The Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens [Hardcover]

E. Fuller Torrey (Author)

Book Description

ISBN-10: 0393066584 | ISBN-13: 978-0393066586 | Publication Date: June 17, 2008 | Edition: 1

A leading expert on mental illness outlines the tragic consequences of deinstitutionalization and sounds the call for reform.

Beginning in the 1960s in the United States, scores of patients with severe psychiatric disorders were discharged from public mental hospitals. At the same time, activists forced changes in commitment laws that made it impossible to treat half of the patients that left the hospital. The combined effect was profoundly destructive. Today, among homeless persons, at least one-third are severely mentally ill; among the incarcerated, at least one-tenth. Of those individuals living in our communities, many are the victims of violent crime. Other untreated individuals commit crimes, including murder and assault. In The Insanity Offense, E. Fuller Torrey takes full stock of this phenomenon, exploring the causes and consequences as he weaves together narratives of individual tragedies in three states with sobering national data on our failure to treat the mentally ill. In the book's final chapters, Torrey outlines what needs to be done to reverse this ongoing—and accelerating—disaster.

Editorial Reviews

From Publishers Weekly

Starred Review. The ill effects of not providing proper treatment for people with serious mental disorders has become all too apparent in recent years, writes research psychiatrist and treatment advocate Torrey (Surviving Manic-Depression). Released en masse from institutions beginning in the 1960s, the most severely ill are most likely to become homeless, incarcerated, victimized, and/or violent. Torrey details how civil liberties suits have prevented such people from being involuntarily institutionalized, leaving them a danger both to themselves and to others. Confronting these issues head on, Torrey offers both the clinical and the anecdotal, citing several tragic examples: in the case of Cho Seung-Hui, the 2007 Virginia Tech killer, he faults both the university and stringent state laws regarding involuntary commitment for neglecting to treat a clearly very ill young man. This reform-minded book calls for a change in laws affecting how mentally ill people are treated, keeping close track of those with a history of violent behavior and creating a more comprehensive treatment approach. Chilling and well documented, this text has many no-nonsense solutions to protect the mentally ill themselves as well as society as a whole. (July)
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From Booklist

Research psychiatrist Torrey says that what began in the 1960s as an unlikely marriage between civil liberties advocates, who saw mandatory institutionalization of the mentally ill as a civil rights violation, and cost-conscious conservatives has resulted in a national catastrophe. That was when state governments decided they could save money by deinstitutionalizing mental patients, shuttering mental hospitals, and turning thousands of schizophrenics and manic-depressives out onto the streets. Ever since then, Torrey has been tallying instances in which severe mental illness has contributed to an escalating number of violent attacks, murders, and suicides and counting the number of severely mentally ill who are either homeless or incarcerated. Though he admits some of his numbers are estimates—most public officials like to pretend the mentally ill are invisible and thus fail to keep an accounting—they speak volumes about the dire need for public institutions equipped to help the severely mentally ill regain control over their destructive behaviors. His cry is loud and clear, but his solutions, alas, are necessarily complicated. --Donna Chavez

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Product Details

• Hardcover: 288 pages
• Publisher: W. W. Norton & Company; 1 edition (June 17, 2008)
• Language: English
• ISBN-10: 0393066584
• ISBN-13: 978-0393066586
• Product Dimensions: 9.2 x 6.6 x 1 inches
• Shipping Weight: 1.2 pounds
• Average Customer Review: 3.8 out of 5 stars  See all reviews (12 customer reviews)
• Amazon Best Sellers Rank: #815,161 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

31 of 36 people found the following review helpful:

5.0 out of 5 stars Long ovedue and too nice..., June 23, 2008

By 

Lewis Tagliaferre "lewtag" (Springfield, VA) - See all my reviews
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This review is from: The Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens (Hardcover)

This author is not kidding...he really tells it as it is, but with a light touch that may miss the mark. State legislators need to be slammed up side the head to get their attention and I fear he is a little too politically correct. As the father of a middle-aged bi-polar daughter, I was blindsided by the impact of her disease. She is one of the lucky ones who found a qualified psychiatrist and medications that are working to keep her off the streets, but barely. Unless you experience the family impact of mental illness most people just walk on by. The civil rights lawyers and courts who curtailed mandatory treatment are the real criminals in this crisis and the author is too easy on them. Mental illness still is a great social taboo in this culture of control and cure. When neither are possible our government seems paralized to respond. Unfortunately, I fear that it will take a lot more homeless people and mentally ill criminal behavior to get the needed attention and reforms. But, hey, never forget that a few highly dedicated people can change things. Meantime, you suffer and hope. Read this book and get involved.

13 of 14 people found the following review helpful:

5.0 out of 5 stars Anyone who works in behavioral health should read this, August 30, 2008

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J. Polsgrove "Southwestdeadhead" (Baja Arizona) - See all my reviews
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This review is from: The Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens (Hardcover)

I am a psychiatric social worker and have been in the field for years. I think anyone who works in behavioral health should read this book. It clearly explores the relationship between the "deinstitutionalization" of the 1950s and 1960s and the relationship as those in mental hospitals were set free to fend for themselves in the community. The relationship unfolkds as the author explains how the population decline in state mental hospitals has been off-set by the soaring number of mentally ill men and women who are wandering the streets homeless, or are locked away in jails and prisons with little to no treatment.

By now, 50 or so years on, it's obvious shutting down mental hospitals was not the solution -- rather, improving conditions and quality of life in the hospitals was what was needed. The author cites hundreds of specific cases in which institutionalized men and women are set free -- to become victims, or to victimize. The community mental health clinic concept works for a certain segment of the mentally ill population. But, as I have seen and experienced on an almost daily basis, there are far too many chronically mentally ill people who have no insight into their illness and the need to take medication consistently, and thus suffer in poverty, filth, and psychic ghettos in the inner cities of America.

The once-hospitalized men and women have achieved the "freedom" lawyers and psychiatrists a generation ago sought. Sadly, to quote from "Me and Bobby McGee" -- freedom's just another word for nothing left to lose. Those of you who work with the men and women who live in run-down housing, eat out of trash cans, are a revolving door in emergency rooms and jail cells will know what I talking about. This book paints a grave picture of the state of public behavioral health's state of the union in the early part of the 21st Century. It's not an easy book to read, but perhaps it will inspire a few people to push for some changes, because the system's broken and it needs fixing -- bad!

8 of 8 people found the following review helpful:

5.0 out of 5 stars Torrey,s Best Book, November 30, 2008

By 

Hermes - See all my reviews

This review is from: The Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens (Hardcover)

E. Fuller Torrey has been one of the most astute commentators on the deinstitutionalization charade for decades. This is his best book. He takes the key states (California and Wisconsin) which contributed to the legislative and court changes to the involuntary commitment laws for people with mental disorders and traces them from their original passing (late 1960s and early 1970s) to the present. He uses case vignettes and journal articles to convey the consequences of the new legislation and court decisions respectively. The result is deeply disturbing and powerful. Torrey has been controversial for years but he is right on target. The solutions to this very problematic reality are extremely difficult. But talking about it is the beginning. This book is an excellent place to start.