Thomas Szasz: Cho Enabler?

It was probably inevitable that someone would take a whack at Thomas Szasz in the wake of the VT killings. Ladies and gentlemen, Jonathan Kellerman's essay about how 1970s crazies "shut down the asylums" and created a mental health crisis.

The libertarians were fueled by Thomas Szasz, an iconoclastic psychiatrist who was, and remains, an outspoken foe of virtually every aspect of his chosen specialty. Hungarian-born in 1920, and witness to vicious state exploitation of medical practice by the Nazis and the communists, Dr. Szasz pushed an absolutist dogma of individual choice, finding ready converts among members of the Do-Your-Own-Thing generation. Though his early essays offered much-needed critiques of the Orwellian nightmares that can result when autocracy corrupts health care, Dr. Szasz devolved into something of a psychiatric Flat-Earther, insisting in the face of mounting contrary evidence that mental illness simply does not exist. Currently, he serves on a commission, cofounded with the Church of Scientology, that purports to investigate human rights violations perpetrated by mental health professionals.

Sounds like a crazy person, right? Kellerman, in his wisdom, suggests the return of long-term involuntary committment.

If the Virginia Tech shooter had been locked up for careful observation in a humane mental hospital, the worst-case scenario would've been a minor league civil liberties goof: an unpleasant semester break for an odd and hostile young misanthrope who might've even have learned to be more polite. Yes, it's possible confinement would've been futile or even stoked his rage. But a third outcome is also possible: Simply getting a patient through a crisis point can prevent disaster, as happens with suicidal people restrained from self-destruction who lose their enthusiasm for repeat performances.

This is the psychiatrist's version of the Derbyshire gambit—if only the people around Cho had behaved exactly as I would have behaved, this tragedy could have been snuffed out! Except that Derbyshire wasn't arguing for the return of Bedlam. Kellerman does aver a little bit at the end of his piece ("Given the excesses of the past–husbands committing troublesome wives, involuntary sterilization of those judged defective–extreme caution is warranted."), which dilutes the impact (and the point) of his Szasz-bashing.

Worth reading: Jacob Sullum's long Szasz interview from 2000.