by E. Fuller Torrey, M.D.
Copyright (c) 2014.
This book tells the story of the American mental health system, starting with JFK’s “reforms” and ending with the Affordable Care Act. JFK, whose sister suffered from mental retardation and a failed partial lobotomy, assuaged his family’s “guilt” by reforming the system to close the state-run mental hospital system. This step federalized the system and took away state responsibility for these actions. In its place, no one – especially a partisan, semi-dysfunctional Congress – takes full responsibility for those struggling with serious mental issues.
In particular, it points out the problems our country has faced with serious mental illness (e.g., schizophrenia and bipolar disorder). For these, deinstitutionalization does not pose a permanent solution as they require inpatient watching, sometimes for the rest of the patient’s life.
Dr. Torrey overlooks the positive steps JFK’s system took towards those with easier-to-tackle mental issues (e.g., Post-Traumatic Stress Disorder and Major Depression). He also fails to fully acknowledge the problems with the prior system of state-run hospitals. Living herded together like cattle is not really a functioning system to begin with. Getting rid of a dysfunctional system for another dysfunctional system is a relatively even-sum game. The remaining question is what steps ought one take towards assuaging these problems.
Dr. Torrey ends with a chapter of policy analysis and proposals which are frankly the best part of this book. He frames these in ten summarized points which will surely tantalize the policy wonks who live among him in Washington, D.C. One can hope that the true knowledge in this book will speak to our Congress and action can be taken for the most difficult psychiatric cases, for whom very few people know about or care about. These patients cannot lobby for themselves, but we can act for them.