There is a saying:
“The definition of insanity is doing the same thing over and over again and expecting different results.”
American Psychosis reveals how, for decades, governmental policy makers of mental illness programs have expected different outcomes despite utilizing the same failed past policies.
E. Fuller Torrey’s insightful book, American Psychosis: How the Federal Government Destroyed The Mental Health Treatment System, is confirmation to what many people suspect of the current mental illness system and policies: This system is broken and current disjointed polices will make it forever difficult to correct.
Dr. Torrey takes us through the history of state and federal governments involvement with mental health care in the U.S. He details how the vision and eventual policy mandates of a few individuals shaped federal and state governmental policy for decades. Psychiatrists, with varying and competing theories on mental health and illness, would be appointed top directors at the National Institute of Mental Health (NIHM) and guided these policies for decades.
Despite the flawed NIMH policies, the directors and administrators used politically opportune times for the advancement of their flawed agendas. The election of JFK and the Kennedy family guilt over a mentally ill and lobotomized Rosemary Kennedy gave NIHM officials the opportunity to realize the creation of community mental health centers (CMHC). The LBJ vision of the “Great Society” and creation of Medicare and Medicaid would provide the states with the ability to release more institutionalized patients to the community. Though Nixon despised psychiatry and wanted to defund many NIMH programs, he would have his own problems with Vietnam, Watergate and a Democratic Congress. Nixon’s problems would spare the NIHM and many of its programs from extinction.
The CMHC’s, during the 1960s and 70’s, were encouraged to become more involved in political and social activism than the treatment of seriously mental ill individuals. The “new patient” would be the less severe, “worried well,” rather than the country’s most seriously mentally ill citizens. The NIMH’s “grand experiment” was comprised of one part “social engineering” and one part “political activism.”
Policymakers at NIMH despised state hospitals and encouraged social and political activism. State mental hospitals were eliminating beds at an alarming rate. Hundreds of thousands of beds have been eliminated since the 1950’s. resulting in an increase of homelessness for mentally ill individuals. Jail and prisons would eventually become the “after-care” for many of these untreated Americans. Cost shifting was taking place. With the advent of Medicaid and Medicare, states were provided a disincentive to care for the mentally ill. Operators of private homes flourished and encouraged those ill to seek help at their facilities. Many for-profit facilities motivated by profits and cost containment would replace the state institutional system. However, without adequate oversight and protection, these facilities would become what the early administrators bemoaned; inhumane warehouses of mentally ill individuals.
Dr. Torrey is a leading researcher on schizophrenia and executive director of Stanley Medical Research Institute. He is the founder of the Treatment Advocacy Center and has published numerous books on mental illness. In addition, Dr. Torrey h as worked for the NIMH and was a principal investigator of a NIMH Schizophrenia/Bipolar Disorder Twin Study. His years of experience and knowledge are used well in American Psychosis.
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