They are so crazy they don’t think they’re crazy.
For years, states have tried to honor the rights of people who don’t want to be treated for their mental illness, so unless adults ask for help, or prove to be a danger to themselves or others, they don’t have to be on meds.
Read Pete Earley’s book, Crazy. The father of a mentally-ill son, Earley chronicles his efforts to get his son committed, so he could get help. His son, of course, did not want help because he did not understand he was mentally ill. Earley tells about one incident when his son is seeing messages and patterns in a magazine as an emergency-room doctor signs his release papers.
What Earley learned, painfully and repetitively, is that he could not demonstrate that his adult son was a danger to himself or others until his son committed a crime. Most mentally ill people who commit crimes tend to commit inconsequential crimes. In Earley’s son’s case, it was a burglary in which he spent hours in a stranger’s bathtub.
In the case of Loughner and Holmes and Lanza, though, the crimes were atypically horrific.
But anyone with a mentally ill adult child will tell you getting treatment for these people is often legally impossible — until it’s too late.