As a forensic psychiatrist who worked in a jail for ten years, sometimes evaluating murderers and on one occasion a mass murderer, I have often wondered what we can do to mitigate or prevent disasters such as the tragedy that just occurred in Tucson.

I can think of no better answer than the letter written in a recent issue of the New York Times by a federal judge who is professionally experienced in the aftereffects of violence. His words speak both to the nature of the problem, and implicitly to our responsibility as psychiatric professionals. Here’s his letter:

To the Editor:

I disagree with the premise that attackers almost never telegraph their intentions ahead of time (“Real Threats Are Said to Rarely Give Warning,” news article, Jan. 12).

Reports that Jared L. Loughner’s bizarre behaviors were known to law enforcement, schoolmates, friends and, perhaps, his family should have raised a red flag that some form of intervention was appropriate before the attack on Representative Gabrielle Giffords.

I almost never had a child abuse case in Family Court that did not involve antecedents such as excessive absences from school, violence in the home or prior contacts with child welfare officials. Similarly, federal crimes are rarely spontaneous and may well be predictable, if not always preventable.

The challenge lies in connecting the dots and implementing appropriate measures before tragedy occurs, including raising public awareness about how to identify dangerous behaviors.

Richard M. Berman
New York, Jan. 12, 2011

Editor’s note: for more on the tragedy in Arizona, check out:

• To stop violence, we must start with ourselves
• Thoughts on a tragedy, with help from Jon Stewart and Dr. Walt Menninger
• Giffords shooting calls for measured, rational response