Free American Psychosis by M. D. Torrey Executive Director E Fuller Page B

planners’ imaginations. . . . The term ‘community care’ . . . merely an inflated catch phrase which concealed morbidity in the patients and distress in the relatives.” 6
As noted previously, these failed mental health programs were not conceived with malevolent intent. Their architects truly believed that closing state mental hospitals and moving patients into the community would improve everyone’s lives. In a 1972 interview, Felix said that his primary motivation was to make psychiatric services available to more people, and this wish was also expressed by Yolles and Brown. As noted by columnist and psychiatrist Charles Krauthammer, the “disaster” of deinstitutionalization was not “the result of society’s mean-spiritedness . . . [or] of mysterious determining forces, but of a failed though well-intentioned social policy. And social policy can be changed.” 7
    IMPEDIMENTS TO CHANGE
    Social policy can indeed be changed, but change does not come easily. Psychologist Franklyn Arnhoff, writing about mental health policy in 1975, observed that “it is extremely difficult to change its course even if there is mounting evidence that its costs or its harmful effects far exceed its benefits.” If we hope to change mental health policies, we must first understand the forces that impede change. These include the following 8 :
1. Lack of understanding of serious mental illnesses . There is a lack of public understanding, including among public officials, of the nature of serious mental illnesses. In recent decades, it has become clear that schizophrenia, bipolar disorder, and severe depression are brain diseases, just as multiple sclerosis and Alzheimer’s disease are brain diseases. However, public understanding lags behind the scientific understanding. Because of the inordinate influence of Sigmund Freud’s ideas on American thought in the last century, many Americans still believe that serious mental illnesses are psychological, not biological, in origin. This lack of understanding is especially acute regarding mentally ill individuals whose brain dysfunction involves the parts of the brain we use to think about ourselves—what we call anosognosia. Despite being overtly mentally ill, such individuals have no awareness of their own illness or need for medication; most such individuals will thus refuse to take medication because they honestly believe that nothing is wrong with them. It is very difficult for most people to understand this.
2. Lack of understanding of the magnitude of the mental illness problem . There is a lack of public understanding, including among public officials, of the magnitude of the mental illness problem as described in the preceding chapters. The deterioration of public mental illness services has been a gradually evolving disaster, like slowly rising water without any major flood to call attention to itself. The mental illnessdisaster also has many manifestations, which at initial glance do not appear to be related. For example, an average American family may be aware that their county taxes are being raised to pay for the new addition to the overcrowded county jail; that they no longer allow their children to go to the public library alone because of all the strange men there talking to themselves; that people are reported by the news as sometimes doing bizarre things, like the man in Buffalo who cut down utility poles with a chainsaw; and that rampage killings, such as those carried out by Jared Loughner and James Holmes, seem to be happening more frequently. All these are consequences of a single problem—the failure to appropriately treat individuals with severe psychiatric disorders—but almost nobody makes the connection.
3. Lack of understanding of the civil rights of people with severe mental illnesses . Americans highly value our civil rights to live as we please and not have the government tell us what to do. Many people thus defend the rights of homeless mentally ill