Over here in the Philippines, we have a lot of political murders, and entering politics can be risky. The dirty little secret is that most of these are against low level politicians, and they are not really about disagreeing with a person’s politics, but about who will control all that lovely money that is funneled through government offices.

But in the US, it is different. The assassination or murder of politicians or government officials is rare.

But Politics has become ugly in recent years. It started with the demonization of Nixon, improved under Ford and Carter, but since Reagan it has gradually gotten worse.

I am not talking about “fringe groups”, but about what one can read in normal newspapers.

The left didn’t just complain about Bush and his stretching of the truth, they demonized him as a mass murderer who hated black people. Since the left controlled the major media, it was hard for anyone to check in on facts without a “way back machine” (aka google cache). The left continues with it’s paranoid hatred, except now it’s aimed at Sarah Palin and the bland middle class Tea party.

Yet the Right isn’t much better; indeed, in some ways it is worse, but until recently, the “crazies” were kept out of the conservative media. Why do I say “until recently”? Well, Limbaugh is obnoxious, but not vicious, but some of his “wanna be” followers on talk radio are as foul as one can wish. We don’t get Glen Beck here in the Philippines, but I started watching one of his shows on Youtube, and had to turn it off because I was lambasted with hate words instead of hard information. Why does this guy have a show on a major network, I’ll never know.

Most of the Tea Party are merely middle class folks tired of not being listened to (despite the slanders in the urban coast media to the contrary), but the Becks and Limbaugh wanna-bes  have enough of an audience to make me worry.

I think it’s about time for everyone to stand back, and take a deep breath, and ask themselves if they are writing and talking with civility.

Because when the rhetoric goes overboard, it can escalate into violence, as is shown in the Tuscon massacre.

Yes, there will be fingers pointed all over, but although we don’t know much about the perpetrator of the Tuscon massacre, reading his writings that have been quoted in the news papers suggest he is psychotic: Mentally ill and not in touch with reality.

From the LATimes:

Forensic psychiatrist Mark Kalish, a clinical assistant professor at UC San Diego, said the video had many hallmarks of mental illness.

“It’s got these paranoid elements,” he said. “He probably suffers from schizophrenia. He’s very nihilistic. It’s delusional. There’s a conspiratorial flavor to it. It is nonsensical, but it’s psychotic.”

I am old enough to remember when modern tranquillizers allowed the mentally ill to be treated as outpatient, instead of being hospitalized for life. This was a blessing to all involved, since it allowed the person to come back and be part of the human family, instead of warehoused for life.

But the problem with out patient treatment is that often schizophrenics stop taking their medicine and relapse if they aren’t monitored by family, friends, or caretakers. And what is worse, there are fewer psychiatric beds available for emergency admissions, and the law makes it difficult to hospitalize anyone who is not overtly psychotic.

I’ve been involved in two cases where I thought an acutely psychotic person was dangerous, and needed immediate hospitalization yet the psychiatrist released him after a few hours. Both went on to commit violence after being denied hospitalization for their acute psychosis.

The modern laws, which assume everyone should be “free”, and assumes everyone is logical, make it hard for families and physicians to hospitalize these patients. The misunderstanding of mental illness, especially schizophrenia, among the American public is terrible, and families often have to cope with laws made by libertarians that make it difficult to force treatment, while lack of funding by the cost cutters make money for clinic and in patient treatment hard to find.

Often, if they take their medicine, these people are as nice as you could wish (unless you ask them to talk about their delusion), but they don’t have insight that the illness can return if they stop their medicine, so they stop it, and go into a deep psychotic state. Most remain harmless to others even when psychotic: they end up “street people” or catatonic, or write reams of nonsense to tell the world what is wrong, but but some of them will act out on their delusions.

We need to make the law easier for a guardian to sign for forced treatment of these folks.

In these days of no insurance and cost controls, we need to look carefully again at mandating supervision of those with serious mentally illness, be it a “loner” like Ted Kaczinski who was delusional about environmental problems, or a loner like John Hinckley, who was under the delusion that Jody Foster would love him if he shot a politician.

Another thing that has to be looked into is the easy availability of guns. Yes, I know. People kill, not guns. But guns make the casualty count higher. As a physician, twice I was on the team treating patients at our small hospital after someone went crazy and attacked an innocent group with a knife. In both cases, one person died, and we saved the rest, something which would probably not be true if the perpetrator had a gun.

So the “good news” so far seems to be that this is not a hit job by a fellow politician, or a major attack by a large, organized militia group that has declared war on everyone.

The bad news: that there are a lot of borderline psychotics and paranoid schizophrenics off their medicine out there, and the incivility and hatred by both sides of the political spectrum may encourage their paranoid delusions, and even encourage them to act on these delusions.

So tone down the rhetoric America before someone else is killed.

The perpetrator was crazy, not a middle class “Teaparty” grandmom or a middle class student activist from the left.

Exaggerated fingerpointing is the cause, not the cure, for this.

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Nancy Reyes is a retired physician living in the rural Philippines. She blogs at MakaipaBlog.

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