On March 8, 2012, 30-year-old John Shick entered the Western Psychiatric Institute and Clinic in Pittsburgh armed with two loaded handguns and shot six people, killing 25-year-old therapist Michael Schaab before being shot and killed by University of Pittsburgh police officers. The shooting happened in the Oakland neighborhood not long after Shick had been told by UPMC Shadyside Family Health Center that he would no longer be treated there because of erratic behavior and threats against staff.

Shick had a documented history of severe mental illness, including diagnoses of schizophrenia, prior involuntary commitments, paranoid and delusional symptoms, threatening staff with a baseball bat, and increasingly disturbing emails to his parents in the months before the attack. Attempts to pursue involuntary commitment were considered but were not completed because required paperwork and legal steps were not carried out.

The shooting prompted lawsuits claiming clinicians should have initiated involuntary emergency procedures; courts later ruled the doctors could not be held liable under the Mental Health Procedures Act because the legal steps for involuntary examination were not fulfilled. The case has been cited in discussions about gaps in the mental health system, including lack of beds, restrictive commitment laws, and failures of follow-through.