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American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System

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Review

"For a few days in September--after a psychotic gunman killed 12 people in Washington's Navy Yard--we were forced to ask ourselves, yet again, how we treat the seriously mentally ill in America and whether we need to rethink our policies and assumptions. No one is better equipped to address those questions than E. Fuller Torrey." --Sally Satel, Wall Street Journal"This is a powerful book on how to prevent the high profile tragedies that galvanize national attention, and the thousands of other tragedies that pass under the radar. I highly recommend it to all advocates and policymakers who care about mental illness." --Huffington Post"This wise and unflinching book is an object lesson in good intentions gone awry on a grand scale. It should be widely read." --New York Times"An important book by a refreshingly candid author who shares his vast knowledge in the interests of the needy." --Kirkus Reviews, starred review"Torrey is the conscience of the country and its most articulate spokesperson when it comes to public mental health care. His latest installment, American Psychosis, is a scathing analysis of the abject failure of U.S. mental health care policy written in his usual lucid and compelling style. Torrey is the Dorthea Dix of our time." -- Jeffrey A. Lieberman, MD, President Elect, American Psychiatric Association; Lawrence C. Kolb Professor and Chairman of Psychiatry, Columbia University College of Physicians and Surgeons; and Director, New York State Psychiatric Institute "The first time I heard Torrey speak at a meeting of psychiatrists I was so offended I got up and left. Five years later I realized that everything he had said was true. This book will, I believe, offend many people; hopefully it will take them less time to recognize the truth of what Torrey has written." -- Alan A. Stone, MD, Former President of the American Psychiatric Association, Touroff-Glueck Professor of Law and Psychiatry in the Faculty of Law and the Faculty of Medicine, Harvard University "Torrey's superb new book is a devastating indictment of America's mental health 'system,' a story of good intentions gone disastrously awry. Torrey combines a deep professional knowledge of severe mental illness with an unparalleled understanding of the politics and policy of mental health. His lively writing weaves together powerful and poignant examples of the problem with hard-headed and yet compassionate solutions to one of America's greatest public policy tragedies." -- Stuart M. Butler, PhD, Distinguished Fellow and Director, Center for Policy Innovation, The Heritage Foundation "With persuasive facts and gripping, tragic examples, Torrey documents what state psychiatric hospitals, community mental health centers, and jails have in common: millions of seriously mentally ill people treated inhumanely and inadequately, causing deterioration in the care of the most vulnerable. He examines the lessons learned from mental illness service programs over the past 50 years and concludes that we should greatly expand the best, such as proven programs in Wisconsin and New York City, and eliminate the worst, such as for-profit mental illness providers like nursing and board and care homes. American Psychosis is an unprecedented, invaluable elaboration of how to alter a national tragedy." -- Sidney M. Wolfe, MD, Public Citizen Health Research Group, Co-author of Worst Pills, Best Pills, and Editor, WorstPills.org "Vintage Torrey: Comprehensive, deep, and thoughtful; biting and to the point; yet hopeful and hoping for change." -- John A. Talbott, MD, Professor of Psychiatry, University of Maryland School of Medicine "The author successfully weaves in political, social, and medical influences of the time, permitting readers to comprehend the challenges faced during this period. It is clear the author has a passion for this subject, and he provides solid conclusions that should leave readers wondering when, if not now, is the appropriate time to overhaul the system once again." -Steven T. Herron, MD, Doody's Health Sciences Book Review

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About the Author

E. Fuller Torrey is Executive Director of the Stanley Medical Research Institute in Chevy Chase, MD, founder of the Treatment Advocacy Center, and Professor of Psychiatry at the Uniformed Services University of the Health Sciences.

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Product details

Hardcover: 224 pages

Publisher: Oxford University Press; 1 edition (October 1, 2013)

Language: English

ISBN-10: 0199988714

ISBN-13: 978-0199988716

Product Dimensions:

9.3 x 0.9 x 6.4 inches

Shipping Weight: 13.6 ounces (View shipping rates and policies)

Average Customer Review:

4.4 out of 5 stars

56 customer reviews

Amazon Best Sellers Rank:

#244,303 in Books (See Top 100 in Books)

Very imformative. A must read for anyone really wanting to understand why our broken mental health care system is the way it is. The answers to the problem are obvious. But we have to change the narrative in the public's mind and get the politicians and policy makers to not be so selfish on the topic of mental illness.

American Psychosis is a devastating but important critique of the American Mental Illness system. The Community Mental Health Center movement began in 1963 with a law signed by John F. Kennedy. Efforts to implement the law failed to achieve the promise of the overly ambitious law. This book goes into detail about the failures. There was a good faith effort by many mental health professionals at the time but funding was stopped by Congress in the early 1980s and early achievements were lost to history. The author offers explanations on how the mentally ill came to inhabit our local and state prisons once the state hospitals gladly shut their doors. It speaks to the terrible toll our most vulnerable citizens and their families have been paying for half a century of neglect by the rest of us. This book spell out ways that can be considered in order to address the current crisis of the homeless mentally ill. It lays down the basis for making changes in a system that has grown intolerable not only for the people who are ill but for the rest of the country that is beginning to look for ways to cope with it.

