Out of the shadows : confronting America's mental illness crisis /

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.