Much can still be done against legal/legislative paralysis simply by sitting down around a table and examining the criteria that might reasonably qualify a diagnosed person for 'at risk' status and thus EMM. Here, then, might be the results of such a discussion. The 'at risk' might possibly be defined as those with medical findings of illness plus one or more of these co-factors; those 1) with felony conviction(s); 2) with unstable conditions (medications found less effective than anticipated but still essential); 3) having publicly announced themselves as dangerous as reported by trusted observers (teachers, for example, have proven to be reliable), and 4) with guns in proximity whether or not owned by the involved person.
Despite the controversies over the true numbers of mentally ill, the categories for 'at risk' persons will, even when the dust has settled, amount perhaps to one percent of the whole group. In other words, this business is aiming very narrowly, and the garden variety of bipolar, schizophrenic, schizoaffective, and so on, need not worry that anyone is 'coming after them'. Those demonstrating considerable responsibility can be given provisional/probationary release from enforced maintenance. Some will own guns as or more responsibly than anybody else.
The only exigent argument, legal or otherwise, against EMM is a worry over the professional competence to identity and gauge risk factors, and to establish and gauge success in treatment. As to the first, even I, a ceaseless critic of the profession, am ready to acknowledge their competence here. A veritable cadre of sub-professions has taken up the pathology of psychopathy and sociopathy with great effort and to great effect. As a theorist in the area I can generalize their findings in my own way: The off-balance person who plans and plots mass-killings is characterized by a deadly composite of 1) paranoia; 2) insensitivity and insecurity of dominance (IID), and 3) generalized contempt for categories, large or small, of humanity. As a rule, schizoidal personalities get angry, not contemptuous. They do, however, have the upper hand on paranoia. The bipolar crowd carries the contempt card but can also manifest a serious amount of paranoia. Both syndromes illustrate IID, though bipolars come to it as a weltanschauung, the schizoids in reaction to threat.
As a result of trait crossings between the syndromes, the overall rule is look to the bipolar whose activities leave tell-tale marks of paranoia, insecurity, low flashpoints, short fuses, over-reactions, and contempt. They may seem to take a schizoid diagnosis (some like to pigeon-hole them into Otto Kernberg's Borderline Conditions, which is roughly Asperger's on steroids), but the dangerous elements are by and large the ones associated with bipolar. The danger of schizoids is that their psychoses are occasionally directly responsible for murder. It tends not to be mass killings, however, and is in any case also occasionally seen in bipolars. Between bipolar and schizophrenia, Alice had something to say on behalf of the bipolar thesis: "But it's no use now to pretend to be two people! Why, there's hardly enough of me left to make one respectable person!"
To offer you a flavor of what is entailed, I have taken a few items from the Bernard Goetz file. The data are from Doug Linder's summary here. My discussion is in three parts: truths, half-truths and falsehoods. The point is to highlight how bipolar traits are rightly and wrongly construed, along with at-risk red flags.
Truth: District Attorney Gregory Waples, of Goetz' outlook: "very twisted and self-righteous sense of right and wrong." Untreated bipolars will hitch themselves to a cause and the twisting begins. They believe they have justice and right on their side, not only holding those in the wrong in condign contempt, but doing so despite what normals will agree is a helpless posture from which they could not meaningfully intervene.
Half-truth : Goetz: "the city doesn't care what happens to you". This is at once the conclusion of his experience, and the object aimed at in gaining that experience. When he parades around gangland with electronic equipment bulging, he is putting himself in 'protected exposure', the protection being his faith that he is right (a loaded gun helps immensely); he will be attacked and the city will have to answer for it. Basically, he's getting what he asks for in order to bring a complaint largely irrational for being impossible to carry out. It takes a bipolar to be so thoroughly impudent.
Truth: Linder's narrative: "The other 15 to 20 passengers on the car, wary of the boisterous gang, moved toward the other end of the car. At the 14th-Street station, Bernhard Goetz, age 37, entered the subway car and took a seat near the youths." More protected exposure. He did precisely opposite what normals do, and that is all we need in order to appreciate that he was willing to challenge a risk in order first to provoke, then to prove people empirically deserving of his contempt, justifying to himself whatever punishment he decides upon.
Falsehood: Linder's narrative, Goetz quoted: he used dumdum bullets because "you need maximum stopping power." With 20-30 witnesses in the car all he needed to do was display the gun and watch for a negative reaction. The bullets exemplify the willingness to match overkill with the degree of contempt. It may also speak to paranoia. This is what no one but bipolars specialize in, barring the military and the mafia (not a few of whom are bipolar in any event).
Half-Truth: Linder's narrative: "In the words of one juror, Goetz might have been reasonable or unreasonable in his feeling that he was trapped, 'but he didn't go out hunting.'" This is why experts are supposed to adjudge mental illness, not jurors. If he didn't go out hunting, he was exemplifying a tried and true pattern of placing himself in situations that would elicit the natural response of overkill that characterizes contempt in action.
Truth: Goetz: "I saw they were intending to play with me like a cat plays with a mouse." He is freely identifying a cat's toying with a contempt that ends with a kill. He was speaking about himself as much as about the boys. When a bipolar holding others in contempt sees them willing to do so to him, they have just vacated all right to his respect. Said Alice to the mouse, "I quite forgot you didn't like cats."
Falsehood: Goetz : "You seem to be doing all right; here's another [bullet]." These are words he admitted to saying at the time. It's hard to wrest more contempt out of a single comment. This is classic bipolar contempt playing the victim like a bipolar might believe a cat does its mouse (except that cats don't do contempt).
Truth: Linder's narrative: "Goetz ran for mayor of New York City in 2001 and the position of Public Advocate in 2005." Untreated bipolars are rarely ever remotely allergic to the limelight While many aggrieved normals run for office in order to do something about it, Goetz was never so much aggrieved as he was valuing his victimhood as a ticket to power and/or importance. In victimhood he found the justification to make his mark, a Zimmerman on steroids, and though the fame be fleeting, the feeling of self-righteousness it brings is a necessary satisfaction to the bipolar crusading a cause.
Truth: Linder's narrative: "Judge Crane sentenced Goetz to a six-month jail term, five years' probation, a $5000 fine, 200 hours of community service, and an order that he seek psychiatric help." It doesn't have to require rocket science to draw rational conclusions. Armed with red flags such as these, psychiatrists can make reliable prognostications.
Whether Goetz be denominated a 'mass killer' can be debated, probably to no real value. The facts are that he did wantonly kill, and did also deliberately, repeatedly, engage circumstances likely to make such possible. Who the hell cares how many he killed? The point is that he's an untreated bipolar looking for trouble. Do you want to be a part of that trouble? Goetz would not have committed any of those acts, nor even the risky behavior nor the killings, had he been on medication. That, and nothing else, is the gravamen.
Another person with the same psychology and with a little more generalized contempt could have skewered everyone on that car. There is no gauging in advance the extent, only the likelihood. Any psychiatrist could, with knowledge of the red flags from police reports, have determined the obvious and instigated the treatment that Goetz nonetheless had the right to refuse at any time, keeping company with perhaps as much as ninety percent or more of diagnosed bipolars.
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