The forthcoming cover from The Stranger, a quirky alt-weekly in Seattle, has an interesting take on Sarah Palin's infamous target map, which showed Rep. Gabrielle Giffords of Arizona under the targets of a gun. On The Stranger's map, Giffords is joined by John F. Kennedy, Martin Luther King, and Abraham Lincoln.



Should mental health care be considered a public safety issue? Last weekend's shooting in Tucson certainly suggests that it should. Unfortunately, when such proposals come up, well meaning advocates for the mentally ill frequently jump in to argue that people with brain diseases are no more dangerous than the rest of us. For instance, in the wake of reports suggesting that alleged Tucson shooter Jared Lee Loughner may suffer from schizophrenia or another untreated, serious mental illness, Vaughn Bell insisted in Slate on Sunday that, "the fact that your chance of being murdered by a stranger with schizophrenia is so vanishingly small that a recent study of four Western countries put the figure at one in 14.3 million. To put it in perspective, statistics show you are about three times more likely to be killed by a lightning strike."

And while it's true that Justice Department and other research estimates suggest that only about 10 percent of the nation's homicides are committed by the mentally ill, it's also true that people with an untreated brain disorder like schizophrenia are far more likely to become violent than someone without one. Refusing to acknowledge this, while instead debating whether or not Congress should bring back the Fairness Doctrine or remove crosshairs from surveyor's equipment, will once again prevent the country from taking the necessary steps to prevent such tragedies in the future.

Federal authorities have long known the risk that untreated mentally ill people can pose when they obsess about politics. Back in 2003, I wrote a story for the Washington City Paper that chronicled the large number of somewhat spectacular and often very violent acts, with a political component, that had been committed in the nation's capital by people who turned out to be suffering from paranoid schizophrenia. (I also found many links between alleged terrorists and serious brain diseases.) There was of course, John Hinckley, who shot President Ronald Reagan. Later came Francisco Duran, a Colorado man who came to DC and opened fire on the White House to attack a "mist" over the president's home, and Russell Weston, who killed two police officers when he stormed the Capitol to prevent it from being annihilated by legions of cannibals. As I wrote back then:

Washington is perhaps the nation's premier destination for [the mentally ill]. Close a mental hospital in Florida and you get Juan Tubbs, the man who recently stymied police with a fake grenade in a high-profile encounter at Union Station. The region just happens to house many of the institutions that pop up in delusional fantasies—the CIA, the FBI, the White House. What better way to bring your conspiracy theories to the world than to make a splash at their front doors?

Unfortunately for area residents, mentally ill people capable enough to get to D.C. to try to press their cases with the president can be very sick and very dangerous. Paranoid schizophrenics, in particular, seem especially attracted to Washington.

A 1990 study published in the American Journal of Psychiatry found that men who had been detained by the Secret Service after showing up at the White House were between two and five times more likely to be arrested later for violent crimes than the general population.

Even eight years ago when I wrote this story, there was a huge and growing pile of research showing that people suffering from untreated schizophrenia commit violent crimes at much higher rates than the general public, and that politics frequently played a role in their crimes. (Schizophrenics who are being medicated are no more dangerous than anyone else, however, a very important caveat.) But even without the political overtones, untreated mentally ill people can pose a real menace. One pair of researchers took a hard look at 20 people who'd pushed strangers in front of New York City subway trains and found that all but one of them had suffered from a severe mental illness. Again from my old story:

Untreated serious mental illness is a huge risk factor for violent crime, particularly among those released from mental hospitals. A 1992 study by Dr. Henry Steadman, now the chair of the national advisory board of the Center for Mental Health Services & Criminal Justice Research, found that 27 percent of released patients reported having engaged in at least one violent act within four months of being discharged. Those findings mirror older research suggesting that discharged patients had arrest rates for violent crimes 10 times that of the general population. Another study, published in the American Journal of Public Health in 2002, found that about 14 percent of adults with severe mental illness (schizophrenia and bipolar disorder) had been violent within the previous year. Not surprisingly, then, 16 percent of jail inmates are estimated to be mentally ill, according to the Justice Department—some 300,000 people, or four times the number who are in mental hospitals today in the United States.

