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I was on the Orange Line a few weeks ago when people suddenly started running.
I’m not sure what caused riders to stampede out of one car and into another while our train sat at the platform. But it quickly became clear that whatever danger existed had passed (or never existed). We settled back into our books, phones, and conversations. Some, like me, probably felt a little silly for overreacting.
Still, I suspect that brief flurry of confusion and fear in part reflected a gnawing concern many Americans have: Falling victim to a violent crime committed in a public place, apparently at random and without warning, by someone experiencing a mental health crisis.
Several recent cases have transfixed the country. The latest seems to have unfolded in Boston. The philanthropist John Axelrod and his dog Tale died after a Saturday-morning hit-and-run while walking on the Commonwealth Avenue Mall. Prosecutors charged the driver, William Haney, with murder and animal cruelty, saying he deliberately ran them over with an SUV. Haney’s lawyer says his client has long struggled with serious mental illness, believed people were trying to harm him, and may have thought Axelrod was someone else.
Axelrod’s killing shocked many locals. It also seems likely to renew difficult conversations about what to do in response. Surveys show growing fear of being victimized by people with mental illness and, in some cases, rising support for tougher interventions.
How grounded are those fears? Here’s what we know about the links between mental illness and crime.
America’s mental health worsened during the pandemic. Yet most Americans who commit crimes aren’t mentally ill, and people with mental illness are more likely to be victims than perpetrators. Violent crime has also fallen precipitously across the country in recent years, including in Boston.
But researchers generally find that severe, untreated mental illness can increase the odds. People with bipolar disorder, schizophrenia, and other serious mental illness are over three times likelier to commit violence than the general public, one study concluded. (Still, for perspective, about 97 percent of those with severe mental illness committed zero violent acts, as did about 99 percent of those without.) Substance use and homelessness can magnify the risk.
There are unanswered questions, though. Some studies find a bigger statistical link between mental health and violence, others less — or even none. Psychiatric symptoms don’t always precede violence, either. As one researcher puts it, “Diagnosis alone is never enough to tell you.”
Medication beats incarceration
Treatment is one obvious way to lower the chances of mental illness turning violent, but it doesn’t happen enough. Stigma and a lack of health insurance can impede diagnoses. Others slip through systems meant to catch them. The mother of Decarlos Brown Jr., the man accused of fatally stabbing a Ukrainian refugee in North Carolina last year, tried to have him involuntarily committed after Brown became violent, started using hard drugs, and complained of “material” in his body. Despite a schizophrenia diagnosis, the order expired after two weeks.
People with mental illness make up a disproportionate share of the US prison population, but the criminal justice system largely isn’t set up to treat them. Police, rather than mental health professionals, often answer 911 calls about people in crisis, which can lead to injury or death.
People unable to understand or control their actions because of mental illness aren’t supposed to be punished under the law, but some prosecutors find ways. In 2022, a jury convicted Latarsha Sanders, a Brockton mother who killed her two sons during a psychiatric episode, of murder. (My colleague Yvonne Abraham has extensively covered Sanders’ case; a similar one heads to trial this summer.) Even when prosecutors dismiss charges, mentally ill defendants don’t always get needed care. Some wind up back in court.
Some Americans support involuntarily hospitalizing mentally ill people. In Boston, neighborhood groups near the city’s troubled Mass. and Cass intersection favor stricter police enforcement to help get homeless people off the streets and into treatment for drug use.
Others say mentally ill people are often victims, too. “To punish the suffering is a lazy answer to a difficult crisis,” Madeline Lambert wrote in the Globe about her own psychotic episode.
There’s still a lot we don’t know about Haney, who was ordered to undergo psychiatric evaluation after pleading not guilty in the deaths of Axelrod and Tale. This week, Bostonians left flowers, dog toys, and handwritten notes on the mall in their memories. As one neighbor wrote, “I can’t stop thinking about this tragic and horrendous act of violence.”
ICYMI: Axelrod, 79, started collecting Hoodsie ice cream lids as a kid. His hobby grew into a pathbreaking collection of the work of Black artists he championed.
🧩 9 Across: Drenched | 🌤️ 43° The sun returns
Windy city: 2025 was Boston’s most blustery year on record. Climate change is partly to blame.
Federal dietary guidelines: The Trump administration released new, Robert F. Kennedy Jr.-approved guidelines that endorse whole milk, whole grains, and protein while discouraging processed foods, added sugar, and artificial sweeteners. The new guidelines remove longstanding limits on alcohol consumption but recommend generally drinking less. (WashPost 🎁)
Biotech boon: After a post-pandemic slump, pharmaceutical and life science companies in Massachusetts are seeing glimmers of hope, including more mergers and acquisitions and a return to investors’ good graces.
Trump vs. Boston: The administration accused the city of flouting federal immigration authorities as part of an ongoing lawsuit attempting to overturn Boston’s so-called sanctuary policy, which limits police cooperation with ICE.
Speaking of: ICE is reportedly considering putting a warehouse for detainees in Merrimack, N.H. Kelly Ayotte, the state’s Republican governor, says federal authorities have told her nothing about it.
Fatal crash: A tractor-trailer struck and killed an Uxbridge police officer as he assisted a driver on an icy highway. Governor Maura Healey ordered state flags flown half-staff in his honor.
Arrested development: Developers once planned a 20-story tower at the Motor Mart Garage on Stuart Street. Six years later, the project is up for sale.
Folding: The Pittsburgh Post-Gazette, whose roots trace back to 1786, will shut down in May. The company that owns the paper cited financial losses but has also been embroiled in a long-running labor dispute with workers. (AP)
Gunplay: A Pawtucket police officer was legally justified when he shot and wounded a mentally disabled man playing with a toy gun last June, the Rhode Island attorney general’s office said.
RIP: Elle Simone Scott, the SheChef founder and “America’s Test Kitchen” food stylist who worked to increase opportunities for women of color in the food industry, died at 49 after an ovarian cancer diagnosis. And Stuart H. Altman, a prominent health economist who worked for Massachusetts governors Deval Patrick and Charlie Baker, died at 88.
By David Beard
Susan Pithie posted this selfie to Instagram and Threads and it unexpectedly went viral.Susan Pithie
🛜 Grandma goes viral: Susan Pithie of Quincy was enjoying a vodka and potato chips when things got weird. Her granddaughter called and asked: “Do you know you’re famous on Threads?” Here is the reason.
🍿 But will they go to Fenway? Who knew the finale of the popular Netflix series “Stranger Things” would have two key characters move to Massachusetts, one to Boston and one to Northampton?
🏠 Home of the Week: Our latest pick is this two-bedroom condo in Marblehead’s historic district, one block from the waterfront, for $700,000.
🎥 Catching up: From “Sinners” to the Ipswich-filmed “Sorry, Baby” to the latest “Mission: Impossible,” here are 15 award-nominated films you can stream ahead of Sunday’s Golden Globes. Plus, Odie Henderson has a retro pick: a 40-year-old under-appreciated classic with the most danceable David Bowie music.
🐶 Where’s doggie gonna live? A new campaign seeks to end pet discrimination in Massachusetts rentals.
🦐 Hungry? Why not try sizzling rosemary shrimp over polenta? That’s among these five healthy and simple Mediterranean recipes. How simple? Each has just five ingredients.
🚶You don’t need a gym: These mobility exercises are important if you spend time sitting at a desk — and they are critical as you age. While we’re improving ourselves, here are 20 things you could declutter right now.
Thanks for reading Starting Point.
This newsletter was edited by David Beard and produced by Diamond Naga Siu.
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Ian Prasad Philbrick can be reached at ian.philbrick@globe.com.