We don't yet know if Jared Lee Loughner was delusional when he went on a shooting rampage in Tucson. He's not talking, and no one has examined him and diagnosed him with anything that's been publicly revealed. But if he turns out to have been delusional -- and, more specifically, schizophrenic -- he would appear to have something in common with a type well known in the Washington area: the White House Case.
"White House Case" is the term of art used by psychiatrists since the at least the 1960s to describe a distinct subset of the mentally ill who become psychotically preoccupied with the inhabitants of the White House or other government offices.
The term originated at St. Elizabeth's Hospital in Southeast Washington, where members of the Secret Service would dump floridly delusional individuals from across the country and even the world who washed up at the White House gates, having incorporated the president into their distorted thinking as villain or savior.
The centrality of political figures in the deluded thinking of the psychotic is a problem Washington has been dealing with as long as there have been political figures and mentally ill -- and one it still grapples with today.
"Washington has a magnet effect," observed Robert Kiesling, the medical director of Pathways to Housing and a former medical director at St. Elizabeth's. "We get a lot of folks from all over the country -- all over the world for that matter -- who come here to do business with the government for various delusional reasons. They make up a high percentage of the homeless population in DC."