Managing Madness

Lynn Gamwell and Nancy Tomes. Madness in America: Cultural and Medical Perceptions of Mental Illness before 1914. Ithaca, New York: Cornell University Press, 1995. Pp. 182. David Gollaher. Voice for the Mad: The Life of Dorothea Dix. New York: The Free Press, 1995. Pp. xi + 538. Gerald N. Grob. The Mad Among Us: A History of the Care of America's Mentally III. New York: The Free Press, 1994. Pp. xiii + 386. That American mental health policy is a shambles seems apparent to anyone who walks the mean streets of the nation's cities. The last time I was in Washington, I repeatedly skirted gingerly by a deranged man seated on the sidewalk outside the Library of Congress. The stench of his body wastes was overpowering. His face crawled with vermin and was contorted in rage, as he shouted an endless torrent of obscenities. I have not encountered the like here in Canada, but perhaps it is only a matter of time. The province of Alberta, where I live, is eliminating almost half of its acute-care psychiatric beds, and already horror stories are surfacing in the media. A professor at my university suffered from depression. Refused admission at a hospital, he shot and killed himself. More recently, a young woman tried to jump off a bridge near the university campus. Pulled to safety by passers-by, she was taken to hospital, examined, and released. She promptly returned to the same bridge and had to be rescued a second time

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