More threads by David Baxter PhD

David Baxter PhD

Late Founder
Crazy in America
Reviewed by Treatment Advocacy Center

Mary Beth Pfeiffer is the author of Crazy in America: The Hidden Tragedy of Our Criminalized Mentally Ill. In this book Pfeiffer profiles the lives of people with mental illness in the criminal justice system.

As you know, the Treatment Advocacy Center is dedicated to eliminating barriers to the timely and effective treatment of severe mental illnesses. TAC advocates for treatment before people become entangled with the criminal justice system.

Here is a special guest blog entry from Mary Beth Pfeiffer in her words:

"Children wait in emergency rooms for psychiatric beds, sometimes for days." ~ June 1, 2007, Hartford Courant editorial.

We all know that America had better than a half-million psychiatric hospital beds 50 years ago, beds that were whittled down in a great, silent wave of untethered humanity called deinstitutionalization. But few realize that deinstitutionalization is continuing, and so is the failure of community care to pick up the slack.

The children referred to in the quotation above, who suffer while waiting for psychiatric beds in Connecticut, are just one group of victims. Add to them the homeless, the incarcerated, the two-thirds of Americans with mental illness who go untreated.

From 1990 to 2000, long after deinstitutionalization was believed over, the nation lost an additional 57,000 psychiatric beds, bringing the total to 86,000. But the bloodletting didn?t stop there: Harrisburg State Hospital closed in Pennsylvania last year and with it 260 beds. In Florida, 36 private psychiatric hospitals have closed in since 1992 ? taking 4,400 beds. In Iowa, 600 general-hospital psychiatric beds were shuttered from 1998 to 2002 -- nearly half the state?s total. Connecticut had three sprawling public mental hospitals in the 1950s, serving 9,000; with additional cuts in recent years it is down to about 600.

America?s system of mental health care is broken. Emergency rooms, which saw psychiatric cases rise by 56 percent from 1992 to 2003, take the brunt in this severely strained system. And jails and prisons act as de facto mental institutions where there is always a bed ? and where at least 330,000 mentally ill people now reside.

America needs leadership on mental health care. We need leaders who are willing to equate the needs of people with mental illness with those who suffer from cancer and heart disease. We need legislators willing to provide funding for housing, clinics and subsidized insurance. We need a media willing to explore the ills of a forgotten and under-funded system.

This isn?t too much to ask.
---Mary Beth Pfeiffer​
Visit Mary Beth Pfeiffer?s web site at to see photographs of her profile subjects and get other information. To buy the book, go to
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