A searing exposé about the criminalization of mental illness that features a simple underlying theme that a society attempting the same disastrous policies over and over but expecting a different outcome is where the actual craziness resides.
Former Marketplace reporter Roth goes broad and deep, first explaining why the United States has never devoted adequate resources to dealing with its millions of mentally ill inhabitants, then using case studies to demonstrate why incarcerating the mentally ill in jails or prisons often makes no sense and does more harm than good. Because compassionate, well-trained, readily accessible professionals are unavailable to most severely mentally ill individuals—those with schizophrenia and/or bipolar disorder especially—when those individuals appear as threats to themselves or others, the first responders are usually police officers or others unequipped to deal with such situations. Too often, Roth explains, encounters between the mentally ill and armed police result in serious injury or death. As for the mentally ill who survive such encounters, their incarceration without medical treatment is quite likely to result in the worsening of the disease, until no amelioration seems possible or suicide results. Although Roth expresses pessimism about the future of mental illness treatment—especially when poverty and race and lack of education enter the equation—she shares rare positive examples of community-based care that is adequately funded as well as the laudable work of a few law enforcement agencies mounting sincere efforts to treat inmates humanely and effectively. In the instances where an incarcerated mentally ill individual enters an actual courtroom, Roth explores how judges can aid in solutions rather than compounding an already fraught situation. Though the subject matter dictates that much of the book is relentlessly depressing, the author is such a talented information gatherer and fluid stylist that the narrative becomes compulsive reading.
An eye-opening book that cries out for change—but can policymakers show the resolve to make that change?