April 9, 1997

Out of the Shadows: Confronting America's Mental Illness Crisis

Author Affiliations

University of Illinois College of Medicine Chicago


by E. Fuller Torrey, 244 pp, $27.95, ISBN 0471-16161-6, New York, NY, John Wiley & Sons, 1996.

JAMA. 1997;277(14):1169-1170. doi:10.1001/jama.1997.03540380083040

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This easy-to-read book offers relevant solutions for the problems associated with severe mental illness. The illnesses so defined—schizophrenia, schizoaffective disorder, manic depressive disorder, autism, major depression, panic disorder, and obsessive-compulsive disorder—affect 2.8% of the US adult population. Because the morbidity caused by these brain diseases, except autism, can be alleviated with appropriate medication, rehabilitation, and supportive therapy, Dr Torrey asserts that society could intervene but, for economic, legal, and ideologic reasons, does not.

Estimates are that 28% to 37% of the homeless population are severely and persistently mentally ill. These patients are eight times more likely to use garbage cans as their primary food sources, and three times more likely to have been victimized than the nonmentally ill homeless. Clearly, this population is suffering.

Before deinstitutionalization, arrest rates for the mentally ill were not higher than the general public. Currently, that pattern has reversed owing to practices that allow for