“Decriminalization” is Misconceived: Towards Improved Drug Policy

Recent reports about the problems that have emerged with Oregon’s experiment in the decriminalization of drugs have rekindled debate about this approach to reducing the damage that results from the current policy of criminalizing illegal substances. I tilt against decriminalization as currently...

Severe, Long-Term Mental Illness: What Does it Take to Live Well?

Typical images of people with severe, long-term mental illnesses are misleading. We think not of people who, despite mental illness, have lives that they find satisfying and meaningful but of homeless people dressed in rags pushing shopping carts with all their belongings and sleeping on heating...

Overcoming the Stigma of Mental Illness: Changing Minds and Creating Opportunities

What can be done to overcome the stigma of mental illness? Because stigma is generally understood as a concatenation of negative attitudes and beliefs, community mental health education designed to change people’s minds seems to be what is needed. But there is another way to think about stigma -...

From Blame to Burden and Beyond: Changing Perspectives on the Family and Behavioral Health

Over the past 40 years or so, there has been a dramatic shift in the views about the dynamics of families with mentally ill family members, a shift from blaming them to sympathizing with them for the burden they have to bear. 50 years ago, when I was learning to be a clinician, I was taught...

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.” Frankly,...

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...