The question of whether to forcibly medicate Jared Loughner with anti-psychotic medications, with the potential of prosecutors then asserting his competency to stand trial for murder, goes to the heart of a serious cultural-legal-medical issues our society needs to address surrounding mental illness.

First of all, Mr. Loughner has a grave, disabling illness, schizophrenia. It is a brain disorder that detaches him, beyond his abilility to control, from reality and robs him of his ability to think rationally. It is THE most severe of all illnesses in that it takes away his power to think or be in the real world. And he has been repeatedly diagnosed as having schizophrnia by multiple mental health professionals. The diagnosis is undisputed.

Secondly, due to the nature of his brain disorder, he lacks the mental capacity to form the intent to commit a crime — even though he was able, under the influence of delusions and distorted thinking and reality, to plan and physically carry a horrendous shooting and killing in Tucson. Mr. Loughner is therefore not a criminal
in that he lacks the needed criminal intent (in law called the “mens rea”) to commit a crime.

The key takeaway for all of us is that at the very first signs of severe mental illness, Mr. Loughner should have been being monitored and receiving treatment. That apparently did not happen in Tucson so as his illness progressed and
worsened and as he went unmedicated, a tragedy occurred and six innocent citizens lost their lives and a dedicated public servant was gravely wounded.

Now, Mr. Loughner is being processed in our criminal justice system and the issue of NOW treating him, in order to give him temporarily enough mental capacity to understand the trial proceedings around him, is raised. Mr. Loughner is a severely ill man; he should be in a psychiatric hospital receiving treatment, if needed for the rest of his life as he has shown violence when untreated and likely would not take medications on his own. He should NOT be enmeshed in our criminal justice system as he is not a criminal, not having had the criminal intent due to a lack of mental capacity, at the time the shootings occurred. Keeping him in a psychiatric hospital under treatment for his foreseeable future, will protect society.

I know something about these issues, as my oldest sister had the same illness as Loughner, chronic paranoid schizophrenia, for 50 yrs and I was a witness to that illness’s devastating consequences for 5 decades. And I am a licensed attorney and longtime mental health advocate and have also witnessed the inhumane and just plain uninformed way our criminal justice treats the severely mentally ill offender who commited an act without criminal intent, under the influence of illness.

The Loughner case is a tragedy of great proportions; but it is not unique. Because of the lack of full comprehension of the nature of this catastropic illnessamong the public, there is little understanding that this is an ILLNESS first and
foremost, and when violence results, as in this case, it is not the act of a criminal under our legal system’s definition of what is required for a crime to be committed. The solution is treatment, immediately, from first manifestations of
this illness, and monitoring to assess treatment efficacy, and illness progress. THIS, not putting Loughner in a prison cell, medicated or not, is what will protect all our citizens.

Florence C. Fee, J.D.
Executive Director

In nearly all health plans, 5% of patients are “complex” and they utilize 50% of health resources

(Zuvekas & Cohen, Health Affairs 26: 249-257, 2007). Over 2/3 of this small group have concurrent physical and mental disorders yet are cared for in a clinical system in which mental health practitioners and medical practitioners rarely converse with eac