Chicago-based mental health clinician Foiles looks at the many ways in which urban poverty, crime, violence, and other socio-economic factors can destroy a life.
“We diagnose people, not cultures or neighborhoods,” writes the author. If neighborhoods were to be diagnosed, some might be sociopathic—but seldom through any fault of their own. For example, he writes of the Cabrini-Green housing project that sprang up in the 1950s and ’60s, providing poor African Americans with public housing in neighborhoods in which they were then not the majority. “To live in Cabrini-Green or any of the other housing projects was to be constantly reminded that you didn’t matter,” writes Foiles: You were surrounded by rats, barbed wire, garbage, warring gangs, and indifferent police and public agencies whose attitude was that the people who lived there were on their own. Small wonder that those in such environs experience trauma, manifested in many ways. The author offers five such case studies. In the case of “Robert,” who grew up in Cabrini-Green, the trauma manifests in PTSD accompanied by literal delusions of grandeur, all of which “read like a novel.” Another patient is categorized as a “frequent flyer,” someone without regular access to medical services so that she must resort to emergency services for every medical encounter, at tremendous cost. The whole enterprise, Foiles writes, is wrapped up in white privilege. The white power structure of Chicago has steadily whittled away services in poor, minority neighborhoods, from public schools to hospitals and mental health clinics. There is seldom any opportunity to intervene at early signs of trauma and illness and seldom much official interest shown in doing so. The author closes with the exhortation that what is needed is “a modern-day Poor People’s Movement to aid those who by circumstance of their birth are at a higher likelihood of experiencing suffering in all its forms.”
An urgent call for reform worthy of serious consideration.