No One Cares About Crazy People Summary

“What happens to those whom society deems disposable? The failure to care for the mentally ill is a tragedy hiding in plain sight.”

1. Schizophrenia: A Complex Illness with Genetic and Environmental Roots

Schizophrenia is a severe brain disorder that significantly disrupts an individual’s ability to think, feel, and behave clearly. It emerges from a combination of genetic and environmental factors. Genes linked to schizophrenia lie dormant until external stresses or specific life events trigger them. The brain undergoes a natural pruning process during late adolescence to early adulthood, removing unused connections. However, this process also allows schizophrenia-related genes to activate, setting the stage for the onset of the disorder.

The prodromal phase often marks the beginning of schizophrenia and is triggered by significant stress, drug use, or life challenges like academic pressure or failed relationships. During this phase, the person may appear normal, but untreated stress increases the likelihood of severe psychotic episodes. Symptoms such as delusions and paranoia then surface, profoundly impacting the individual.

Substance abuse, particularly cannabis use, plays a notable role in triggering schizophrenia for those genetically predisposed to it. Studies suggest a direct link between cannabis and the emergence of psychotic disorders, making substance avoidance an important preventative measure for many at risk.

Examples

• Genes linked to schizophrenia become active during brain pruning in adolescence.
• Stress from schoolwork or heartbreak often coincides with the onset of symptoms.
• Research in the Lancet confirmed cannabis use as a trigger for psychosis.

2. The Damage of Denying Mental Illness

Many influential figures, such as psychiatrist Thomas Szasz, dismissed mental illness as a myth. He argued that what is labeled as mental illness was simply behavior society found irritating rather than a real medical condition. His ideas significantly damaged public understanding of mental illness and reduced the number of professionals pursuing psychiatry as a career.

In 1975, Szasz's claim that treating mental illness violates civil liberties gained legal grounding. A Supreme Court ruling barred involuntary treatment for the mentally ill unless patients posed a threat to themselves or others. Sadly, this overlooked the reality that many people with schizophrenia lack the insight to recognize they need help.

Such policies led to devastating consequences for untreated individuals, worsening their symptoms over time. Prolonged psychosis cements itself deeper in the brain, making recovery even harder. Szasz’s lasting influence persists through organizations like the Citizens Commission on Human Rights, which continue to emphasize his controversial views.

Examples

• Thomas Szasz’s book, The Myth of Mental Illness, challenged the legitimacy of psychiatry.
• The Supreme Court restricted involuntary mental-health treatment, complicating care.
• People with schizophrenia often can’t identify their need for help, delaying treatment.

3. The Collapse of Mental Institutions Left Patients Abandoned

The closure of mental institutions in the 1960s and 1970s left patients struggling to manage on their own. Policymakers assumed that new drugs like Thorazine would allow people with mental illnesses to function independently, but psychiatric drugs are not cures. They merely mitigate symptoms in some cases.

The tragedy was compounded by the failure to provide community resources promised by the Community Mental Health Act of 1963. Less than half of the proposed centers were built before funding was cut to redirect resources to the Vietnam War. Without these centers, many were discharged from institutions with no resources to support them.

Pharmaceutical companies exploited the changes, profiting from the idea that drugs could replace holistic care. Despite settling legal cases for false claims, these companies reaped massive financial gains as former patients were left to fend for themselves.

Examples

• Institutions closed, trusting medications like Thorazine to replace live-in care.
• The Community Mental Health Act’s funding was diverted, halting its efforts.
• Pharmaceutical companies misled the public, promising cures that didn’t exist.

4. Deinstitutionalization Led to Homelessness and Incarceration

As psychiatric hospitals shuttered, people with serious mental illnesses found themselves living on the streets. Lacking support networks and the ability to hold jobs, many became homeless. This marginalized group grew rapidly, with former patients unable to navigate the system necessary to receive assistance.

Without income or housing, some turned to petty crime, landing them in prisons. Correctional facilities became the default mental-health institutions in the United States. Once inside, these individuals faced inhumane conditions, including solitary confinement, which worsened their mental-health issues.

Even worse, encounters with law enforcement often ended fatally for those with mental illnesses. Police lacked the training to deal with erratic behaviors, leading to unnecessary violence in cases where compassion could have saved lives.

