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

by E. Fuller Torrey (Author)
Key Phrases: violence risk assessment, individuals with severe psychiatric disorders, assisted outpatient treatment, United States, Herb Mullin, Bryan Stanley (more...)

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 & Co.; 1 edition (June 17, 2008)
• Language: English
• ISBN-10: 0393066584
• ISBN-13: 978-0393066586
• Product Dimensions: 9.4 x 6 x 1.1 inches
• Shipping Weight: 1.2 pounds (View shipping rates and policies)
• Average Customer Review: 4.0 out of 5 stars See all reviews (10 customer reviews)
• Amazon.com Sales Rank: #64,845 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

17 of 21 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 (REAL NAME)

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.

3 of 3 people found the following review helpful:

1.0 out of 5 stars From wrong assumptions flow wrong conclusions, May 4, 2009

By	Sylvia Caras (Santa Cruz, CA) - See all my reviews (REAL NAME)

This week I watched a CSpan rerun (6/08) of a Washington Journal interview of Torrey and his book Insanity Offense. Torrey is very smooth, totally confident, completely dismissive of the rights of 'the seriously mentally ill.' He is sure he knows what's good for `those people'.

The basis of his position is the assumption that medicine has the right, the duty, and the authority to intervene and treat what medicine has defined as treatable (in this case the consensus document Diagnostic and Statistical Manual), and that medicine's decision trumps any individual patient's protest. He is working to change laws so he can prevail. But like other fundamentalists, he ignores challenges that might require more nuance.

3 of 3 people found the following review helpful:

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

By	J. Polsgrove "Southwestdeadhead" (Baja Arizona) - See all my reviews (REAL NAME)

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!