Playing Russian Roulette

 A man stabs a woman on the subway

He is disturbed and delusional

He failed to take his medication

He thinks the police and the FBI are after him

They are now

He is a danger to the community

He should have been restrained and kept in hospital

Thousands of time bombs waiting to explode

"I don't want to be kept in hospital"

"I have been stable for many years"

"Most mentally ill people are more of a danger to themselves"

Do we restrict the movements of all mentally ill people?

The doctors have to decide

They have blood on their hands

How many innocent people must die before something is done?

Banner headlines in the newspapers demand action

The stigma grows and uncertainty and distrust reigns

Care in the community that is the buzz word

But motiveless killings undermine the idea

What do we do?

"Do you want to restrict my movements?"

"I don't always take my medication"

"But I know I am no danger to the public"

The killer is apprehended and the trial takes place

He is to be detained in a secure unit

And the community feels safe

"My right to freedom means your life is at risk"

If you cross the road your life is at risk

If you fly on a plane your life is at risk

We have to balance the risks against the benefits

Maybe we are playing russian roulette with mental health

It is only a matter of time before someone else dies

"So what you gonna do - lock me up"

"Or Spin the Barrel?"