Examples

• Homelessness grew as discharged patients failed to access housing or aid.
• Jails and prisons now house more mentally ill people than hospitals.
• James Boyd, diagnosed with schizophrenia, was fatally shot by police while unarmed.

5. Public Skepticism Toward Mental Healthcare Weakens Support

Public mistrust in psychiatric solutions impacts everything from funding to quality of care. Misinformation spread by figures like Szasz and profit-driven pharmaceutical companies undermined the legitimacy of mental-health treatment in the public eye.

This skepticism discourages those with illnesses from seeking help and leaves families feeling unsupported. The stigma attached to mental illness also keeps policymakers from making meaningful progress in improving care.

With misinformed attitudes, many Americans view mental illness as a personal failing rather than a medical condition. This perspective creates barriers to understanding and addressing the real needs of those suffering.

Examples

• Misinformation fosters public mistrust in psychiatry’s intentions.
• Families affected by schizophrenia often feel helpless in navigating care.
• The stigma surrounding mental illness creates societal prejudice.

6. Early Intervention Saves Lives and Reduces Costs

Diagnosing and treating mental illness early is vital. Early intervention could prevent the escalation of disorders, giving individuals a better quality of life. By catching mental illness in its early stages, treatment becomes more effective.

The author shares his personal experience of losing one son to suicide and narrowly saving another who developed schizophrenia. His family’s struggles highlight the pressing need to intervene before patients reach a crisis point.

Aside from moral reasons, early intervention can save taxpayers money. It’s far cheaper to provide treatment than to incarcerate individuals with untreated illnesses. Programs aiming for prevention reduce expenses for families and society.

Examples

• Early treatment for schizophrenia may have saved the author’s son’s life.
• The National Alliance on Mental Illness estimates cost savings by treating instead of jailing.
• Delaying treatment worsens the disorder, further burdening families.

7. Community-Based Support Programs Are Effective

Social reintegration can work wonders for people with mental illnesses. Psychiatrist Courtney Harding demonstrated that mentoring patients to rebuild confidence and community ties has long-term benefits. Many went on to lead stable, fulfilling lives.

This approach challenges the medication-heavy methods that focus only on maintenance. Programs that help individuals reconnect with society produce better results than simply prescribing drugs to manage symptoms.

Mental healthcare should not merely stabilize but strive to improve lives. Empowering patients can help them make meaningful contributions to their communities.

Examples

• Courtney Harding’s study showed mentoring improved patients’ independence.
• Psychosocial rehabilitation strengthens community and personal skills.
• Over half of Harding’s participants showed long-term advancements.

8. Police Need Mental-Health Training

Encounters with law enforcement often turn dangerous for people in psychotic states. Police are typically unprepared for these situations and may escalate instead of de-escalating incidents.

Training officers to recognize and respond to mental-health crises could prevent unnecessary violence. Programs teaching crisis intervention have proven successful in reducing harm during such incidents.

Society must rethink its reliance on police as the first-response agents in mental-health emergencies. Separating law enforcement from medical intervention could reduce tragedies.

Examples

• James Boyd’s death shows the dangers of untrained police interactions.
• Crisis intervention training de-escalates potentially violent situations.
• Separating police and health responders provides a safer alternative.

9. Public Advocacy Can Drive Change

The public has the power to demand better mental-health policies. Advocating for vulnerable individuals and bringing their struggles to light fosters a more compassionate society.

Raising awareness can build momentum for legislative reforms that prioritize funding and community care. Families affected by mental illness often act as powerful voices for change.

Collective action moves society toward humane, effective solutions. Reducing stigma and providing real support improves lives and saves resources over time.

Examples

• Mental-health advocacy organizations raise awareness through campaigns.
• Families with loved ones affected by schizophrenia share stories to inspire reform.
• Public-supported policies enhanced resources in other health crises.

Takeaways

1. Advocate for early screenings and preventive care for mental health to intercept illnesses before they escalate.
2. Support community-based rehabilitation programs that offer mentoring, skill-building, and reintegration services for patients.
3. Encourage law enforcement agencies to adopt crisis-intervention training, ensuring safer interactions with individuals suffering mental-health crises.