Despite a few unpersuasive arguments, this is a formidable entry in the field of books about the mental health crisis.
The former director of the National Institute of Mental Health diagnoses and prescribes cures for a mental health care system that’s “a disaster on many fronts.”
In his first book, psychiatrist and neuroscientist Insel explains an apparent paradox of mental health care: “Current treatments work,” but too few people get their benefits, and outcomes for the U.S. as a whole remain “dire.” Arguing that the crisis exists “because we fail to deliver on what we know, or we fail to use what works,” the author often slights evidence suggesting that the poor results persist because some common treatments do not work or are overused rather than underused. He ignores, for example, well-regarded studies that have found that depression and ADHD are overdiagnosed and overtreated, and he oversells some treatments he supports. For readers who can live with Insel’s overly bullish view of certain remedies, however, this book offers a wealth of fresh, clear, and mercifully jargon-free facts and insights into America’s mental health care problems and possible solutions. The author links the crisis to the Reagan administration’s slashing of federal spending on community health and its scaling back of support for the “deinstitutionalization” promoted by John F. Kennedy and others. He also describes the potential benefits of “supported education and employment” programs and of controversial technology like digital phenotyping. In the strongest chapters, Insel shows how current U.S. policies have ravaged the poor, the homeless, and the incarcerated; the U.S. has so few hospital beds for the mentally ill that some police do “mercy bookings,” which let people get care in jail that hospitals can’t provide: “The Los Angeles County Jail and Chicago’s Cook County Jail are now the largest mental health institutions in the nation.” Insel makes clear that such mental health conditions involve moral and civil rights issues, adding important dimensions often neglected in similar books.
Despite a few unpersuasive arguments, this is a formidable entry in the field of books about the mental health crisis.Pub Date: Feb. 15, 2022
ISBN: 978-0-593-29804-6
Page Count: 336
Publisher: Penguin Press
Review Posted Online: Nov. 23, 2021
Kirkus Reviews Issue: Dec. 15, 2021
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
PERSPECTIVES
A philosophically rich critique of state violence and mass apathy.
An Egyptian Canadian journalist writes searchingly of this time of war.
“Rules, conventions, morals, reality itself: all exist so long as their existence is convenient to the preservation of power.” So writes El Akkad, who goes on to state that one of the demands of modern power is that those subject to it must imagine that some group of people somewhere are not fully human. El Akkad’s pointed example is Gaza, the current destruction of which, he writes, is causing millions of people around the world to examine the supposedly rules-governed, democratic West and declare, “I want nothing to do with this.” El Akkad, author of the novel American War (2017), discerns hypocrisy and racism in the West’s defense of Ukraine and what he views as indifference toward the Palestinian people. No stranger to war zones himself—El Akkad was a correspondent in Afghanistan and Iraq—he writes with grim matter-of-factness about murdered children, famine, and the deliberate targeting of civilians. With no love for Zionism lost, he offers an equally harsh critique of Hamas, yet another one of the “entities obsessed with violence as an ethos, brutal in their treatment of minority groups who in their view should not exist, and self-decreed to be the true protectors of an entire religion.” Taking a global view, El Akkad, who lives in the U.S., finds almost every government and society wanting, and not least those, he says, that turn away and pretend not to know, behavior that we’ve seen before and that, in the spirit of his title, will one day be explained away until, in the end, it comes down to “a quiet unheard reckoning in the winter of life between the one who said nothing, did nothing, and their own soul.”
A philosophically rich critique of state violence and mass apathy.Pub Date: Feb. 25, 2025
ISBN: 9780593804148
Page Count: 224
Publisher: Knopf
Review Posted Online: Dec. 14, 2024
Kirkus Reviews Issue: Jan. 15, 2025
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