Saturday, October 5, 2013

Review: American Psychosis

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American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment SystemAmerican Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System by E. Fuller Torrey
My rating: 4 of 5 stars

American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System is a must-read for anyone who is a consumer of behavioral health services or working in the field because it is such an eye-opening read about the complexities of why our current mental healthcare system (if you call it that) is totally useless. I am probably a bit more invested in the future of funding and the provision of mental health services because I am working in the field and often have to make referrals only to find that most of the referral resources are overburdened and under-funded, and we have yet to see a push that has any teeth to it to change that. I have even started to believe it's impossible to ever get people in power to take the need for comprehensive behavioral health care seriously, but, according to E. Fuller Torrey, that was not always the case.
Thanks to progressive ideals in the 1940s and 50s, mental illness briefly went from being a state-funded issue handled in asylums to a federal-funded issue to be handled by community clinics. In theory, much of the original proposal sounded Utopian. Entire communities would be molded in such a way to prevent anxiety and eventually, we would have a great society free of mental illness. We just needed to focus on mental health.
That type of model works fine for the "low pathology" populations dealing with the normal stresses brought on by transitions through life stages. Unfortunately, for many patients struggling with chronic psychiatric disorders that require intensive treatment, community treatment does not work very well in large part because the patient needs to be proactive in obtaining, continuing and actively participating in his or her treatment. While all of that sounds nice, in many psychotic illnesses like schizophrenia, patients often do not realize that they are sick and need medication. Also, the ideal low-stress community (assuming will power and a clinic were enough to create that) would not bring someone with delusions and hallucinations the same sort of solace it would to a slightly anxious young woman who just had a bad day at work.
American Psychosis is a bit information heavy and repetitive at times, but definitely worth the read. Also, it's worth noting that this review is based upon a digital ARC, so some of the repetitive sections could have been edited out since.

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