Our system for dealing with mental illness is indeed, crazy. It is also cruel. I dated a man with bipolar disease. He had been diagnosed in his twenties, took medication, and went for long stretches of time without disastrous symptoms. He was creative, loving, and intelligent. But when he did have manic episodes he would lead the police on high speed chases, end up sleeping under bridges, quit his job, say innapropriate sexual things to women and generally destroy his life.

When he became manic, it was extremely frightening. I tried to get help for him. I was amazed that there were no legal mechanisms for taking care of a person who was temporarily unable to care for himself. He was hallucinating and I knew that. He had a well documented medical history. It was clear that he had a disease and that in the past that disease had caused him to hurt himself and others. It seemed crazy that he had to be in current imminent danger of hurting himself or another person before he could be hospitalized. One of the key elements with bipolar is that the person doesn't believe there is anything wrong. It felt completely crazy to sit in an emergency room and have a doctor ask him how he felt and then tell him he should take some anti-psychotic drugs if he felt odd. Of course he felt fine. Of course he didn't take the drugs. It's the ultimate Catch-22.

The lack of support was one fact among many that made me decide that I would not be able to continue my relationship with him. Our society's inability to lend even the most modest support to people with mental illness alienates not only them, but also, their families and those who love them.

I've read with interest your posts on mental illness. Some made me laugh. Some made me shake my head in disbelief. Some were pretty accurate.

Of course, like any illness, everyone is going to exhibit diferent symptoms. The tough thing about mental illness is that it effects a pretty delicate organ of your body, your brain, and it is sort of hard to understand your illness or do what you have to to get better when you don't think clearly. Things get muddled up. So expecting people whose brains aren't working in tip top condition to take their meds or not do stupid things they wouldn't do if they were well (like breaking into houses or ptting themselves in dangerous situations) is expecting a little too much.

As far as a "cure". I will always have bipolar. I am well right now. Most of the time that is. I get stressed out pretty easy but I have learned how to handle that. My meds work and I go religiously to the therapist and psychopharmacologist. But I haven't been able to return to work full time yet and am in danger of losing my house again. And I have absolutely no idea where I am going to get the $300 I need for a prescription that runs out in a week (I have really lousy insurance - $6000 deductible) But I am one of the lucky ones. It took me ten years and I am back to "normal" - whatever that is. My illness did not kill me - although it was touch and go for many years.

Mental illness is the most feared, misunderstood illness around. More and more people are dying from it everyday. I wonder how many need to die before this nation recognizes it as a "real" illness and stops blaming the patient, their parents or whatever else they can think of and starts finding a cure. People shouldn't be treated like this and have to suffer so terribly just because they have an illness that effects their brain.

Of course this father knows, first hand, what goes on in mental health "care" in America. Being a psychiatrist I understand well what he is trying to say. I have gone through the things he describes as a psychiatrist. I tried to hospitalize patients not only for the protection of others but, more important for their own protection.

The mixture of mental health managed care, ambitious state administrators and community workers have tried to develop the idea that every mental patient in America can and should be treated in the community. All three groups profit from not hospitalizing people who need to be in the hospital. Lawyers frequently feel that they are defending the civil rights of patients by "denying them hospitalization". The result is the mess we have today, so well described in the book.

Yes, we need to go back to good mental hospitals. Notice that I said "good" and not the old deposit of patients from the past. We need to change the criteria for admission to include medical advice and not only crime. Hospitalization for good medical advice frequently will prevent crimes that occur because mentally ill people are not having the treatment and support they deserve.

I wish the people responsible for the present state of non care in the mental health field read this book.

Congratulations to the author.

Marcio V. Pinheiro MD

My brother has been living with an undiagnosed form of high functioning austism for years.. on top of violent physical and sexual abuse growing up... We moved to north Florida when he was 12 and he began to have problems at school.. my mother didn't know at the time what his condition was.. but we knew he needed help... but my mother had no health insurance at her job and the state aid didnt have much mental health help... a few visits a year to a shrink doesnt do much for a serious condition... but unless he was a danger to himself or others there was no assistance until it got to that point.. after back and forth for what seemed like an eternity.. nothing.. after some bad incidents he was finally sent to a crisis stabilazation unit.. from there he was sent to a juvenile mental health/rehab facility.. at 12 he was put in with kids up to 17 years old who were either addicts or mentally ill.. he was exposed to more drugs there than he had ever been around in his middle school.. shortly after he became a real addict.. by 16... the sweet kid who would never kill an insect was threatening our pets... burning his clothes on the lawn.. overdosing on anything he could get his hands on.. sent from one rehab to another.. his life was hell.. the time spent visitng made me feel so helpless.. these places didnt have a functional treatment system.. and when they did.. they really didnt have the mental health aspect he needed.. his addiction was only the by product of his original problem and not a single doctor addressed this issue... he was shipped here and there.. sometimes he would get into a really helpful place.. but usually the state wouldnt pay for more than a few weeks at a time.. which isnt enough.. he was sent to live in the homes mentioned in the article.. the were scams set up to make money off the state.. he ended up in a south florida hospital until the beginning of 2005 when he ran away and lived on the street until he could contact us... since moving here.. we have managed to find a compentent doctor and he's doing better than ever.. holding a job and being a productive member of society.. but i still see in his face the pain from his experiences.. if he had just had a normal doctor.. if he had just been treated before it got out of hand... but there was noone to help us 9 years ago.. it was my mother and i alone trying to help him.. i hope people realize how truly horrid this system is.. i hope people know that something has to change... there's more to this story of course but space is limited.. this something that has to change.. noone should have to experience what our family did