Insane

Starred review from April 2, 2018
Marketplace reporter Roth’s cri de coeur uses moving anecdotes of how the American criminal justice system treats the mentally ill to make the problem palpable. Roth provides a deeply disturbing synthesis of her research, both academic and in the field, including conversations with professionals, and the mentally ill, to show how despite the increased understanding of mental illness over the last two centuries, and apart from the development of more effective medications, “we continue to treat people with mental illness almost exactly as we did before electricity was invented.” In one of the more unsettling examples, a businessman and former firefighter with bipolar disorder was arrested for indecent exposure after he stripped naked in the hallway of a hotel when he was unable to open the door to his room. Later, when he turned violent, correction officers with no access to his medical records or understanding of the care he needed put him in solitary confinement. Roth proposes sound alternatives, such as San Antonio’s investment in a 24/7 crisis center devoted to keeping people with mental illness “out of the criminal justice system and into effective treatment.” Roth strikes a powerful balance between big picture analysis and individual stories to make this searing account of America’s misguided treatment of the mentally ill hard to ignore.