Dr. Steven Sharfstein, past president of the American Psychiatric Association, said the problems are both financial and legal.

“What was a red flag for me is that he was seen in a mental health facility and held for one day. That is a symptom of the dysfunction of our mental health system,” said Sharfstein, who is president of Sheppard Pratt Health System in Baltimore.

“If someone isn’t readily seen as imminently dangerous, there is no time and money set aside to do a more in-depth and effective diagnosis. He may have been hiding a paranoid psychosis that with a few days of observation might have come out.”

The National Alliance on Mental Illness in a 2006 report gave the U.S. mental health system the below-average grade of “D”.

“Untreated mental health is the nation’s No. 1 public health crisis,” Michael Fitzpatrick, the group’s executive director, said in a telephone interview.

“In recent years, states like the Commonwealth of Virginia have systematically reduced their funding for mental health services,” he added.

“The reality is that in many communities, it is impossible to get mental health services unless you have been arrested,” Fitzpatrick said.

Even if treatment is available, patients often are too sick to believe they need treatment. And unless a patient presents an imminent threat, many states prohibit involuntary treatment.

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