Mental Illness: Facing the reality

Nearly a half-century after the beginning of what Seattle P-I reporter Carol Smith describes as "a grand experiment" in better treatment of the mentally ill, the law and institutions are a long way from knowing exactly how to protect the public from the occasional deeply dangerous individual.

Amid the largely successful effort to end the forced warehousing of the mentally ill, we have failed to summon the will to make modest adjustments in favor of safety. The price can be horrid. Prosecutors have charged a dangerous mentally ill repeat offender, James A. Williams, with the New Year's Eve murder of Shannon Harps. The 31-year-old Sierra Club worker was stabbed to death outside her Capitol Hill apartment.

As Smith recounted in shaking detail, Williams was a walking, slow-motion crime spree, spreading threats and violence over at least three states from his youth to a 1995 gunshot wounding of a stranger at a Seattle bus stop. He was sentenced to 11 years in prison and went into community supervision under the state's Dangerous Mentally Ill Program, which a 2007 analysis showed was reducing recidivism.

One could hardly imagine a more impressive group of corrections workers than the ones trying to deal with the dangerous offenders. Yet, even in King County, where support for the mentally ill generally is a relatively high priority compared with many places, money is a challenge.

For the few among the mentally ill who are dangerous, the squeeze includes money for housing, treatment centers and supervision. To save money, moreover, the program that tracked Williams may have to cut the time it offers services to participants in half, to 2 1/2 years.

One of the reasons for so many homeless on America's city streets (what are suburbs doing to clear their neighborhoods?) is that everyone failed to anticipate the degree to which emptying psychiatric hospital beds would require more housing options. It's a form of cruelty to leave people, most of whom aren't dangerous, without treatment or housing, even if the larger goal is freeing them from what had been a system in which confinement had little to do with danger.

As Smith's story noted, states have failed to face up to the legal changes that might be required to confine and treat somewhat more of the dangerous mentally ill offenders. As numerous family and friends of the mentally ill have found, the hurdles are far too high for keeping people confined after initial holds of up to 72 hours.

It's easy to overlook the personal, social and medical triumphs involved with the substantial deinstitutionalization of the mentally ill over a generation and more. But legislators and the governor ought to face the reality that many people, some of whom are every bit as troubled as Williams and remain on the streets, still have little of the help they need.