On a winter night in Taipei, random violence erupted throughout two of town’s busiest metro stations. Inside minutes, lives have been misplaced, dozens have been injured, and a well-recognized cycle adopted: shock, worry, requires extra safety, and questions on public security. However for these of us in well being care, this shouldn’t be framed as a failure of policing alone. It must be acknowledged for what it actually is: a failure of the well being system lengthy earlier than the primary blade was drawn.
Random violence doesn’t emerge from nowhere. It’s hardly ever sudden, and nearly by no means remoted. It’s typically the ultimate seen collapse of invisible techniques (untreated psychological sickness, social isolation, fragmented care, and repeated missed alternatives for early intervention). Metro stations like Taipei Most important Station and Zhongshan Station are usually not simply transit hubs. They’re the nervous techniques of a metropolis. When violence erupts there, it displays greater than particular person pathology; it reveals collective pressure. Crowding, anonymity, stress, and disconnection converge. When the system fails, the breakdown occurs the place the alerts are most concentrated.
After each such incident, hospitals grow to be the ultimate security internet. Emergency departments take up the chaos. Surgeons function by way of the evening. Intensive care items stretch their limits. Psychological well being professionals are requested to intervene, however solely after irreversible hurt has occurred. Well being care is repeatedly positioned as a reactive system, tasked with restore however denied a task in prevention.
This sample ought to concern clinicians. We’re skilled to acknowledge warning indicators, danger components, and deterioration trajectories. But when those self same rules apply exterior hospital partitions (in communities, transit techniques, and public areas), we faux they’re past the scope of drugs. They aren’t. Psychological well being will not be solely the area of psychiatry. It begins in main care, neighborhood outreach, continuity of therapy, and early identification of these drifting out of care. Each untreated psychotic episode, each interrupted follow-up, each affected person misplaced between techniques is a medical failure, even when the results manifest removed from the clinic.
It’s uncomfortable to ask these questions after acts of violence. We worry that acknowledging systemic gaps might sound like justification. It isn’t. Accountability and prevention are usually not opposites. They’re inseparable. We should ask: The place was this individual months earlier than the assault? Had been there encounters with the well being system that went nowhere? Was therapy inaccessible, discontinued, or fragmented? Did anybody discover, and in the event that they did, did the system enable them to behave?
Public transport violence will not be solely a safety subject. It’s a inhabitants well being sign. When psychological misery accumulates with out pathways for care, it doesn’t disappear. It erupts. As clinicians, we can’t restrict our duty to the second a affected person arrives bleeding on the emergency division door. If we actually imagine in prevention, we should advocate for psychological well being techniques that perform earlier than disaster, not after headlines.
Hospitals shouldn’t be the final line of protection. They need to be a part of a continuum that by no means permits despair to succeed in this level. When random violence breaks out in a metro station, it isn’t only a tragedy of public security. It’s a reminder that drugs, when disconnected from neighborhood and continuity, arrives too late.
Gerald Kuo, a doctoral pupil within the Graduate Institute of Enterprise Administration at Fu Jen Catholic College in Taiwan, focuses on well being care administration, long-term care techniques, AI governance in medical and social care settings, and elder care coverage. He’s affiliated with the Dwelling Well being Care Charity Affiliation and maintains an expert presence on Fb, the place he shares updates on analysis and neighborhood work. Kuo helps function a day-care heart for older adults, working carefully with households, nurses, and neighborhood physicians. His analysis and sensible efforts give attention to lowering administrative pressure on clinicians, strengthening continuity and high quality of elder care, and creating sustainable service fashions by way of information, expertise, and cross-disciplinary collaboration. He’s notably fascinated by how rising AI instruments can help getting older medical workforces, improve care supply, and construct better belief between well being techniques and the general public.