People most at risk of violence from the seriously mentally ill are their own family members. (A Justice Department study found that 25 percent of people who had killed their parents were suffering from an untreated brain disease.) But these serious brain diseases can create the sorts of random tragedies we saw in Tucson when they lead to delusions that are influenced by the current culture. As I explained in 2003, after a rash of unusual crimes committed by the mentally ill:

Mental illness is complex, its symptoms mercurial, changing depending on the environment. Just as the press and public demand a narrative to rationalize horrific crime, so do insane people attempt to create their own story lines to explain the frightening chaos in their brains. The narrative is a coping mechanism. With a disease such as schizophrenia, which can cause aural, visual, and even corporeal hallucinations, most people either have to face the reality that their brains are malfunctioning or come to believe, as [Capitol shooter Russell] Weston did, that a neighbor's satellite dish really is spying on them. The brain seems to prefer the fiction, which often is less frightening.

When creating their narratives, the mentally ill draw heavily from cultural cues, in an attempt to make their tales socially acceptable. That's why, when extraterrestrials and UFOs started to enter pop culture through books and radio in the '50s, delusional people started claiming to have been abducted by aliens. The 1953 movie Invaders From Mars set off a wave of such reports. In the United States, schizophrenic people often claim they're being spied on by the CIA or the FBI. In Ireland, delusions focus on the IRA, and in the Middle East, the guilty party is often the United States or Israel and Jews.

Often, too, delusions have some basis in fact, with slight distortions. For instance, when a schizophrenic claims that the CIA did mind experiments on him, he knows that it's not totally outside the realm of possibility, because the CIA really has done mind experiments on people. Or when African-Americans claim AIDS is a government conspiracy to wipe out their race, they only have to point to the Tuskegee syphilis study as evidence of what unthinkable horrors the government is capable of.

The cultural context of delusions blurs the line between sanity and insanity in a way that makes it difficult for people to intervene with a mentally ill individual before he blows up a federal building.

Little of this understanding seems to inform our current discussion about Loughner, though. Instead, members of Congress are calling for laws that would ban bringing guns near members of Congress or regulating talk radio. Gun control measures will be proposed and die quietly, no doubt. But mental health care—long ignored as the province of neurotic yuppies taking to the couch to discuss their frigid mothers—is barely an afterthought. Yet of all the possible solutions to such mass violence, real mental health reform holds the most promise for saving lives by ensuring that people with brain diseases get the care they need before they seek out the always easily accessible American firearm.

Sometimes these tragedies do lead to change. In 1999, for instance, after serious advocacy by the family of a woman who was pushed in front of a subway by an untreated schizophrenic, New York State created a much stiffer mental health law to allow for violently mentally ill people to be court-ordered into community treatment and essentially forced to take their meds. But when sick people invoke political leanings before shooting members of Congress or sending mail bombs to timber industry lobbyists, politics always seem to prevent a sensible, effective response.

In light of the Tucson tragedy, it would be nice to see the mental health system, or what's left of it, come up for real discussion, including serious consideration of vastly expanding mental health services so that people like Loughner's parents or his philosophy professor or his algebra teacher could have actually gotten him the help he needed before he killed someone. (In the past year, Arizona cut $36 million from its mental health programs, nearly 40 percent of its budget.) If nothing else, maybe it's time for some public service announcements about the symptoms of schizophrenia—how to distinguish them from ordinary teen angst or political passion, and how to intervene. Lots of research now shows that the longer someone with a brain disease remains untreated, the more severe their dangerous delusions are likely to become. Yet most people go years before such disases are properly diagnosed. Early intervention could save a whole lot of lives.

At some point, the country's political leaders will have to find some self-interest in tackling the problem. An estimated 4.5 million Americans suffer from the severest forms of brain disorders, schizophrenia and bipolar disorder. The National Advisory Mental Health Council estimates that 40 percent of them—1.8 million people—are not receiving treatment on any given day. While most of those folks will remain law abiding citizens, enough of them will make headlines with an act of violence that failing to find a way to treat them isn't just a public health crisis, but a public safety one, too. 

