Jordan Neely was “gentle, earnest and stable” during his 15-month stay in a Rikers Island mental-observation unit, staff members told New York magazine. He took his medications and engaged in treatment. Mr. Neely’s severe mental illness had left him jobless, homeless and increasingly unstable before a 2021 assault arrest. Now he seemed a perfect candidate for an alternative to incarceration, a residential facility, where he would continue to receive treatment.

But less than two weeks after his arrival, Mr. Neely, 30, walked out and went back to the streets. A few weeks later, he boarded a subway train in Manhattan. He began yelling that he was hungry and thirsty, that he didn’t mind going to jail, that he was ready to die. Allegedly fearing for the safety of other passengers, an ex-Marine named Daniel Penny grabbed Mr. Neely and put him in a chokehold. When he finally let go, Jordan Neely was dead.

Mr. Penny’s trial on charges of manslaughter and criminally negligent homicide is underway in Manhattan. The verdict will revolve around various particulars: whether Mr. Neely’s outburst put Mr. Penny and the other passengers in reasonable fear for their life, whether choking Jordan Neely was an appropriate response to that fear and what, if anything, other passengers said or did while Mr. Neely died.

But the verdict will also raise a far larger question: Are we finally so exhausted by the unpredictability and occasional violence of the insane in our streets and so pessimistic about the possibility of a solution that we accept that the best option left to men like Mr. Penny is to choke a frightening madman until he’s dead?

Madness — those serious and spectacular forms of mental illness that seem to separate the sufferer from the fabric of ordinary human life — has always posed a problem for society. It is exhausting to be a friend or a parent or a sibling or a spouse to somebody who’s lost his or her mind; you do not know what to do, how to help, how to stop worrying all of the time, how much more you can take. In public, the mad annoy, discomfit, inspire terror and sometimes terrorize. But madness is worst for the mad themselves.

I began to crack up as a teenager. I acted out in school. I became “difficult”: paranoid and aggressive and increasingly unsanitary. Convinced I was being poisoned, I tried to remove a lymph node with a knife. More than once, I became so threatening that the police got involved. At 24, I entered lifelong treatment for what would ultimately be diagnosed as schizoaffective disorder. After a decade of mood stabilizers, antipsychotics and other medications, I am stable and safe and able to live a largely ordinary life.