Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens »

E. Fuller Torrey is a research psychiatrist specializing in schizophrenia and manic-depressive illness. He is the president of the Treatment Advocacy Center and the associate director for laboratory research at the Stanley Medical Research Institute. He lives in Bethesda, Maryland.

A leading expert on mental illness outlines the tragic consequences of deinstitutionalization and sounds the call for reform.

Publishers Weekly

The ill effects of not providing proper treatment for people with serious mental disorders has become all too apparent in recent years, writes research psychiatrist and treatment advocate Torrey (Surviving Manic-Depression). Released en masse from institutions beginning in the 1960s, the most severely ill are "most likely to become homeless, incarcerated, victimized, and/or violent." Torrey details how civil liberties suits have prevented such people from being involuntarily institutionalized, leaving them a danger both to themselves and to others. Confronting these issues head on, Torrey offers both the clinical and the anecdotal, citing several tragic examples: in the case of Cho Seung-Hui, the 2007 Virginia Tech killer, he faults both the university and stringent state laws regarding involuntary commitment for neglecting to treat a clearly very ill young man. This reform-minded book calls for a change in laws affecting how mentally ill people are treated, keeping close track of those with a history of violent behavior and creating a more comprehensive treatment approach. Chilling and well documented, this text has many no-nonsense solutions to protect the mentally ill themselves as well as society as a whole. (July)

1 Introduction: The Origins of a Disaster 1

2 Death by the Roadside 9

3 Thirteen Murders to Prevent an Earthquake 24

4 "The Odds Are Still in Society's Favor" 41

5 The Killing of Three Devils 69

6 The Sad Legacy of Ms. Lessard 82

7 God Does Not Take Medication 111

8 The Consequences of Unconstrained Civil Liberties: Homeless, Incarcerated, and Victimized 123

9 The Consequences of Unconstrained Civil Liberties: Violent and Homicidal 140

10 An Imperative for Change 161

11 Fixing the System 177

12 Coda: Death by the Roadside 197

App. A U.S. Studies of the Prevalence of Serious Violence by Psychiatric Patients Living in the Community 209

App. B Studies from Other Countries of Homicides Committed by Individuals with Psychotic Disorders 213

Notes 219

Index 251