This is from the NY Times article about the young man who recently killed several people, and himself, in a mall:
(here is the link http://www.nytimes.com/2007/12/08/us/08gunman.html?hp )
“We all cared about this child,” said Sandra K. Markley, a deputy county attorney who represented the state in a juvenile case involving Mr. Hawkins and played a role in determining his course of treatment. “I’ve been reviewing his file, and, of course, there is a lot of second-guessing. But there were no indications that he was harmful in this way.”
That is the point state officials have emphasized. Todd Landry, the director of children and family programs for the Department of Health and Human Services, said at a press conference Thursday that “all appropriate services were provided when needed and as long as needed.”
The state estimates it spent more than $265,000 on Mr. Hawkins’s care.
“He was in good facilities,” Ms. Markley said. “He had good supervision. It didn’t all go perfectly, of course. But we deal with a lot of troubled children, and, as far as we could tell, he was no more troubled than many of them.”
But even with the intervention, said Denis McCarville, who runs Cooper Village, the state failed Mr. Hawkins.
“If this were a physical health issue — if he had leukemia — you would not say that as much as possible had been done,” Mr. McCarville said. “This was not pursued. As you can see, there continued to be issues.”
It is Mr. McCarville’s comment, just above, that captured my attention. His voice is one we hear after every such horrific event, after each occasion when a person, usually a man, takes up weapons and goes to a public place, killing multiple innocent people (often strangers, but not always). Voices like that of Mr. McCarville are loudest when it is found (and often it is) that the person has had some sort of mental health treatment, usually for substance abuse and/or depression. The conclusion is quickly reached that (a) these problems are readily fix-able; and (b) therefore, somebody (someone other than the killer) should have fixed them. In other words, as we usually are told by those who knew the man, “He needed help.”
It would be comforting to think that someone (other than the killer) is to blame; this would mean that these events are preventable. Indeed, after each such event, we scramble to figure out HOW to prevent them: better “security” is often sought. Metal detectors? More videocameras? No parking of vehicles close to courthouses? Or schools, or malls? How about nobody even ALLOWED in schools and malls and courthouses… and post offices, and office buildings, and fast food restaurants?
As a forensic psychologist, a professor of counseling psychology, a former prosecutor, and a former defense lawyer, I have a fairly broad and deep perspective on the people who engage in these horrific events, and on their mental disorders, and the available treatment for any of those disorders. And I have some bad news: this business of providing “help” for those who “need help” is often, even at its best, not so effective. The unfortunate truth is that what passes for “treatment” of substance abuse disorders has a dismal success rate. Treatment for mood disorders is better, but far from perfect (believe me, it isn’t like giving someone antibiotics for an infection, or insulin for diabetes). And, usually, those who shoot up people in malls have a lot more going wrong for them, mentally and emotionally, than the usual combination of substance abuse and depression. Typically, there are deeply rooted personality disorders, as well, and those are just as hard to treat as is substance abuse and dependence.
This world will never be totally safe from people who are angry, hopeless, and unable or unwilling to control themselves. Successful “treatment” for the most dangerous of these individuals (and we seldom have any way of accurately identifying which of them are “most dangerous”) requires them to begin to exercise self-control, to begin to make effective and positive choices. Sometimes it requires them to remove themselves totally from an environment that supports their lack of self-control, and their bad choices. None of this is easy and often it is, or seems, completely impossible, both for those who are getting the help, and for those who are trying their best to give it.
There are genetic and other prenatal factors, and there are economic factors; there is the insane contemporary diet of “entertainment" that our kids are raised on; there are horrific family backgrounds, and there are neighborhoods terrorized by drugs-and-violence... There is a toxic multitude of factors that combine in many different ways to produce these individuals who “need help.” And the forces that attempt, after the fact, to alleviate these causative factors, and provide “help” to damaged and dangerous individuals, are pitifully under-funded, and too often staffed by people who have minimal training, and gigantic caseloads. Let's not trivialize these staggering problems by believing in the fairy tale that anybody who "needs help" can "get help," and then everything will be OK...
Viktor Frankl 
