Hi Modulous,
My experience in Canada (at about the time Reagan was closing the psych wards) was they were much better at getting people into treatment, similar to England.
That being said - the belief that the mentally ill are more likely to be criminally violent isn't quite so clear when the evidence is examined (it may still be true, but the effect is much smaller than public perception). ...
I agree, but it could also lead more people to think that danger is out there and behave as if the guy down the street was "suspicious" -- a secondary effect.
As for what a doctor should do if a patient confesses to intrusive violent thoughts and fantasies? It's difficult because these symptoms commonly appear in mentally ill people with no subsequent violent behaviour. If you force medication on them, put them in a hospital against their will etc., you just deter ill people from talking about their problems out of (justified) fear.
Complicated in the US by the whole freedom and liberty issues along with pride of independence etc etc. It would smack of "socialism" (= evil) to many just because of the way faux noise is always harping on such things.
... One of the signs a problem is brewing, I believe, is the development of a plan. So if this guy did have a specific plan, that should have raised an alarm ...
Which always seem to be found afterwards, and hard to get before. Perhaps a half-way measure, an open ward with observation with freedom to come and go (outside their home, with the possibility of getting a search if it seemed warranted), but that would put a lot of extra work load out there.
Not an easy problem to solve. It may just be that there are too many people ...
Enjoy.
Edited by RAZD, : ps - it's time to lose the hat ...
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