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Cities, Culture, Public Safety, Health, Governance

Insane Consequences: How the Mental Health Industry Fails the Mentally Ill

By DJ Jaffe
Prometheus Books 2017 ISBN: 1633882918

One of the most important books written on how to reform the mental health system.

E. Fuller Torrey

About the Book

This well-researched and highly critical examination of the state of our mental health system by the industry's most relentless critic presents a new and controversial explanation as to why—in spite of spending $147 billion annually—140,000 seriously mentally ill are homeless, 390,000 are incarcerated, and even educated, tenacious, and caring people can't get treatment for their mentally ill loved ones. DJ Jaffe blames the mental health industry and the government for shunning the 10 million adults who are the most seriously mentally ill—mainly those who suffer from schizophrenia and severe bipolar disorder--and, instead, working to improve "mental wellness" in 43 million others, many of whom are barely symptomatic. Using industry and government documents, scientific journals, and anecdotes from his thirty years of advocacy, Jaffe documents the insane consequences of these industry-driven policies: psychiatric hospitals for the seriously ill are still being closed; involuntary commitment criteria are being narrowed to the point where laws now require violence rather than prevent it; the public is endangered; and the mentally ill and their families are forced to suffer.

Insane Consequences proposes smart, compassionate, affordable, and sweeping reforms designed to send the most seriously ill to the head of the line for services rather than to jails, shelters, prisons, and morgues. It lays out a road map to spend less on mental "health" and more on mental "illness"--replace mission creep with mission control and return the mental health system to a focus on the most seriously ill. It is not money that is lacking; it's leadership. 

This book is a must-read for anyone who works in the mental health industry or cares about the mentally ill, violence, homelessness, incarceration, or public policy.


“One of the most important books written on how to reform the mental health system.”
E. Fuller Torrey, MD, author of Surviving Schizophrenia

“Essential reading for anyone concerned about America’s most vulnerable.” 
Sally Satel, MD, Yale University School of Medicine

“A slashing, comprehensive, highly readable call to awareness and action.” 
Ron Powers, Pulitzer prizewinner and author of No One Cares about Crazy People

"The truth in this book haunts me with its blazing clarity. Jaffe's informed and passionate plea for fundamental change is rooted in a sense of deep humanity. He has paid attention to those who are neglected and suffering right under our noses and challenges us to do something about it."
Glenn Close, actress and cofounder of Bring Change 2 Mind

 “A timely and thoughtful analysis of a broken system that needs replacing.” 
Pete Earley, bestselling author of Crazy: A Father’s Search Through America’s Mental Health Madness

"Illuminates the countless and unacceptable failures of our mental health system--including the barbaric criminalization of mental illness."
Thomas J. Dart, Cook County sheriff

“This book will break your heart, make you furious, and ultimately give you hope when you read Jaffe’s smart ideas for reform.” 
Susan Adams, senior editor, Forbes

"[We're] forcing people with no recognition of their illness onto the streets or into the jails in the name of civil liberties. Insane Consequences details what we should do."
Norman Ornstein, resident scholar, American Enterpise Institute

“DJ Jaffe calls us back to common sense and basic decency in this deeply felt, important book.” 
Rich Lowry, editor, National Review

“A smart and compassionate call to action.”
Allen Frances, former chair of the Department of Psychiatry at Duke and of the DSM-IV Task Force, and author of Saving Normal

"I am proud that DJ Jaffe, a constituent and member of the Harlem chapter of National Alliance on Mental Illness, has been tirelessly advocating to help the seriously mentally ill. Through increased awareness and improved public policy as outlined in this book, we can combat challenges we face to ameliorate mental health.”  
Charlie Rangel, former representative (D-NY)

About the Author

DJ Jaffe is executive director of Mental Illness Policy Org., a nonpartisan think tank, which creates detailed policy analysis for legislators, the media, and advocates. He regularly appears on television and has written opinion pieces for the New York Times, Washington Post, Wall Street Journal, and articles for National Review and Huffington Post. He has served with numerous nonprofits including the Treatment Advocacy Center and National Alliance on Mental Illness. He has a seriously mentally ill relative and lives with his wife, Rose, and dog, Pickles, in Harlem.