http://en.wikipedia.org/wiki/Irving_Gottesman

who was credited as the main adviser on schizophrenia relied on by the author of the book A Beautiful Mind. Gottesman has spent much of his career researching schizophrenia and debunking former theories about the origin of schizophrenia. Twin studies, especially studies of the unusual cases of monozygotic twins reared apart, and adoption studies have consistently shown that schizophrenia develops from an underlying genetic vulnerability (probably varying greatly from patient to patient, according to the best evidence from genome-wide association studies) that makes a patient all too likely to develop full psychotic symptoms over the course of childhood without careful treatment. Gottesman's research goal is to define "endophenotypes" that can be reliably measured clinically to identify patients who need one kind of preventive or supportive treatment rather than another. But we are nowhere near identifying endophenotypes for any major mental illness.

"Self-medicating with marijuana, Tim’s drug of choice for lowering the volume of the voices in his head, got him suspended from the first high school he attended — a public, vocational-technical school in Middletown, Conn. — and placed on court-ordered probation." We do know that young people whose family history suggests genetic risk for major mental illness (which might not be known for a particular adopted child) are playing with fire if they take schedule I drugs without medical supervision. Many of the worst outcomes found in families in which some relatives become mentally ill and some do not are among the persons who "self-medicate" (that is, abuse drugs) rather than reduce risk of perturbing their brain chemistry.

"If I were a legislator today, I’d mandate — and provide funding to ensure — that every teacher receive training in recognizing symptoms of mental illnesses."

Teacher who are credentialed to teach elementary school receive specific training in how to teach reading, and receive specific training in how to teach elementary mathematics, but mostly do a remarkably poor job in those important tasks anyway. There are not today any reliable lists of early symptoms of mental illnesses to guide an adult who sees young children as to who will develop severe mental illness in adulthood. Diagnostic criteria for psychology and psychiatry are not that well developed yet, and communicating criteria for best practice to future teachers in schools of education or to in-service teachers through in-service training programs is already a vexing problem in reading instruction and mathematics instruction.

"I’d see that pediatricians are trained to make screening for mental health concerns a regular part of well-child exams."

I think some of that is already done today. At least, my four children certainly seemed to be asked routine questions in well-child pediatrician visits that could raise red flags on the basis of certain answers to those questions. Again, there simply aren't that many effective early screening tools for mental illness today of any kind. One of the best tools for identifying people at highest risk for developing mental illness is to know the complete medical history of their nearest relatives--but that is the hardest tool to use for some adopted children.

"I’d require school administrators to incorporate recommendations from pediatricians and mental health professionals into students’ IEPs."

What I hear from parents whose children have IEPs (individual education plans, under federal law about special education) is that it is often annoyingly difficult to get a school to follow an IEP, even though that is mandatory by law. It is the parents's responsibility, in the first instance, to make sure that all relevant information is provided to the professionals who work with the parents in drafting the IEP. The parents have to push back if the IEP isn't drafted helpfully at first, and they have to keep an eye on whether or not the school implements the IEP.

All in all, this sad story is a good reminder that EVERY parent, and maybe especially an adoptive parent, needs to be cautious about reducing risk of future harm for all children in the parent's care. The author's description of his situation makes his situation sound very rough. He surely hoped that his son would be living independently and thriving by the son's current adult age. What I've learned about parenting after two decades is that parenting never completely ends. Launching a child into self-sufficient adulthood is wonderful. (I have done that once so far.) But there will always be scary issues for parents to watch out for that they have to take care of themselves.

AFTER EDIT: Several comments below this comment talk about the risk of drug abuse for persons who have underlying vulnerabilities to mental illness. I agree with the suggestion that alcohol (legal for all adults) is surely dangerous in such cases and perhaps tobacco (also legal for all adults) is too. But I will remind all readers here that marijuana was specifically mentioned as the now homeless person's "drug of choice" in the submitted article, and marijuana alone, plus the genetic vulnerabilities, is enough to turn some formerly productive young people out on the street unable to support themselves. (It was probably observations of situations like this decades ago that helped convince legislators to change marijuana's legal status from permitted to largely banned. The article submitted here makes the correct point that sometimes legislation has unintended consequences, and perhaps the "drug war" is ineffective policy for reducing the harm that mind-altering drugs cause individuals and society.) Richard Branson has argued that Portugal's different pattern of regulating drugs has reduced drug use and has reduced various social harms from drugs that are Schedule I drugs here in the United States.

But that said, I will stand by my statement "We do know that young people whose family history suggests genetic risk for major mental illness (which might not be known for a particular adopted child) are playing with fire if they take schedule I drugs without medical supervision. Many of the worst outcomes found in families in which some relatives become mentally ill and some do not are among the persons who "self-medicate" (that is, abuse drugs) rather than reduce risk of perturbing their brain chemistry" because it is a factually correct statement. I don't know of any physician who regularly treats psychotic patients in emergency rooms who recommends that young people with family history medical risk for psychosis use marijuana. That is a distinctly bad idea.

ONE MORE EDIT:

I shared the article submitted here among my Facebook friends, and one thoughtful friend suggested the article, from the same newspaper in 2005, "Social Network's Healing Power Is Borne Out in Poorer Nations"

http://www.washingtonpost.com/wp-dyn/content/article/2005/06...

as an interesting contrast to the situation described in today's article. There is some good back and forth among experts on schizophrenia in different countries in the previous article. Diseases influencing human behavior often manifest differently in different cultures.