally shot a television reporter and a cameraman in the midst of a live interview in Moneta, Va., it was a scene that has become all too familiar to us.

In all these scenarios, we learn after the fact that the perpetrator has had a troubled past in which he exhibited bizarre and disruptive behavior, and frequently a history of diagnosed but untreated mental illness. The media and public erupt in outrage, but after the chest thumping and soul searching, nothing is ever done.

As a psychiatrist, I’ve treated thousands of patients with serious mental illness over my 30-year career and consulted on too many such criminal cases. I find it lamentable that we still cannot connect the dots and take effective action, as a vast majority of these tragedies are preventable.

A 2007 case that I was asked to review illustrates the problem. It involved an 18-year-old man, an athlete and a good student, who began with high hopes.

However, at the start of sophomore year, he quit the football team, left school and went home. At home he was withdrawn, disheveled, talked to himself and was suspicious of his friends and family. His parents knew something was wrong and sought treatment. When a mobile crisis team was called to the house he refused to engage with them. Although he clearly was ill, he was not aggressive, so they told his parents to continue monitoring their son’s behavior and to call if he became a threat to himself or others. The next day he stabbed his twin half-brothers with a kitchen knife, killing one of them and severely injuring the other. Read More