An absorbing, sometimes harrowing history of the medical treatment of the mentally ill in the US, from its roots in England—think Bedlam—to the present, and a scorching indictment of the status quo.
Whitaker, a science reporter for the Boston Globe, does a bang-up job of showing how treatment of the mad has reflected society’s changing political views and philosophical values. He recounts how the 18th-century European view that the mentally ill were beasts to be subdued and tamed led to fearfully harsh treatment, whereas in the early 19th century, the Quaker perspective that the mentally ill were fellow human beings deserving of empathy, resulted in humane therapy emphasizing gentle kindness and the comforts of a good home. In the 20th century, the eugenics movement in the US, which saw the mentally ill as hereditary defectives without rights, led to brain-damaging therapies—insulin coma, metrazol-induced seizure, electroshock, and prefrontal lobotomy—that were applied without the consent of patients and robbed them of the part of the mind that made them human. In the 1950s, chlorpromazine was introduced as a chemical lobotomy, useful for making disruptive patients sluggish and manageable. However, Whitaker points out, under the influence of pharmaceutical-industry marketing efforts, it and other neuroleptics came to be seen as safe and effective antischizophrenic drugs, a view that not only benefited drug companies financially but gave psychiatry the status of a scientific discipline and provided states a rationale for discharging medicated patients from overcrowded public mental hospitals. Whitaker argues that far from being effective, neuroleptics induce pathological conditions by causing irreversible brain damage. He cites World Health Organization studies showing that in countries where doctors do not keep their schizophrenic patients on neuroleptics—India, Niger, Colombia—recovery rates are dramatically higher than in the US. And according to the author, the hubris of the American medical community makes change unlikely.
Sure packs a wallop.