Mental Health in America: Looking Back With Pride and Ahead With Hope

In the early 1970s at the height of deinstitutionalization in New York, I worked at a psychiatric rehabilitation program on the West Side of Manhattan that primarily served people who had been in state psychiatric hospitals for 5, 10, 20, even 40 years. Each week I went to Manhattan State Hospital...

For One Mind, Too Many Silos

In the worlds of advocacy and policy making, there are sharp distinctions drawn among Alzheimer’s (and other dementias), mental illness, and substance use disorders. This results in separate, distinct, and insular fields of policy and practice, often referred to as “silos.” [caption...

Stigma Is Being Used as a Political Weapon: Reject It

I and many others have said it before but, as recent events make clear, we will have to say it again and again and again: Mental illness is not the cause of mass murder in the United States. The continuing assertion by the political right that it is has become a core element of the vituperative...

The Triumph of “Recovery”

By the early 1970s, just a few years after aggressive deinstitutionalization began, it became clear that merely keeping people with serious and persistent mental illness out of the hospital and in the community was not enough. It was not even enough to make sure that they got good psychiatric...

Volunteering Makes Old Age Meaningful

When I moved to Baltimore to be closer to my daughter and grandchildren, I left behind 50 years of work in New York’s mental health community, 20 years of teaching at Columbia University School of Social Work, an active life in jazz and in photography, many friends, and (though I tried to avoid...

Let’s Celebrate Our Workforce

Every day when he left home to serve as the attending psychiatrist at an inpatient unit at a general hospital, he wondered whether he would contract COVID at work that day and bring it home to his wife and two small children. Maybe he had already brought it home. Had stripping in the garage and...

Pain and Its Impact on the Opioid Epidemic

In several past articles on the opioid epidemic in America, I have complained that the problem of severe, chronic pain has been overlooked as a contributing factor. It appears that that is no longer true. For example, a very recent report by the National Academies of Science to the Food and Drug...

To Improve Adolescent Mental Health, We May Need to Address Adverse World Events

It appears that the prevalence of mental disorders among adolescents has been increasing. The National Survey of Drug Use and Health (NSDUH) shows an increase in major depressive episodes.1 A study about children and adolescence who are eligible for SSI by virtue of mental disabilities found an...

Will “System Transformation” Transform the System? Before We Celebrate: 20 Questions That Need Answers

System transformation is underway in New York State and throughout the United States through the development of elaborate financial structures such as accountable care organizations and health homes. No doubt these new structures will change the way business is done in the mental health system. But...

Deaths of Despair: Social Research Suggests Troubling Trends for the Next Generation of Older Adults

Recent social research suggests that the next generation of older adults may be more troubled than the current and previous generations. This, of course, is counterintuitive. 70 is the new 50, we say; 80 the new 60. We are living longer, and we are healthier, right? Yes, but will the next...