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Strictly Irrational

by Theodore Dalrymple

American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System, by E. Fuller Torrey (Oxford, 224 pp., $27.95)

Reviewing American Psychosis, I should declare an interest: Dr. Torrey was the first author who ever sent me a signed and dedicated copy of a book, and I have remained silently grateful to him ever since. It was his 1980 book Schizophrenia and Civilization, in which he argued that, there having been no convincing descriptions of schizophrenia before the 19th century, something new must have arisen at the time of the Industrial Revolution to cause it. (Viral theories were popular at the time he wrote, and the urban overcrowding caused by industrialization would have favored a virus’s spread.)

In the present book, Torrey describes the causes and consequences of the hasty closure of state mental hospitals. It is part historical and part epidemiological; as always, he writes very clearly and is forthright in his views, which are commonsensical. I do not mean this in any derogatory way: Descartes started his Discourse on Method by saying that good sense was the most evenly shared thing in the world, but in those days he had not the advantage of knowing the American Psychiatric Association or the Medicare system.

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