Movements to deinstitutionalize people with mental illness and to make institutionalization more legally difficult have resulted in a lack of space and resources for the care of those with severe mental illness, and many have ended up in jails and prisons.
Registries of those considered dangerous focus wrongly on those with mental illness, who account for only 4 percent of violent acts committed in the United States.
Particularly in a small community, patients may want to avoid the social stigma of seeking mental health care by receiving it from their primary care physician—who may know them well enough to have some insights an unfamiliar specialist would not.
PSOs are not required to share their data, which limits the ability to achieve a much-needed national perspective. Regardless, the are a step in the right direction.