Transforming Madness: New Lives for People Living with Mental Illness

A quiet revolution is taking place in the care and treatment of the mentally ill, observes Neugeboren in this invaluable state-of-the-art report. Within the last five to 10 years, antipsychotic medications have become much more effective and their side effects less debilitating. Just as important, he notes, is the emergence of recovery programs, peer support centers and community treatment facilities that make it possible for the severely mentally ill to go to college, hold down jobs, marry and raise children--even without being fully cured. There is a downside, though: general hospitals, now the primary providers of inpatient psychiatric care in the U.S., are as dreadful as they were a quarter-century ago, the author opines. In his moving 1997 memoir, Imagining Robert, Neugeboren, who is also a novelist (The Stolen Jew) and teaches at UMass--Amherst, discussed his brother's three decades of breakdowns and hospitalizations. This deep personal involvement with psychiatric illness propels the present book, an open-ended odyssey in which the author astutely probes a profession deeply divided between psychotherapeutic and pharmacological approaches. While acknowledging the value of drugs, Neugeboren makes a strong case for psychotherapy in the treatment of schizophrenia, other psychoses and mood disorders. Though the narrative at times feels padded, the searing profiles of people who have recovered and built new lives, often after having been pronounced medically hopeless, along with Neugeboren's selective evaluations of treatment programs, will make his journey enlightening to patients, their families and caregivers, as well as to general readers. Author tour. Agent, Richard Parks. (May)