Several weeks before Aaron Alexis killed 12 people at Washington Navy Yard in September, he told police in Rhode Island that he heard voices emanating from hotel walls. Years earlier, he accused strangers in public places of laughing at him and randomly shot at the tires of a car owned by construction workers near his home.
One of the most tragic and frustrating aspects of Alexis’ case, and that of many other mass shooters, is how their earliest symptoms of mental illness seemed to slip through the system.
Untreated mental illness doesn’t usually erupt in violence, of course. More commonly, delusions, manias, and paranoias simply emerge in adolescence and quietly build, potentially making it hard for their host to function normally in later years. Often, people with schizophrenia or bipolar disorder don’t recognize their symptoms until it’s too late, causing them to depend on treatment with aggressive doses of anti-psychotic medications, which themselves can cause mental fogginess and extreme lethargy, for their entire lives.
But a four-year project from the National Institutes of Mental Health, wrapping up this summer, aims to change that. It attempts to intercept serious mental illnesses when their symptoms first crop up, allowing these patients to return to normalcy quickly—and, the NIMH hopes, permanently.
“The time between the onset of psychotic symptoms and when appropriate treatment is initiated is a critical period,” said Robert Heinssen, a schizophrenia expert who launched the RAISE project. "With what’s called ‘the duration of untreated psychosis,’ the longer it is, the more likely it is you’re going to have an unfavorable outcome.”