 In the wake of the killing frenzy in Tuscon, members of Congress have called for a renewed ban on high-capacity gun magazines of the sort that allegedly let Jared Loughner take 31 shots and hit 20 people before pausing to reload. The Federal Assault Weapons Ban, which expired in 2004, limited new gun magazines to a maximum of 10 rounds. According to the DC-based Violence Policy Center, clips that hold more than that have featured in some of the worst mass murders in the US in recent years:

Just months after refusing to help Republicans overturn the Democrats' health care reform law, the US Chamber of Commerce has changed course and decided to push for repeal, Chamber CEO and President Tom Donohue indicated Tuesday morning. Donohue pointed to claims that the bill will raise premiums and kick people off their insurance plans as justification for the big business lobby's shift:

[C]osts are rising and health plans are being forced to change…Officials have already raised the cost estimates of the bill and have acknowledged that the savings earmarked for Medicare will never materialize…

Workers who have been banking on employer-based coverage when they retire are being told not to count on it…[W]ith key provisions under challenge in the courts by states and others, it’s time to go back to the drawing board.

Last year, while strongly advocating health care reform, the Chamber was a leader in the fight against this particular bill—and thus we support legislation in the House to repeal it.

Donohue's comments, delivered as part of an annual address, stand in sharp contrast to remarks he made last March, shortly before the Democratic health-care bill crossed the finish line in the Senate. While the Chamber was vocal about its opposition to certain elements of health reform, Donohue promised the K Street behemoth would not actively work to repeal the legislation. "If people want to try and repeal, let them. We’re not going to spend any capital on that," Donohue told the Wall Street Journal.

Last spring, the Chamber vowed to focus its energies on rolling back regulations in the legislation instead of repealing the entire law. "Should the legislation passed by the House today become law, the Chamber will work through all available avenues—regulatory, legislative, legal, and political—to fix its flaws and minimize its potentially harmful impacts," Donohue added after the bill passed the House. The Chamber believed, rightly, that full repeal of health care reform was extremely unlikely and that it would be a waste of time and money for Big Business to try to overturn it. "We'd like it to go away. But we're business people, and we're pragmatic," James Gelfand, Chamber's director health policy, told Time in an article entitled "Resist, Not Repeal."

But with the Republicans securing their new majority in the House and key seats in the Senate, the Chamber may have felt emboldened—or perhaps pressured—to swing in favor of repeal, despite the long odds. The organization poured more than $32 million into the midterm elections, supporting Republican candidates almost 90 percent of the time. Now the Chamber seems to have made the calculation that backing the GOP repeal movement might be the right strategic move in the new Congress. Though repeal is still unlikely to pass with President Obama in the White House, supporting the Republican line might help Big Business get some of the more incremental changes that it wants to see.

Watch David Corn talk about who Jared Loughner really is:

They might have relinquished their majority and coveted committee chairmanships, but House Democrats are quickly proving they've lost none of their savvy despite their diminished ranks. With a major battle looming over the federal government's debt ceiling, Democrats like Barney Frank of Massachusetts are mulling a strategy that potentially could divide the GOP's more centrist lawmakers from the party's tea party cadre. How? By voting against legislation to raise the debt ceiling.

Why would Democrats vote against something nearly all of their party supports? As The Hill reports Tuesday, Democrats are threatening to oppose the debt ceiling bill as a way to force more Republicans to vote for a bill that many of them outright oppose. "It is up to the majority to get this bill through; they can't duck the responsibility," Barney Frank told the Hill. Given the dire warnings by Obama administration officials about what could transpire if the $14.3 billion debt ceiling isn't boosted—Treasury Secretary Tim Geithner said failure to do so would cause "catastrophic economic consequences," and White House economic adviser Austan Goolsbee predicted "a worse financial economic crisis than anything we saw in 2008"—top Republicans have all but conceded the need to increase the amount of debt the US can take on.

