No One Cares About Crazy People | Ron Powers

Summary of: No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America
By: Ron Powers


In ‘No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America’, Ron Powers delves into the complex world of mental health, particularly schizophrenia, as well as the societal debate surrounding the care and treatment of those afflicted with mental illnesses. Through a comprehensive exploration of the science behind the onset of schizophrenia, the cultural impact of figures like Thomas Szasz, and the consequences of deinstitutionalization, the summary provides readers with an eye-opening look at the state of mental health care in America. The book also emphasizes the importance of early diagnosis, alternative treatments, and the responsibility of society to advocate for those who may not have a voice of their own.

Schizophrenia: The Role of Genes, Pruning, and Triggers

Schizophrenia is a devastating mental illness caused by the interaction of genetic and environmental factors. Certain genes contribute to the onset of the disorder, but symptoms usually emerge during adolescence when the brain is pruning cells. This process destroys particular cortical synapses, which facilitates communication between neighboring cells. Still, when the old synapses are pruned, the genes involved in schizophrenia come to life, filling in the gaps that trigger a psychotic breakdown later on. The disorder’s onset is always the result of external triggers, such as stress and marijuana use, that can precipitate the prodromal phase of schizophrenia. A recent article cites research confirming the link between cannabis use and psychosis, including schizophrenia.

The Myth of Mental Illness

The Myth of Mental Illness is a pivotal book by Thomas Szasz that challenges the existence of mental illness. Szasz sees the treatment of mental illness as authoritarian and inhumane, so he aimed to prevent others from interfering with the lives of those suffering from mental illness. He argues that mental illness is merely a set of societal norms that are pathologized and that the mind, unlike the brain, is intangible. Therefore, mental illness is not something that can be deemed “wrong.” This perspective contributed to a decline in medical professionals choosing mental health as a specialty. In 1975, the Supreme Court made it a violation of civil liberties to hospitalize or medicate a person with mental illness without their consent. Although this protects civil liberties, it can take months to receive such an order, and untreated psychosis can worsen a person’s condition. Szasz’s opinions have been polarizing, but his work in casting doubt on the legitimacy of psychiatry has been influential in how mental illness is viewed.

Mental Institutions Disaster

In the 1960s, psychiatric institutions closed, freeing Americans with mental illness in a mass deinstitutionalization move. These patients were expected to be cured by drugs such as Thorazine, a schizophrenia treatment. However, such drugs only stabilized patients, and they could not make the illness vanish. Despite the lack of a cure, pharmaceutical companies have capitalized on the general public’s desperation and lack of knowledge regarding mental illness, paying countless settlements for advertising false promises of cures. Kennedy’s 1963 Community Mental Health Act promised state-level community care and support after releasing patients from institutions. The program’s implementation began well, but it was stopped by the Vietnam War, and funding was slashed. Less than half of the proposed centers existed by 1973 when the institutions closed, resulting in 280,000 patients discharged with no place to go. Americans with mental illness were left to fend for themselves, with no one to care for them and no tools to care for themselves.

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