Midmorning on January 8, 2011, in Tucson, Arizona, Jared Lee Loughner, an unemployed 22-year-old, opened fire on a crowd in a Safeway parking lot, murdering six individuals and injuring over a dozen others.

In what appears to have been an assassination attempt, Loughner shot U.S. Representative Gabrielle Giffords in the head, point blank. As of this writing, Congresswoman Giffords has survived the attack, thanks to the expertise of her doctors and the extraordinary, manmade miracles that we regularly receive as a consequence of advances in medicine. Imagine if this had happened a century ago. Giffords, it is almost certain, would have died en route to a dirty hospital or very soon after her arrival. After all, penicillin, something so basic that we take it for granted, was discovered and made available during World War II, and it is hard for us today to understand just how far medicine has come since then.

Many people have asked why Loughner targeted Giffords and murdered six others. Clarence Dupnik, sheriff of Tucson’s Pima County, attributed it to intolerance and the tone on talk radio, asserting that, “[T]he vitriol that comes out of certain mouths, about tearing down the government, the anger, the hatred, the bigotry that goes on in this country is getting to be outrageous.” Loughner, according to this line of thinking, was an unbalanced person reacting to inflaming rhetoric. We’ll call this the media hypothesis.

Some members of the media immediately blamed the shooting on Sarah Palin and various tea party groups. According to this narrative, political conservatives, Governor Palin in particular, were responsible for the murders. Interestingly, Congresswoman Giffords was, herself, quite conservative by many standards (a “Blue Dog Democrat), and the pogressive website Daily Kos included her on a list of “targets” for political primaries). Let’s lump these together and call them the political hypothesis.

Loughner’s friends, however, have said that he wasn’t particularly political. He wasn’t an avid watcher of news programs and didn’t listen to talk radio, and they don’t believe that he was influenced by Rush Limbaugh or Sarah Palin. In fact, his favorite books (according to his YouTube account) were Mein Kampf and The Communist Manifesto. Some have said that Loughner used to be a pretty normal kid, but that his personality changed abruptly after a breakup with a high school girlfriend. Let’s call this the heartbreak hypothesis.

I’d like to offer an alternate hypothesis, one that it pretty obvious but unpopular with pundits and politicians, because it doesn’t have a solution and doesn’t offer the opportunity for a program that they can push: Jared Loughner is insane.

The Unfortunate Tale of Geoff and Darla

A couple of days after the Tucson story broke, I got a call from Geoff, an old friend who had been rattled by the story and awakened repeatedly by nightmares (His name isn’t really Geoff, but he values his privacy, so I’ve changed the names and left out a lot of details about where they lived, etc). The reason that Geoff was upset was that the incident reminded him of his life a few years ago, when he was married to a woman named Darla. I remember Darla, but I haven’t seen her in years. She was an attractive but unsettling woman, whose presence made people uncomfortable and who was alienated from most around her.

She and Geoff met and married quickly. He tells me that he rushed into things because he was young and foolish, sort of a hopeless romantic. Plus, he saw in Darla someone who needed his help, and once they had formed a connection, he felt obligated to take care of her. She was extremely energetic at times, and very enthusiastic, but she was also unpredictable. During their short engagement, Geoff and Darla lived together, and there were times when her behavior scared him. A great example is their upstairs neighbors. One of them had a set of loud wind chimes, and the night after he hung them, they prevented Darla from sleeping. She banged on the ceiling and screamed obscenities in the middle of the night, demanding that he take down the wind chimes. He did, and never really looked at her the same after that.

After they had been married a few months, Geoff and Darla bought a home on a cul de sac, in a rural area that was a pretty good distance from his work. She had dropped out of community college and quit her job during their engagement, and so she stayed home while he worked. His job was demanding, and so he left the house early and came home late, and while he was gone, Darla rarely ventured outdoors. She watched television continually and nurtured a few hobbies, to keep herself occupied. She cried regularly. At one point in this period, she went from being an agnostic to being a fervent Christian, and she began conversing with God daily.

A few months after the wedding, they learned that they were going to have a baby. For the most part, she did what the doctors told her, such as avoiding alcohol and taking prenatal multivitamins. Her depression deepened during the pregnancy, however, and he had to travel some for work. Still isolated, she became suicidal, and at one point she penned a twenty-page suicide note, though she never followed through. Near the end of the pregnancy, her connection to reality, which had been weakening, broke. Late one night, she told Geoff that she could see, in the bathroom mirror, that there was a demon behind her eyes, telling her to kill him. She was doing her best to resist, but she needed a cross.

Geoff was panicked and didn’t know what to do. There didn’t seem to be any harm in getting a cross for her (though his willingness to do so may have helped to cement her delusion, as he was playing along), so he drove her to a gas station and bought a piece of cheap religious jewelry. In the parking lot, she hid her face. “What’s wrong?” he asked. She fearfully pointed at a gray-bearded biker and said, “Don’t look at him. Don’t! He’s a watcher.” She explained, “Watchers are people that walk around, and they look like normal people. Don’t look at him! They watch over us for the devil, and they can steal your soul.”

