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Elmira - Steele Memorial Library 1 362.1968 TOR Adult NonFiction Book
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Horseheads Free Library 1 362.1968 TOR Adult NonFiction Book
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Summary

Summary

In 1963, President John F. Kennedy delivered an historic speech on mental illness and retardation. He described sweeping new programs to replace "the shabby treatment of the many millions of the mentally disabled in custodial institutions" with treatment in community mental health centers.This movement, later referred to as "deinstitutionalization," continues to impact mental health care. Though he never publicly acknowledged it, the program was a tribute to Kennedy's sister Rosemary, who was born mildly retarded and developed a schizophrenia-like illness. Terrified she'd becomepregnant, Joseph Kennedy arranged for his daughter to receive a lobotomy, which was a disaster and left her severely retarded. Fifty years after Kennedy's speech, E. Fuller Torrey's book provides an inside perspective on the birth of the federal mental health program. On staff at the National Institute of Mental Health when the program was being developed and implemented, Torrey draws on his own first-hand account of thecreation and launch of the program, extensive research, one-on-one interviews with people involved, and recently unearthed audiotapes of interviews with major figures involved in the legislation. As such, this book provides historical material previously unavailable to the public. Torrey examines the Kennedys' involvement in the policy, the role of major players, the responsibility of the state versus the federal government in caring for the mentally ill, the political maneuverings required to pass the legislation, and how closing institutions resulted not in better care - aswas the aim - but in underfunded programs, neglect, and higher rates of community violence. Many now wonder why public mental illness services are so ineffective. At least one-third of the homeless are seriously mentally ill, jails and prisons are grossly overcrowded, largely because the seriouslymentally ill constitute 20 percent of prisoners, and public facilities are overrun by untreated individuals. As Torrey argues, it is imperative to understand how we got here in order to move forward towards providing better care for the most vulnerable.


Author Notes

E. Fuller Torrey is Executive Director of the Stanley Medical Research Institute in Chevy Chase, MD, and Professor of Psychiatry at the Uniformed Services University of the Health Sciences.


Reviews 2

Library Journal Review

Torrey (executive director, Stanley Medical Research Inst.; psychiatry, Uniformed Services Univ. of the Health Sciences) continues to argue that deinstitutionalization of mental patients has precipitated the deterioration in U.S. psychiatric care, simultaneously flooding communities with untreated and/or homeless populations of the mentally ill. This is not a new argument for Torrey (The Insanity Offense: How America's Failure To Treat the Seriously Mentally Ill Endangers Its Citizens; Out of the Shadows: Confronting America's Mental Illness Crisis), who has spoken out about the issue for years. The book does provide additional historical background on the genesis and collapse of the community mental health movement. The author traces the beginnings of the movement to President John F. Kennedy and his family's guilt about Rosemary Kennedy's lobotomy. Kennedy wrested control of psychiatric institutions from the states, instead creating federal programs that were bound to fail because they were virtually unenforceable and provided no backup support systems for patients who were cast out of hospitals. The leading luminaries at the National Institute of Mental Health successfully lobbied for federalization, thereby leaving the mental health treatment system in shambles. Torrey helpfully offers solutions, maintaining that successful care can come through community mental illness centers, not community mental health centers. In the end, his argument is convincing. VERDICT This powerful polemic presents a compelling case for the reform of the mental illness treatment system.-Lynne Maxwell, West Virginia Univ. Coll. of Law Lib., Morgantown (c) Copyright 2013. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.


Choice Review

The federal mental health care system began in the Kennedy administration. The mental health issues of Kennedy's sister, Rosemary, and their effects on the Kennedy family were clearly a motivating factor in the president's desire to reform/improve the system. Up to the 1960s, dealing with individuals who were mentally ill was largely a state responsibility, and patients were treated in state mental hospitals. The quality of care in these institutions was generally uneven and less than desirable; however, these hospitals were good at keeping individuals with serious impairments off the streets. Here, Torrey (executive director, Stanley Medical Research Institute) draws on his personal experience at the National Institute of Mental Health when the federal mental health program was being developed to discuss the program's strategy and implementation. He examines how mental health ideology, politics, underfunding, and outright neglect has prevented this program from reaching its potential and has actually caused harm. Torrey connects the closing of state mental hospitals with increased community violence, homelessness, and incarceration of the mentally ill. He does provide a chapter on suggested solutions, but it is clear that unless the public better understands the issues confronting the mental health system, improvement will be slow and limited. Summing Up: Recommended. Upper-division undergraduates and above; general readers. R. L. Jones emeritus, Pennsylvania State University, College of Medicine


Table of Contents

Preface
Acknowledgments
1 Joe Kennedy: A Man with Problems
2 Robert Felix: A Man with Plans
3 The Birth of the Federal Mental Health Program: 1960-1963
4 Short, Unhappy Life of the Federal Mental Health Program: 1964-1970
5 Death of the Federal Mental Health Program: 1971-1980
6 Perfect Storm: 1981-1999
7 of the Current Disaster: 200-2012
8 What Have We Learned and What Should We Do?

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