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Joe Nocera is to be complimented for reminding us that deinstitutionalization of the mentally ill has been a failure. It relied on substituting psychotropic medication for human contact with professionals who could assess safety and danger—albeit imperfectly—and use these drugs wisely. It was generally agreed among my colleagues when deinstitutionalization occurred that those advocating civil rights for patients were co-opted by politicians who wished to save money by closing mental hospitals. It is time to examine the mental health system again and put professionals between potential killers and society. How this is to be done requires a new conversation that is long overdue. In the wake of Sandy Hook it should begin now. Meanwhile, all the ways to regulate guns needs to happen.
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