![]() While we do not know if this was true in the eighteenth century, some recent studies suggest that being born or growing up in an urban area increases one’s risk of developing schizophrenia and other psychoses. ![]() ![]() Urbanization may not simply have been a factor in making Americans more wary of their mentally ill neighbors it may have increased mental illness rates as well. But a bigger part may have been an unmanageable increase in the mentally ill population. Part of it was the end of small town life a little village where all the families know each other is more likely to tolerate someone’s eccentricities than a large city of atomized individuals. The part I found most interesting here was Cramer’s theory about why this system ended. Cramer describes it as “gloriously idyllic…mental illness appears to have been rare, and small town life tolerated all but the ‘furiously mad’ to live in the community.” ![]() But this option seems to have been used judiciously, and the incarcerated individuals managed to avoid most abuse and torture. Getting somebody committed for mental illness was an informal process usually involving finding the friendly local magistrate and explaining why it was a good idea. A few very violent people were locked away, usually in the basements of general hospitals or in prison cells. Some would wander off, and there was a general understanding among colonial towns that if they found a mentally ill person wandering they would return them to their town of origin, who had the ultimate responsibility of caring for them. Some were given jobs, with the understanding that they needed the support and their idiosyncrasies would be excused. Most of the mentally ill lived with families or in their own houses, where other members of the community supported them as best they could. Mental illness seemed to be pretty well-understood and nobody was accusing psychotics of being witches or trying to beat the demons out of them or anything. Mental health care during the colonial era was surprisingly non-terrible. So the author asks: how did we get to this point? He answers with a fascinating history of American mental health care. But eventually he would stop taking the drugs for one reason or another, decompensate, and end up back on the streets, his previous progress ruined. Sometimes he’d stay stable for months, even a year or two. Occasionally he would keep taking the drugs after getting out, become pretty with-it, and try to go back to college. Usually he’d leave after a few days to a few weeks. There the government gave him a monthly disability check, which he spent on alcohol and a room in a disgusting hotel when the money ran out around the middle of the month, he spent the next few weeks on the street until he got his next check, after which the cycle repeated itself.Įvery so often he would break some law or annoy somebody enough to get arrested, at which point the police would bring him to a psychiatric hospital, he’d be placed on drugs, and he’d get better. His parents asked him to leave, and he wandered around until he ended up in Santa Monica. Then he went to live with his family – including his brother the author – where he stopped his medication, started acting violently, smashed windows, screamed at people, and was otherwise a poor housemate. He ended up in a psych hospital where he got Thorazine and improved quickly – which meant, ironically, that when it came time for his commitment hearing two weeks later, the judge thought he looked pretty normal and released him. Around 22 – the usual age for this to happen – he started acting weird, dropped out of college, obsessed over weird things like nickels, started thinking random people were plotting against him, et cetera. Smart guy, joined the military, did well, finished his tour of duty, went to college, studied electrical engineering. But in the end I just wasn’t convinced.īut first, his brother Ron. I found the book interesting and engaging, and its arguments intellectually honest and well-written. Cramer tells the story of his schizophrenic brother Ron, who was poorly treated because of the lack of an institutional system and so ended up dealing with homelessness and violence, then surveys the history and current state of mental health care in America and the various reasons why deinstitutionalization was a bad idea. After I wrote about Prison And Mental Illness, a reader recommended I read My Brother Ron by Clayton Cramer, a recent book/memoir arguing against deinstitutionalization.
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