Some patients at St. Elizabeths Hospital in Washington, D.C., aredesignated “White House cases.
” To gain that distinction,they first display some type of bizarre behavior at the White House orother prominent public building. They are then referred to the federalmental hospitaly by a Secret Service agent who considers them to bementally disordered and potentially dangerous to a public official. How dangerous, in fact, are these individuals? David Shore andcolleagues at St. Elizabeths reviewed Secret Service records of 328White House cases treated between 1971 and mid-1974. Although 22percent of this group threatened a prominent politician before or afterhospitalization, none of them had made an assassination attempt as ofAugust 1984.
One of the patients, however, shot and killed a SecretService agent in 1980, and two others assaulted nonpoliticians. Thetypical White House case was an unmarried, white male with a diagnosisof paranoid schizophrenia, report the investigators in the MarchAMERICAN JOURNAL OF PSYCHIATRY. Many patients sought to advise or gainhelp from the President, who had been incorporated into their delusionsas a benevolent authority. Shore and co-workers are now examining whether White House caseswere more likely than the general population to be arrested for violentcrimes during the follow-up period.