But some factions of the GOP, including its tea party-affiliated members, refuse to back the debt limit boost, setting the stage for an interparty battle. Rep. Michele Bachmann (R-Minn.), who launched the House's tea party caucus, has said she won't support increasing the ceiling. "Congress has had a big party the last two years," she told CBS' Face the Nation. "They couldn't spend enough money and now they're standing back, folding their arms...taunting us about how are you going to go ahead and solve this big spending crisis?" But at the same time, GOP budget guru Paul Ryan of Wisconsin admitted, "Just refusing to vote for [raising the debt ceiling], I don't think that's really a strategy...Will the debt ceiling be raised? Does it have to be raised? Yes."

Obviously House Democrats won't adopt this strategy if they don't think Republican leaders like John Boehner and Eric Cantor can ultimately whip up the votes to pass the bill. If Democrats do go the "no" route, it could be a preview of their tactics for the next two years, forcing the GOP into uncomfortable positions and pitting the Republican Party's more right-wing lawmakers against the moderates.

Here's more from the Hill:

But rather than rallying to Obama's side, House Democrats are remaining aloof. They say it is the GOP's responsibility to raise the debt ceiling now that Republicans are the ones in charge of the chamber.

"I reject any attempt to shift the responsibility to the minority," Frank said. "Don't do us any favors."

When asked if Democrats will whip members to pass the debt-ceiling increase as Obama has asked, a Democratic leadership aide told The Hill it is up to Republicans to get the bill through the chamber.

Republican leaders are on record as saying the debt ceiling must be raised, but whether they can get their members to go along with that remains to be seen. Their position is complicated by the GOP’s crop of 84 freshman lawmakers, many of whom ran on a strict platform of fiscal responsibility and risk being seen as sell-outs if they approve more federal debt.

Why doesn't Glenn Beck have confidence in America?

During his Monday radio show—when the subject was the Tucson tragedy—Beck came to the rescue of his friend Sarah Palin, who had come under criticism for a map her political action group had created last year that placed cross-hairs over the districts of 20 Democratic legislators it had targeted—including the one represented by Rep. Gabrielle Giffords (D-Ariz.). Beck read to his audience an email from Palin in which she declared, "I hate violence. I hate war. Our children will not have peace if politicos just capitalize on this to succeed in portraying anyone as inciting terror and violence." And Beck also read aloud a note he had sent Palin:

Sarah, as you know, peace is always the answer. I know you’re feeling the same heat—if not much more—on this. I want you to know you have my support. But please look into protection for your family. An attempt on you could bring the republic down.

Ponder that for a moment. If someone attempted an attack on Palin would it truly destroy the foundation of the United States of America? Beck wasn't even referring to a successful assault; he mentioned merely an attempt. And that does beg the question, does he think the country is in such a weak state that it would crumble if some nutcase tried to harm Palin?

This is overheated rhetoric—even on a Beckian scale. Is he that eager to suck up to Palin or to pander to her followers? This nation, after all, has experienced—and survived—tough times: depression, war, civil war, riots, 9/11, and so on. Americans soldiered on after the assassinations of Abraham Lincoln, John Kennedy, Martin Luther King Jr., Robert Kennedy, and others.

Any political violence would be horrific—no matter the victim. But for most Americans, Palin is not the center of the universe—or the country. They certainly would carry on if she were the target of violence. This nation is made of sterner stuff than Beck suggests.

The only Republican cabinet secretary in President Obama's administration, Transportation Secretary Ray LaHood, has decided to toss bipartisanship aside, get off the sidelines and weigh in on a hotly contested race this week: the election of the next Miss America. In a blog post on Monday, LaHood, a former Illinois congressman, officially endorsed Miss South Dakota and urged people to vote for her in the "America's Choice" segment of the pageant, where the public gets a chance to help pick the winner. 

It seems rather unusual for a high-ranking federal official to offer such a public endorsement of a beauty queen. (Miss Illinois must be steamed!) But Loren Vaillancourt, the contestant from South Dakota, has apparently won a fan in LaHood by taking up his signature issue: distracted driving. Vaillancourt has made her pageant platform all about keeping teenagers from texting and talking on cell phones while driving. And she's got a personal stake in it all, which seems to have captured LaHood's attention. Vaillancourt's only brother was killed in 2009 while riding in a car with a distracted driver who pulled out in front of a semi. His death prompted his sister to use her platform to raise awareness about the dangers of distracted driving.

