In 1963, President John F. Kennedy delivered an historic speech on mental illness and retardation. He described sweeping new programs to replace "the shabby treatment of the many millions of the mentally disabled in custodial institutions" with treatment in community mental health centers. This movement, later referred to as "deinstitutionalization," continues to impact mental health care. Though he never publicly acknowledged it, the program was a tribute to Kennedy's sister Rosemary, who was born mildly retarded and developed a schizophrenia-like illness. Terrified she'd become pregnant, Joseph Kennedy arranged for his daughter to receive a lobotomy, which was a disaster and left her severely retarded.
Fifty years after Kennedy's speech, E. Fuller Torrey's audiobook provides an inside perspective on the birth of the federal mental health program. On staff at the National Institute of Mental Health when the program was being developed and implemented, Torrey draws on his own first-hand account of the creation and launch of the program, extensive research, one-on-one interviews with people involved, and recently unearthed audiotapes of interviews with major figures involved in the legislation. As such, this book provides historical material previously unavailable to the public.
Many now wonder why public mental illness services are so ineffective. At least one-third of the homeless are seriously mentally ill, jails and prisons are grossly overcrowded, largely because the seriously mentally ill constitute 20 percent of prisoners, and public facilities are overrun by untreated individuals. As Torrey argues, it is imperative to understand how we got here in order to move forward towards providing better care for the most vulnerable.
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Devastating analysis on US mental health policy!
This audiobook starts pretty slow, but the historical preamble sets the stage for the more-concise facts that start pouring in during the 2nd half.
The topic of mental health, de-institutionalization, lack of accountability, and for-profit "solutions" are highly relevant. Just walk in the city and you'll encounter the consequences when you pass the homeless people muttering to themselves. And that's only the portion that are not incarcerated or in for-profit nursing homes (which should be used for the elderly).
Honestly took me a while to get used to, but the story makes up for it.
When making public policy, use science/research/evidence over ideology.
In this book, the shutting down of State mental hospitals was based on ideology around society and mental health that sounded good but parts of it were simply not backed by scientific evidence (which admittedly was sparse during that time since psychiatry was still in its infancy). The movement had no chance of evolving during the Nixon/Reagen era: they not only supported privatization, they were hostile to psychiatry!
The narration is quite poor.