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Out of the Shadows: Confronting America's Mental Illness Crisis / Edition 1

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Overview

There are the ones we try not to notice. Filthy and disoriented, they wander the streets and back alleys of America, a danger to themselves and often to the communities they haunt. Then there are the millions more we don't see, the ones who suffer behind closed doors for years, a burden only to themselves and their loved ones. Many of these end up committing suicide, or worse. There are also the tens of thousands who are currently being "warehoused" in our jails, and because of their inability to comply with even the most rudimentary codes of conduct, many receive cruel, sometimes fatal, treatment from other inmates and exasperated jail officials. And, finally, there are those who, because they are not being treated, explode with senseless violence, destroying lives, and leaving the rest of us angry, perplexed, and a little less certain about our own safety. They are our five million mentally ill, and try as we might to sweep them under the rug, they represent human tragedies and a major social problem that continues to grow in magnitude.

Now, in this hard-hitting and humane exploration of the mental illness crisis in America, psychiatrist E. Fuller Torrey reveals how we have failed our mentally ill and offers a viable, provocative blueprint for change.

Torrey begins by examining the consequences of our current mental illness policies on homelessness, our penal system, and the spread of violence in America. He then explores the economic, ideological, and legal reasons why, even though billions of tax dollars are spent each year on the mentally ill, they continue to receive less-than-adequate care. And finally, he proposes a three-phase approach to correcting the situation,including: cost-shifting to states as single-responsibility funders of treatment programs; commitment and involuntary treatment for those deemed incapable of making decisions for themselves; and divorcing, both ideologically and economically, serious mental illness (schizophrenia, manic-depressive illness, and other brain-based disorders) from mental health (the "worried well," and people suffering from quality-of-life and emotional problems).

Out of the Shadows is a fact-filled, compellingly argued, and compassionate assessment of mental illness in America: where we are, how we got there, and where we should be going. It is essential reading for healers, policymakers, and the millions of families whose lives have been touched by serious mental illness.

The book contains black-and-white illustrations.

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Editorial Reviews

Doody's Review Service
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.
Virginia Galloway
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.
Kirkus Reviews
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.


4 Stars! from Doody
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Product Details

  • ISBN-13: 9780471161615
  • Publisher: Wiley, John & Sons, Incorporated
  • Publication date: 10/28/1996
  • Edition number: 1
  • Pages: 256
  • Product dimensions: 6.41 (w) x 9.55 (h) x 0.99 (d)

Meet 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.

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Table of Contents

1 People in the Shadows: The Many Faces of Mental Illness 1
2 Nowhere to Go: Homelessness and Mental Illness 13
3 Jails and Prisons 25
4 Walking Time Bombs: Violence and the Mentally Ill 43
5 Psychiatric Ghettos: Communities and Families 61
6 Looking Backward: Where We Have Been 81
7 New Initiatives in Funding 91
8 From Legal Folly to Common Sense: The Right to Get Well 141
9 From the Woody Allen Syndrome to Brain Disease 167
10 Looking Forward: Where We Should Be Going 193
Appendix The Magnitude of Deinstitutionalization 205
References 209
Index 237
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