During the decade of the eighties, two images of mental illness have come to dominate the public imagination and the mass media in the United States. One image is of the violent, paranoid killer. This is the image featured on the evening news. John Hinckley's attack on President Reagan is perhaps the most famous example. It has been shown all over the world and has been replayed scores of times in the United States. Hinckley was under the care of a psychiatrist at the time. This and other similar cases have focussed media attention on the alleged negligence of psychiatrists in allowing these insane killers to go free. John Lennon's killer left a mental hospital in Hawaii, travelled to New York, and gunned down his victim. An acutely psychotic man released from a Massachusetts state hospital travelled to Florida and decapitated an innocent young boy. A man sent home on a visit from a New York state hospital, killed the wife he had been threatening to kill. This image of violent insanity unleashed by incompetent psychiatrists blends into that other familiar image of violent crime: mugging, rape, murder–crime in the streets.

Whatever the explanation for these kinds of violence, whether it is madness or badness, it is clear that the American public now wants more protection. Many Americans feel betrayed by the criminal justice system and in addition there is a growing public feeling that incompetent psychiatrists and radical civil libertarians have together deprived the public of a measure of much-needed protection and unleashed maniacs on society. Is the American public correct? Are they now more at risk?