NCPA - National Center for Policy Analysis


June 17, 2008

In his new book, "The Insanity Offense," Dr. E. Fuller Torrey, a psychiatrist who cares for patients with schizophrenia and manic-depression, examines how the emptying of state-run mental hospitals in the late 1960s produced a social disaster. 

Dr. Torrey begins his book with the history of the mentally ill in America: 

  • In the 1840s, civic crusaders such as Dorothea Dix brought national attention to delusional and distressed mental patients, who tended to fill the country's jails, workhouses, and shelters, where they often suffered ugly mistreatment.
  • As a result of Dix's work on behalf of the mentally ill, state governments accepted responsibility for the care and treatment of the mentally ill from the mid-1840s to the 1960s.
  • Then in the 1960s, new laws were passed with the direct intent of emptying state hospitals, releasing the patients and saving money.
  • The new laws deprived psychiatrists of the authority to hold patients under surveillance unless they were "immediately" or "imminently" dangerous to themselves or others.
  • These changes were pursued by a new alliance of rash conservatives seeking to save public money by abandoning a traditional state obligation and self-righteous liberals defining the neglect of these patients as defending their civil rights.

Torrey then describes the grim consequences -- in death, violence, and suffering -- of laws that released the seriously mentally ill from the oversight of state mental-health services and permitted them to wander away from the treatment and protection they desperately needed:

  • This disaster continues to affect approximately 400,000 individuals and their families.
  • At any given time, there are 218,000 seriously mentally ill individuals in prison.
  • More than 30 percent of prison inmates are mentally ill.
  • There are 175,000 seriously mentally ill that are homeless.

Source: Paul McHugh, "Wrong Prescription," Wall Street Journal, June 14-15, 2008; based upon:  E. Fuller Torrey, "The Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens," W. W. Norton, June 16, 2008.

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