As they drove away, she fastened the necklace. “This cross is no good,” she said. “I have to get another one. This one doesn’t work. It’s not the right kind. We need to find a store that sells others.” They drove to a 24-hour Wal Mart and bought cross earrings. She put them in and breathed, relieved, explaining that the demons were gone.

The next day, Geoff tried to figure out what to do, but he didn’t know who to ask, much less what to ask. Eventually, he talked to a mental health professional who said that he could not make any diagnosis over the phone, but Geoff needed to take Darla to a hospital and have her assessed; he warned that this could lead to her involuntarily committment. Geoff called her obstetrician and explained what was happening to a nurse, because Darla was only a week away from her due date, and the doctors would probably have to induce labor before they could give her the appropriate psychiatric medications. He then drove home and, tears in his eyes, told her that he had to take her to the hospital.

She was furious, and as they drove there, she told him how she had always feared being locked in an institution, that this was the worst thing that anyone had ever done to her. She said that she would hate him forever, that she would put on whatever show the doctors expected, convince them that she was better, and get her revenge when she got out. She guaranteed him that he would never see their child.

Geoff did not know what to do. He didn’t know what his rights were, or his responsibilities. He was terrified that he might be making a mistake. He was frightened that Darla would take their baby away as she had threatened, and he feared for the safety of the child without his presence to stabilize her. Most of all, he felt sorry for her, for how small and lost she seemed, and so when they were going through the intake process, Geoff told the people at the hospital that she was ok and that it had been a false alarm. He lied his way out of the situation, and after a night talking to medical personnel, he and Darla left the hospital.

Geoff says that this is probably the worst mistake he has ever made.

Their child was born a few days later, and Geoff was hopeful that Darla’s delusions had simply been a side-effect of pregnancy, that she would go back to being eccentric and unpredictable, but no longer psychotic. That didn’t happen. Instead, she became verbally and physically abusive, often hitting him and threatening to do the same to the baby (Eventually she became abusive to the child as well). She threatened with knifes, slammed doors repeatedly, locked herself in rooms, and threatened to drive their car into the opposite lane on the Interstate.

The world in which she lived became increasingly divorced from reality, though he tells me that this waxed and waned. Some weeks she was very delusional, some less so. She believed that the piano tuner wanted to steal their baby, that the neighbors wanted to poison their pets, and that her online detective work would lead to the arrest and capture of key Al Qaeda members. She believed that God was sending her numerical messages through clocks and that if she could decode them, she would be able to understand her future. She redecorated their house, painting the walls wild, mismatched colors. Her behavior was very unpredictable, and Geoff never knew if she did things to make a point or because she was tormented. On one occasion, she lit a cigarette and calmly held it to the back of her hand, giving herself a third-degree burn.

Geoff became increasingly isolated, largely out of shame, and he only left the house to go to work and church. A deeply committed evangelical Christian, he believed that divorce was allowable only in the case of adultery, and so he stayed in the marriage for years. Darla’s friendships never lasted more than a few weeks (Her friends later told Geoff that they feared her), and he stopped talking to most of his.

Eventually, after a particularly frightening episode in which she claimed (again) to be demon-possessed (this time hurting their child, Geoff, and herself), Darla asked to be committed. Geoff took her to the hospital, where she stayed for a week. She was given antipsychotic medicine and mood stabilizers, and she was like a new person, but eventually she stopped taking her medicine. She began cheating on Geoff with another patient from the hospital, and one night, while she was out of the house, he drove away late at night, with the child and a suitcase full of clothes, fearing for the safety of himself and his child.

He took out a restraining order, gained full custody, and became a single dad. He drank heavily for the next few years, trying to make the pain and fear go away. Eventually, he stopped drinking, and he leads a pretty normal life now. When he told me this story (I’d heard bits and pieces over the years), he said that he isn’t as kind as he used to be. Pain hardened him, though he is trying to recover and restore the gentle spirit that he had when he was young. I don’t know what became of Darla. I knew her through my friendship with Geoff, and so I lost touch with her years ago. It is fine with me, because she scared me, especially the last couple of times I saw her.

The Challenge of Violent Psychosis

I don’t think that Jared Loughner was inspired by talk radio, the news, or political pundits. I think that he was crazy like Darla. I don’t know if she was ever diagnosed with anything, but from the way that Geoff has described her, she sounds like a schizophrenic. Reports of Loughner’s behavior lead me to suspect that he suffers from a similar disconnect from reality.

Society is not responsible for his actions. He is responsible for his actions.

Loughner is, in all likelihood, psychotic, and I imagine that he latched onto Gabrielle Giffords for a reason that only he can explain, even if that explanation makes no sense to anyone other than himself. Bigotry did not drive him to murder; chemistry did. His brain is most likely scrambled, due to natural chemistry (caused by schizophrenia or something along those lines), drugs (Reports claim that he used cocaine, marijuana, psilocybin mushrooms, and the dangerous, legal hallucinogen salvia divinorum), or both. Psychosis often starts in an individual’s adolescence, so this fits the timeline of his reported downward spiral pretty well.

