A 2007 case that I was asked to review illustrates the problem. It involved an 18-year-old man, an athlete and a good student, who began with high hopes.

However, at the start of sophomore year, he quit the football team, left school and went home. At home he was withdrawn, disheveled, talked to himself and was suspicious of his friends and family. His parents knew something was wrong and sought treatment. When a mobile crisis team was called to the house he refused to engage with them. Although he clearly was ill, he was not aggressive, so they told his parents to continue monitoring their son’s behavior and to call if he became a threat to himself or others. The next day he stabbed his twin half-brothers with a kitchen knife, killing one of them and severely injuring the other.

Incidents like this are part of the glaring array of social pathologies that emanate from our country’s failed mental health care system. We need to identify mental illness early and intervene before the person’s symptoms disrupt their lives and society. One way to do this is to embed mental health professionals in emergency rooms and general medical clinics. Another, since many mental disorders begin in adolescence, is to train school personnel and guidance counselors and provide them with screening instruments and referral sources for mental health care.