Pure Madness: How Fear Drives the Mental Health Service

By Jeremy Laurance.
ISBN 0 415 369 800  

The subtitle sets the scene, although Jeremy Laurance reminds us
that 90 per cent of the 600,000 with enduring mental health
problems do not pose a danger to themselves or others. In graphic
style he recalls high-profile violence that has emphasised the fear
of enabling “forensic” patients the freedom to live in the
community unmonitored.

Although a role of government is to protect the community, it faces
the criticism of denying freedom based on a psychiatric risk
assessment. Meanwhile, funding is being diverted from community
care for the 90 per cent to accommodate and monitor those
considered dangerous. Mental illness is assumed, incorrectly, by
many to mean schizophrenia and potentially dangerous. Let us not
forget that mental illness is a variety of diagnoses dominated by,
among other things, depressions, neuroses and brain

It is no coincidence that the major mental illnesses and consequent
suicides and murders are high in deprived communities such as
Hackney in London. This is where poverty, crime, single parents,
poor schooling and disease predominate.

The question, obscured by the constant drama, is what should be
done to prevent mental illness.

John Wilder is director, Psychiatric Rehabilitation

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