The lead article takes the form of a debate. E. Fuller Torrey, M.D., and Jonathan Stanley, J.D., challenge the main conclusion of the MacArthur Violence Risk Assessment Study, and that study's authors, led by John Monahan, Ph.D., and Henry J. Steadman, Ph.D., respond. The findings, first published in 1998, indicated that the link between mental illness and violence is indirect: people with mental disorders are more likely than others to abuse substances, and people who abuse substances are much more likely than people who do not to engage in violence. Dr. Torrey and Mr. Stanley point out that in the MacArthur sample of 951 psychiatric patients, three patients killed six people—a rate much higher than the homicide rate in the general population. Dr. Monahan and Dr. Steadman respond that selecting a few cases is not a systematic assessment of rates. They also respond to several critiques about the MacArthur Study's design, standing by the study's conclusions (page 147).