In 2019, the National Institutes of Mental Health (NIMH) estimated that 51.5 million Americans suffered from some sort of mental illness ranging from minor to severe. Of these, NIMH estimated that 13.1 million suffered from a Serious Mental Illness. About two-thirds received some kind of treatment. Women were much more likely than men to suffer from SMI, but also much more likely to receive treatment. Young people (18-25) were much less likely to receive treatment than were older people.
A couple of recent high-profile cases have brought attention to the interaction of the mentally ill with law enforcement. Entangled as they are with other social issues, the mental illness issue has faded into the background. What gets missed is the sheer complexity of the problems and the wide ranges of people who are affected.
During 2019, the second chapter in a small tragedy concluded. In January 2015, Thomas Gilbert, Jr. shot and killed his father, Thomas Gilbert, Sr. From January 2015 to May 2019, Tom Jr. languished in jail as the court tried to figure out if he was competent to stand trial. Eventually, the presiding judge found him competent.
It seems obvious that he was mentally ill. His mother recounted a promising life gone to ruin from his late teens on. He “didn’t like to be controlled,” so he defied his father by quitting high school soccer. He became obsessed about “contamination” by things and then by other people. His washed his hands obsessively, discarded clothing, furniture, and even college roommates, and stayed away from places like Kennedy airport from fear of contamination. He did a lot of drugs. He left Princeton mid-way through his freshman year to surf in South Carolina, but ended up in a hospital in Charleston after going three days without sleeping. The young man resisted every effort by his parents to get him professional help or even to stay in touch with him. After he eventually graduated from Princeton, he couldn’t get or keep work.
However, none of this is enough to establish mental incompetence or to support an insanity defense. What makes someone “competent” to stand trial? A “defendant is incompetent [only] if he or she is incapable of rationally communicating with his or her attorney or rationally comprehending the nature of the proceedings against him or her…..The threshold for establishing competency is often identified as notoriously low.” Moreover, in New York, the burden of proof is on the accused. The prosecutor here argued that Tom Jr. had long intended to kill his father: he had driven to Ohio to buy the murder weapon seven months before the killing; he had sent his mother out of the apartment on a ruse just before he shot his father. He killed his father because his father has cut off financial aid.
Prosecutors also commonly argue that the accused is shamming. If Tom Jr. was shamming, then he was doing a pretty good job of it in the early stages of his trial. He repeatedly interrupted his own lawyer and objected to his mother’s testimony about his unraveling sanity.
The trial dragged on into late June, when the jury found Thomas Gilbert, Jr., guilty of murder. In September, the judge sentenced him to life in prison without the possibility of parole until he had served 30 years.
At least in prison he can be denied access to firearms and be forced to take his medications. His parents had no such power.
 https://www.nimh.nih.gov/health/statistics/mental-illness.shtml#:~:text=Mental%20illnesses%20are%20common%20in%20the%20United%20States.,severity%2C%20ranging%20from%20mild%20to%20moderate%20to%20severe. Serious Mental Illness (SMI) defined as “a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.”
 Walter Wallace, Jr. https://en.wikipedia.org/wiki/Killing_of_Walter_Wallace; Daniel Prude. https://en.wikipedia.org/wiki/Killing_of_Daniel_Prude
 See: https://waroftheworldblog.com/2015/01/19/by-the-waters-of-babylon/
 So, maybe he was surfing at Folly Beach. See: https://www.islasurfschool-charleston.com/journal/2018/6/11/5-things-to-know-about-surfing-in-charleston
 For what it’s worth, see the article on the co-occurrence of obsessive-compulsive disorder (OCD) with bipolar disorder (manic-depressive). https://www.psychiatrictimes.com/view/bipolar-plus-ocd-which-treat-first That seems to my un-tutored eye to be what was happening to Thomas Gilbert, Jr.
 See the very useful discussion at: https://www.law.cornell.edu/wex/insanity_defense
 You can follow the story in the articles by Edgar Sandoval and others in the New York Times. See: https://www.nytimes.com/2015/11/05/nyregion/thomas-gilbert-jr-is-fit-for-trial-in-wealthy-fathers-death-psychologist-says.html; https://www.nytimes.com/2019/05/30/nyregion/murder-trial-thomas-gilbert.html; https://www.nytimes.com/2019/06/07/nyregion/murder-trial-thomas-gilbert.html?action=click&module=RelatedLinks&pgtype=Article; https://www.nytimes.com/2019/06/18/nyregion/murder-trial-thomas-gilbert.html?action=click&module=RelatedLinks&pgtype=Article; https://www.nytimes.com/2019/06/28/nyregion/murder-trial-thomas-gilbert-verdict.html?auth=linked-facebook&searchResultPosition=1; https://www.nytimes.com/2019/09/27/nyregion/thomas-gilbert-murder-sentence.html;