Out of the Shadows: Confronting America's Mental Illness Crisis

by E. Fuller Torrey

Overview

"Powerful. . . . The crisis [Torrey] delineates should stir any halfway sensitive human being to anger."—The New York Times Book Review

"Brilliant and remarkably detailed. . . . Dr. Torrey, our clearest and most informed voice for the mentally ill, offers his own insightful plan for a way out . . . of a healthcare scandal that remains one of America's most enduring shames."—Phil Donahue.

"If President Clinton is looking for a worthy goal to accomplish in his second term, here's one: Rescue the homeless mentally ill. It can be done. . . . Dr. E. Fuller Torrey . . . provides a five-year road map in Out of the Shadows."—New York Daily News.

"An important book . . . timely and very well written."—The New England Journal of Medicine.

"Controversial ideas, forcefully presented."—Kirkus Reviews

"Moving and vivid. . . . Torrey's powerful prescription for change challenges conventional wisdom and political correctness. His searing case examples will haunt the reader."—Laurie Flynn Executive Director National Alliance for the Mentally Ill

Product Details

ISBN-13:	9780471245322
Publisher:	Wiley
Publication date:	02/26/1998
Edition description:	REV
Pages:	256
Product dimensions:	6.18(w) x 9.28(h) x 0.76(d)

About the Author

E. FULLER TORREY, M.D., is a research psychiatrist at the Neuroscience Center of the National Institute of Mental Health. He is also the author of fifteen books, including the bestselling Surviving Schizophrenia, which has been described as the "bible" of the mentally ill and their families.

Table of Contents

People in the Shadows: The Many Faces of Mental Illness 1

Nowhere to Go: Homelessness and Mental Illness 13

Jails and Prisons 25

Walking Time Bombs: Violence and the Mentally Ill 43

Psychiatric Ghettos: Communities and Families 61

Looking Backward: Where We Have Been 81

New Initiatives in Funding 91

From Legal Folly to Common Sense: The Right to Get Well 141

From the Woody Allen Syndrome to Brain Disease 167

Looking Forward: Where We Should Be Going 193

Appendix: The Magnitude of Deinstitutionalization 205

References 209

Index 237

Editorial Reviews

This is a concise, informative exploration of the mental illness crisis in America. The author provides the startling facts of our situation as an impetus for change, then catalogues the necessary steps to change. The aim of the book is simply to answer ""Why?"" Why do our mental illness problems exist? Why does the established system not work? Why has the crisis gotten worse, instead of better? What can we do? The book is needed because the current situation is depraved, inhumane, and not functional. The book answers these questions and offers a practical outline for change. The book is a valuable resource for mental health workers and the families of the mentally ill. The book is informative and pedagogic for anyone endowed with the power to invoke change. The author is learned about the state of America's mental illness crisis and has the clarity of vision and acumen to illustrate a solution. The illustrations are sufficient, but more would be useful. The references are expansive, almost overwhelming, yet necessary for a complete understanding of the gravity of the mental illness crisis. The table of contents is adequate and the index is superb. The book is attractive. The appendix detailing the magnitude of deinstitutionalization state by state is provocative, This is a palpable exploration of America's mental illness crisis. It humanely describes the privations of our mentally ill and methodically explores the economic, ideological, and legal reasons for such a state. The provided solution to the crisis is viable and informative. This book will provide mental health workers and the families of the mentally ill with insightful knowledge and has the potential to be acatalyst for change, if read by policymakers.

Virginia Galloway

The crisis, simply put, is that 2.2 million of the estimated 5.6 million Americans with serious mental illness are not being treated. Instead, these "walking time bombs" are often homeless in the community or incarcerated in prisons. Torrey, a clinical research psychiatrist, explores how this situation came to be and offers some radical proposals for remedying it.

Torrey ("Nowhere To Go", 1988; "Freudian Fraud", 1992, etc.) notes that for the majority of people with severe mental disorders treatments to effectively control their symptoms are already available, and with research, better ones would surely be found. To that end, he urges formation of a National Brain Research Institute. Meanwhile, however, Torrey sees much that can be done to provide humane and cost-effective services for the severely mentally ill. With numerous anecdotes and impressive statistics, he builds a dismaying picture of society's failure to care for the mentally ill. He then argues for major ideological, economic, and legal changes, as well as a change in how we think about serious mental illnesses. Too often they are seen as occupying one end of the spectrum of mental health, linked to social reform and liberal causes and thus highly politicized. Torrey asserts that when serious mental illnesses are properly viewed as neurological disorders of the brain, research funding, treatment resources, and professional expertise can be more readily obtained. To eliminate cost-shifting between levels of government, which he sees as the primary cause of the present situation, he would make the states responsible for providing services and accountable for treatment outcomes, with the federal government providing block grants. While these proposals may arouse polite debate, the legal remedies he calls for—changing the laws to permit involuntary treatment, including involuntary commitment to hospitals—raise some very troubling images and are likely to elicit loud objections.

Controversial ideas, forcefully presented.

Kirkus Reviews

Reviewer: Virginia Galloway, BA (Rush University Medical Center)
Description: This is a concise, informative exploration of the mental illness crisis in America. The author provides the startling facts of our situation as an impetus for change, then catalogues the necessary steps to change.
Purpose: The aim of the book is simply to answer "Why?" Why do our mental illness problems exist? Why does the established system not work? Why has the crisis gotten worse, instead of better? What can we do? The book is needed because the current situation is depraved, inhumane, and not functional. The book answers these questions and offers a practical outline for change.
Audience: The book is a valuable resource for mental health workers and the families of the mentally ill. The book is informative and pedagogic for anyone endowed with the power to invoke change. The author is learned about the state of America's mental illness crisis and has the clarity of vision and acumen to illustrate a solution.
Features: The illustrations are sufficient, but more would be useful. The references are expansive, almost overwhelming, yet necessary for a complete understanding of the gravity of the mental illness crisis. The table of contents is adequate and the index is superb. The book is attractive. The appendix detailing the magnitude of deinstitutionalization state by state is provocative,
Assessment: This is a palpable exploration of America's mental illness crisis. It humanely describes the privations of our mentally ill and methodically explores the economic, ideological, and legal reasons for such a state. The provided solution to the crisis is viable and informative. This book will provide mental health workers and the families of the mentally ill with insightful knowledge and has the potential to be a catalyst for change, if read by policymakers.

Doody's Review Service