Mental health has been an abysmal failure in identifying the potential mass murderer and educating the public about the nature and limits of psychiatric treatment. Freud clearly stated in his writings almost one hundred years ago that not everyone can be a patient and not everyone can be treated. That is as true in America today as it was in Vienna in the late 1800's.

Psychiatrists need to set aside their academic training and listen to their gut, not their professors. Humans experience an automatic physiological reaction in the presence of danger. Experience teaches that we ignore our gut instincts at our own peril.

To sit with a child, adolescent or adult that is like the mass killers is to feel instant fear, disgust and rage. The listener's gut tightens, the fists clench and the hairs on the back of his neck stand on end. He wants only to escape. This set of physical reactions distinguishes between normal, neurotic, asocial and evil. Our animal cousins are far better at this skill, not being crippled by political correctness or religious compassion.

Organized mental health needs to explain to the public in plain English that psychotherapy does not fix people. It gives them tools and sometimes tablets to ease symptoms and to better understand themselves. No more, no less.

The mental health establishment must separate its own private ambitions for power and more funds for research from its greater responsibility to the public. Professional organizations such as the American Psychiatric Association have the responsibility to alert the public that there is no treatment for the asocial psychopath who is consumed with anger and hates humanity.

Young men like Adam Lanza, Jared Loughner, James Holmes, Seng-Hui Cho, Eric Harris and Dylan Klebold are savages that walk among the unsuspecting civilized populace. They need to be identified, apprehended and isolated. They are examples of normal human psychosocial development run amok for a myriad of reasons. It is naïve and dangerous to think any of them might have benefitted from rehabilitation and remediation. Their hearts and minds are immune to all human goodness, much less therapeutic insight.

R. Claire Friend, MD is Editor, UCI Quarterly Journal of Psychiatry