STUCK IN TIME

An anecdotal indictment of the system that treats children with mental-health problems, as well as an unpersuasive call for a new order. Gutkind (English/University of Pittsburgh; One Children's Place, 1990, etc.) dubs our institution-centered mental-health system ``absurd,'' contending that its methods aren't based on solid research. He proposes instead an untested model of individualized care based on family preservation, claiming that the need for change is too urgent to wait for research to validate this model's viability. Gutkind's interest in the mental-health system was triggered by the experiences of Daniel, a seriously troubled youth for whom he acted as a Big Brother and whom he watched being bounced from group home to mental hospital to family to the street. To understand the present system, the author sat in with doctors, nurses, social workers, and other staff members of Pittsburgh's Western Psychiatric Institute as they dealt with disturbed adolescents and their families. Individually, these professionals appear well meaning and often kind, but the rigidities of the system render their efforts largely ineffective. Though he includes brief sketches of several patients and their families, Gutkind concentrates on the Scanlons, so devastated by the behavior of their mentally disturbed teenage daughter, Meggan, that they relinquish parental rights over her. Another teenager who catches Gutkind's attention is Terri, diagnosed with multiple disorders, whose eventual commitment to an adult psychiatric hospital seems inevitable. The author intersperses these dismal stories with facts and figures demonstrating the extent of the problem (millions of American children with serious mental problems, but only one-fifth of them receiving any treatment). In conclusion, Gutkind details rather optimistically how his proposed family preservation model might have helped Danny, Meggan, and Terri. Sincere, but offering little comfort to families with disturbed children and, probably, little in the way of realistic solutions.