LaHood writes:

Look, I think all of these young women are to be congratulated for their thoughtful service platforms. But Loren Vaillancourt, Miss South Dakota, has taken on a cause that is central to DOT's core priority: safety. And she has done a terrific job raising awareness among young people in South Dakota.

Now, through her partnership with State Farm's "Teen Driver Safety" Facebook page, she is extending her reach. All week at the Miss America pageant, Loren will be posting to the sfteendriving page and--whenever possible--updating her video diary there.

For all that she has done in this fight, she has my vote this week. I hope you'll consider giving her yours.

The new Miss America will be crowned on Saturday. We'll see whether getting the Transportation Secretary's vote helps push Miss South Dakota into the winner's circle.

All 53 Senate Democrats have endorsed some level of filibuster reform—but will they actually make it happen? The push to overhaul this procedural tactic, which has allowed the minority to block debate on a number of legislative issues, is the top item on the table heading into a two-week break for senators, and prospects of passing it are unclear. The outcome hinges largely on whether Senate Democrats are willing to go it alone in the absence of an agreement with the Republican leadership.

"The key to us succeeding in this is going to be a point when our leadership says they're on board and they're ready to take us into battle," says Jeff Merkley (D-Ore.), one of the three cosponsors of a reform package released last Wednesday. That will be the test over the next few weeks, as Majority Leader Harry Reid huddles with Mitch McConnell to see if a deal can be brokered. Merkley and the other senators behind the reform package are also trying to muster public support over the recess this week and next, though Oregon's junior senator says he believes the Democrats already have the backing of most Americans. "When I raised this topic back home, the reaction was stronger than on any given policy issue," he notes. "The citizens are way ahead of the Senate in understanding the dysfunction in this institution."

Glock's "superior firepower" clipGlock's "superior firepower" clipThe Tucson shooter's killing frenzy finally came to an end on Saturday after he allegedly emptied his semi-automatic Glock handgun of its 31 bullets. According to witness reports, as he was changing the clip, a wounded woman tried to grab the gun from him. His next shot jammed before two men wrestled him to the ground.

Before 2004, when the Federal Assault Weapons Ban expired, the shooter never would have been able to get off so many shots before pausing to reload. The ban, enacted in 1994 in the wake of mass killings in San Francisco and Waco, limited gun magazines to a maximum of ten rounds. Assuming that the shooter would've achieved the same hit ratio with the smaller clip, he would have shot six people and maybe killed one or two instead of shooting 20 and killing half a dozen.

"If he was restricted to a 10-round magazine, lives could have been saved," says Daniel Vice, a senior attorney with the Brady Campaign to Prevent Gun Violence. According to a 2004 study (PDF) by the University of Pennsylvania's Jerry Lee Center of Criminology, "attacks with semiautomatics—including assault weapons and other semiautomatics equipped with large capacity magazines—result in more shots fired, more persons hit, and more wounds inflicted per victim than to attacks with other firearms." 

The Brady Campaign is supporting a new bill by Carolyn McCarthy (D-NY) that would renew the Assault Weapons Ban, a Democratic priority that the Obama administration had essentially abandoned.

Of course, a renewed ban will do little to get rid of the thousands of high-capacity clips already in circulation. While seven states and the District of Columbia ban clips of the sort Jared Loughner allegedly used, they're widely available in Arizona gun stores and enthusiastically marketed by gun makers. As the Glock website puts it: "Compact and subcompact GLOCK pistol model magazines can be loaded with a convincing number of rounds."

Read our exclusive interview with a friend of the alleged shooter, Jared Lee Loughner, who describes Loughner's family, bizarre dream journal, and his obsession with Rep. Giffords. Full coverage of the shooting and its aftermath is here. Front page image courtesy of Joe Holst/Flickr.