America has suffered through many school and workplace massacres. The common factor among most of them has been young men, guns and mental illness. After each massacre, the nation has gone through its breast-beating introspection and public mourning. The pattern is now well-established, but nothing changes. We are so powerless, it seems.

Gun ownership is a quintessentially American phenomenon that the civilized world can't fathom. Given the NRA's and the gun lobby's stranglehold on American politics, there's little chance for a change in the easy access to and number of guns an individual can purchase.

Truly, the only thing we can readily affect is mental illness. All of the young men who have attacked and killed so many and so senselessly have suffered from a mental illness that, like most human pathologies, can be diagnosed and then subjected to different treatments.

As a nation, we have obdurately refused to address the problem of mental illness, holding on to the ancient prejudice that equates mental illness to some dark presence. By not supporting vigorous research into mental illness, we perpetuate our ignorance and demonize the mentally ill. We must acknowledge that mental illness is of epidemic proportions, since to one degree or another it affects 57.7 million (26 percent of) Americans.

We have spent billions of dollars studying cancer, heart disease, etc., and discovered chemical markers for many. But less energy and money have been spent on mental illness, despite our understanding that there's a chemical basis to many psychiatric conditions. We need to find chemical markers for diagnosis, progression and severity. A secondary benefit to such an understanding will be to destigmatize mental illness.

We know Seung-Hui Cho was mentally ill, probably schizophrenic. Less is known about the psychiatric history of Columbine's Eric Harris and Dylan Klebold. We do know that 8 percent of all kids suffer from some kind of depression; that unipolar and bipolar disorders lead to increased psychological difficulties; and that substance abuse and suicide attempts increase as mentally ill kids age.

We have difficulty recognizing mental illness in the young, often confusing serious behavioral problems with normal, temporary adolescent behavioral changes. Better recognition of mental diseases can act as a deterrent of future massacres by making an honest attempt at therapy and intervening with these vulnerable kids.

We have been poor caretakers of the weak and vulnerable among us. Pete Earley's "Crazy: A Father's Search Through America's Mental Health Madness" (Putnam Adult, 2006) chronicles the sad story of his son's mental illness and the absurdity of our society's management of it. We can change our arcane and impractical laws. We can easily alleviate suffering and future tragedies by "outing" mental illness by giving it the same weight and coverage as other physical ailments by health care providers.

Parents should be taught to recognize the signs and symptoms of mental illness in their kids and be willing to refer them to mental health professionals. Teachers and medical professionals must learn how to identify mental illness and know what to do with that knowledge. Adults must watch their own emotions and avoid shame, stigma or guilt and be willing to seek help.

Mentally ill kids often grow into sick adults; many end up in our jails, where institutional brutality is the norm. Between 10 percent and 15 percent of prisoners have severe mental illness. Twenty-five percent of prisoners in "solitary" are mentally ill; half of them try suicide. Added to the physical and mental suffering, the financial burden to America has been astronomical - something easily alleviated by wise psychiatric therapy.

Before the next Columbine or Virginia Tech, let's step up to the plate and resolve to tackle the issue of mental illness in America. The richest nation on Earth can intelligently evaluate and treat tomorrow's potential mass murderers. Given wisdom and will, we can still abort future killing rampages if we institute a proactive diagnostic, therapeutic strategy.

Pius Kamau of Aurora is a thoracic and general surgeon. He was born and raised in Kenya and immigrated to the U.S. in 1971. His column appears on alternate Thursdays.