Torrey's book as an interesting and easy read. He outlines the history of how the mentally I'll have been cared for, or more often neglected, abused, and victimized. Torrey explains what government programs have been tried and what parts worked, but more often why they didn't work. Torrey offers a lot of suggestions on the services mentally ill clients require to function in society. Government officials, psychiatrists, medical personnel, social workers, and families should read this book and be motivated to make the system work for those unable to help themselves.

An amazing review and analysis of the care for the mentally ill in the US.He writes very clearly and well supported by facts.A must read for anyone trying to understand why 35-40% of the homeless and +30% of the prisoners in the US are clinically mentally ill!

Walks on the Margins, a Story of Bipolar IllnessI've been talking and writing about our broken mental health care system and the need for change since shortly after our son was diagnosed with mental illness in 1999 and we began battling to find good treatment in that "system." It's been well over a decade now, yet nothing has changed. That we dare to call mental health care a "system" is laughable. After all "system" implies organization of services, coordination of care, and oversight. In too many cases, there are no services at all. And instead of care, there is only chaos. I've never understood how this could have happened--how we could be failing the mentally ill among us so completely.E Fuller Torrey, in his recently released book, American Psychosis, has made it painfully clear. With uncompromising and fierce analysis and insight, he has explained how things went so wrong after JFK signed the community mental health act in 1963. The motivation for legislation was laudable, the outcome, however, was a disaster. Fifty years since, the mental health care system is in shambles.Mental health hospitals had already begun closing in the 50's and continued to do for many reasons--exposure of the horrible conditions and lack of treatment in some, new medications that brought the worst symptoms under control, changes in Medicare and Medicaid that disallowed coverage for psychiatric hospital care, lawsuits and changes in commitment criteria, and the feeling that there were better ways to treat those who live with mental illness. With the closings and the new law came a hopeful paradigm- community mental health centers would provide care in outpatient settings where those with mental illness could reengage as members of their families and communities.Why was the plan such a failure? The legislation, says Torrey was fatally flawed. "It encouraged the closing of state mental hospitals without any realistic plan regarding what would happen to the discharged patients, especially those who refused to take medication they needed to remain well. It included no plan for the future funding of mental health centers. It focused resources on prevention when nobody understood enough about mental illnesses to know how to prevent them. And by bypassing the states, it guaranteed that future services would not be coordinated."The failure of the community mental health care program was due to more than just poor planning and lack of funding. For me, the most troubling was the changing philosophy of those who were charged with leading the program. As plans were being formulated, their focus shifted from the care for those with severe mental illness to one of prevention, which in turn became a movement to address our social and cultural ills in order to promote mental health. Admirable perhaps, but such grandiose notions were far beyond the scope of community mental health centers that were supposed to serve those with mental illness. The change in thinking, Torrey says, altered the essential function of community treatment.Many of those who were released from hospitals were severely ill, didn't have family support, had chronic long-term needs, and had no place to go. Says Torrey, "Our failure to protect such mentally ill people by insuring they receive treatment is a major miscarriage of our mental health care system and a blot on our claims to be civilized." So many ended up homeless and in jail and the travesty continues to this day. The result? The largest mental health providers in the nation are our prisons and jails: Cook County in Illinois, Los Angeles County, and Rikers Island in New York among them. The complete failure of mental health care in this country is a sad commentary on how personal biases and ambitions, wrong headedness, and political aspirations can shape policy and impact people in such devastating ways.In the last chapter Torrey acknowledges that change does not come easily. Progress is impeded by the lack of understanding of serious mental illness, failure to understand the magnitude of the problem, economic and political interests, and the lack of leadership. However, "the fact that we know what to do to correct the existing mental illness diaster is the good news," he says. He explains how we can incorporate what we've learned into successful programs. When we know how and why the system fails and when we look at what successful treatment looks like, as Torrey does, then we can begin to work to achieve it.Torrey concludes his book with a 1947 quote from Out of Sight, Out of Mind by Frank Wright:"Throughout history the problem of the mentally ill has been dodged. We have continually avoided mentally ill patients--we have segregated them, ostracized them, turned our back on them, tried to forget about them. We have allowed intolerable conditions to exist for the mentally ill through our ignorance and indifference. We can no longer afford to ignore their needs, to turn a deaf ear to their calls for help. We must come face to face with the facts.""Isn't it time to finally do so?" Torrey asks.I urge anyone who is concerned about the current state of mental health care to read this book. And I thank Dr. Torrey for writing it.

Thus book was a concise explanation of the causes of our current state of psychiatric treatment and the ensuing effects. I work in mental illness and often find myself feeling like that although the old state hospitals weren't without their flaws, they had to have been better than homelessness and incarceration as the primary setting patients are seen in. I was hoping for more information about what went wrong at in impatient settings in the past but there was little about that.

Made me sick! Very interesting.when I see in my own state that you must be a danger to yourself or others is this the reason mentally sick people snap, there is no help for those in need.You try to get help for someone and the door is shut in your face.Some end up in the streets, terrible.

For those interested in the history of psychiatric care, this is a wonderful library addition.

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