What, then, of moral responsibility? Is an individual absolved because he is psychotic? Certainly not. Legal responsibility, perhaps (I am not a lawyer), but not moral. An individual may be living in a world of pure delusion, but he is still responsible for choosing good, or for submitting to others who stop him from choosing evil.

I believe that the only thing that could have prevented the murders in Tucson would have been the institutionalization of Loughner. If he had been on the right medicine, he may have been able to lead a relatively normal life, but many psychotic people are non-compliant (A great example is Geoff’s ex-wife Darla). The problem with this solution is that it required the attention and action of people who cared for him (His parents are the most obvious candidates). Many people don’t know their right and responsibility to have an individual committed if he presents a threat of harm to himself or others. In many states, false charges that lead to an individual’s commitment can lead to significant trouble for those making the charges.

So what is the solution? I don’t know. In all honesty, I don’t think that there is one. If more people understood mental illness and were willing to commit their loved ones, if necessary, it would increase the probability that people like Loughner are committed before they can kill, but it is no guarantee. People are responsible for their own behavior (and, to a certain extent, for preventing things from happening if they have the power).

It is important to note that mental illness is pretty common and that most mentally ill people are able to lead normal, productive lives. Even schizophrenics can thrive, if they stay on their medicine, and they deserve our compassion and respect. I, for one, cannot imagine the struggle that they must endure. The vast majority of mentally ill individuals are not dangerous like Jared Loughner.

We are all of us imperfect and imperfectible. Psychotic murderers, like the poor, will always be with us, and while advances in medicine and improvements in the mental health system can mitigate the risks associated with their madness, nothing can guarantee safety all of the time. At best, we can reduce the number of actively psychotic people out and about through commitment and medication.

I think that the risk of events like this is a cost of living in a free society. It’s not an answer that I particularly like, but I think that it’s true.

Policy Prescriptions

Some will try to use the murders as an excuse to grab guns, but making guns illegal (or harder to get) will not stop a dangerous psychotic, and it will make society in general more dangerous. While gun bans keep guns out of the hands of law-abiding citizens, many guns used in crimes have been obtained illegally; a well-armed populace is the best deterrent to crime.

An individual who is evil, psychotic, or both only needs a copy of the Anarchist Cookbook and a few household items. That’s enough to kill a crowd. A knife or car or blunt instrument or pair of strong hands is all an evil person needs to kill another individual. While easy access to guns reduced the amount of effort that Loughner had to exert to kill, I doubt that it increased his ability or intent to kill.

Given Loughner’s fascination and proficiency with guns, an outright ban may have prevented the Tucson murders, but there is no guarantee that it would have, and the costs of a ban (or serious restriction) on guns would outweigh the benefits of possibly preventing incidents like this one. Another issue is, of course, the constitutionality of gun bans; even if they are the best idea in the world (and I don’t believe that they are), that doesn’t make them pass constitutional muster.

Within the parameters of what the Constitution does allow, every policy decision involves a trade-off, and we must weigh the cost and benefits of that trade-off. Avoiding absolutes (Completely ending poverty, violence, drug use, etc) can lead us to make measured policy decisions, understanding trade-offs and the fact that we cannot eradicate suffering and evil, merely reduce them and mitigate their effects.

Regarding mental illness, general education about mental health would go a long way toward preparing people to deal with psychotic family members, neighbors, and friends. Most people, I suspect, do not know what to do if a family member becomes psychotic, how to take out a warrant (if necessary), how to have someone involuntarily committed, etc.

I don’t think that a federal program can help, except perhaps to leverage best practices and share Public Service Announcement resources, and the like.

I do think that increased mental health funding at a state and local level would be a good thing. Many homeless individuals suffer from severe mental illness, and considering the neighborhood effects of homelessness, governmental assistance should occur at the local level, where individuals suffer and cause problems. There are many things that only the government can do (particularly related to public safety), and unless there is a significant upsurge in private, charitable care of the mentally ill (which does not seem likely), it should be a function, at least at some level, of government.

The more tax money we send to Washington, the less is available for state and local taxes, where it can be used more appropriately, effectively, and needfully. I cannot envision a bureaucracy that could manage mental health resources more effectively than a local one (That is, actually help patients and communities).

Ironically, an unintended consequence of Social Security and the federalization of medicine, a goal of which was to help the helpless, was a rise in homelessness. In the mid-1960s, through amendments to Social Security, many mental health resources shifted from states to the federal government. This led to the closure of many mental hospitals, and many of the formerly-institutionalized patients (or individuals who would have been institutionalized) were left to fend for themselves.

Again, we cannot say that locally funded and controlled mental health would have prevented the Tucson killings, but by making mental health a community issue, more than a national one, we would likely be able to provide better services to the mentally ill, helping them and the communities where they live.

I am no expert, and I could be wrong, but it is a conversation worth having.

Cross-posted at The Joy of Reason.