From Kirkus Reviews
Trenchant and lively expos of the private mental-hospital business, full of attention-grabbing tales of despicable villains, chagrined confessors of misdeeds, brave whistle- blowers, and even some heroes of sorts. Names, dates, and places are all here. Investigative reporter Sharkey (Deadly Greed, 1991, etc.), his curiosity piqued and his ire raised by a brief personal encounter with a psychiatric hospital, takes a hard look at the abuses of such for-profit institutions. The provision of mental- health benefits by employers, now mandatory in many states, provided an irresistible opportunity for the psychiatric hospital business. Dominated by a few large chains with expansionist visions and aggressive marketing techniques, the industry boomed in the late 1980's, with the number of psychiatric hospitals more than doubling between 1984 and 1989. High-pressure advertising encouraged inpatient mental-health treatment for ordinary adolescent behavioral problems and run-of-the-mill emotional difficulties. Competition for patients with insurance coverage led to payoffs to clergy, family counselors, ans school and hospital officials; bonuses for psychiatrists willing to come up with appropriate diagnoses; misleading use of crisis hotline phone numbers; and even abduction of potential patients. Sharkey, who writes with a practiced reporter's directness, concentrates on marketing abuses, but he also gives a glimpse of common practices inside treatment centers: overmedication; therapy resembling punishment more than treatment; and discharge dates pegged to insurance expiration dates. The industry has promised reforms, but Sharkey notes that the basic problem remains: how to provide proper mental-health care in an atmosphere of profit incentives. An impossible-to-ignore alarm about one segment of the medical-industrial complex, timed perfectly for the year's big health care debate. -- Copyright ©1994, Kirkus Associates, LP. All rights reserved.
From the Inside Flap
As Americans examine the out-of-control spending on health care, Bedlam exposes one of the costliest and most insidious medical scandals of recent times: the rapacious advance of the for-profit mental-health industry. By the end of the 1980s it had managed to lay claim to about 25 percent of all money spent by U.S. employers on employee health benefits. During the 1980s, as the Recovery Era dictated broader insurance coverage for an ever-growing range of disorders, addictions, and behavioral problems, investor-owned psychiatric hospitals expanded at a dizzying rate. Using "guerrilla marketing," co-opting the psychiatric profession, and even hiring clergymen, guidance counselors, and other trusted community figures as bounty hunters, these psychiatric hospitals sought to bring in paying customers to a plethora of "treatment programs." Most seemed to have one thing in common: Patients miraculously improved the day their insurance expired. Beyond the horror stories of patient kidnapping, fraud, and abuses of children and adolescents, Bedlam examines the unholy alliance between modern "biopsychiatry" and the hospital, pharmaceutical, and "addiction" industries. It is an alliance that has succeeded in establishing, as federal policy, the astonishing notion that in any given six-month period, more than 20 percent of Americans need professional psychiatric care - and should be covered for it with generous insurance benefits.
As new health-care reforms provide for expanded mental-health coverage - in a formula that reflects the lobbying goals of the psychiatric industry - Bedlam blows away the public-relations smoke screen and shows what happens when modern marketing strategies are applied to psychiatric care. This is a truly shocking and important book, and one that, once read, will never be forgotten.
About the Author
With over twenty years in the media industry, JOE SHARKEY has been a reporter and Assistant National Editor for "The Wall Street Journal", City Editor for "The Albany Times-Union", and a reporter for "The Philadelphia Inquirer". He is the author of three books and lives in New Jersey.
