As soon as I noted Dr. Stephen Seager’s comment that mental illness
is in no way "psychological" I switched on my bias-meter,
alert for signs of psychiatric paternalism. There were instances
of bias, but on the whole the book was surprisingly even-handed.
Stephen Seager’s Street Crazy is an informative, engaging,
and above all well-rounded introduction to the complex problem
of the homeless mentally ill in the United States.

Seager recounts his own experiences working as a hospital psychiatrist
in Los Angeles. Historical, political and medical information
and statistics are wound around anecdotes and a longer narrative
– Seager’s search for the elusive John Doe. Doe is a schizophrenic
patient brought into the psychiatric emergency room by police,
having been found wandering down a freeway. He is kept on the
psychiatric ward just long enough to present himself lucidly at
a Mental Health Court hearing and be judged fit to take care of
himself:

‘ "Where does Mr. Doe live?" Perkins went on.

"He claims to live in an abandoned building on 39^th
and Crenshaw. But…"

"Thank you, Dr. Seager," Perkins said curtly. "That’s
all, your Honor."’

Through John Doe’s story, Seager explores the tensions between
the medical and legal systems. This unwilling partnership aims
to guarantee the adequate treatment of people with mental illnesses,
while protecting their other rights. But these goals are in constant
conflict, as health and freedom so often are. Which should take
precedence? Seager tracks the historical basis of the current
precedence of legal rights, and suggests improvements in the way
the systems work together.

Street Crazy is non-technical and very easy to read. Seager’s
historical, political, legal and medical interludes complement
the story, and the hard facts are as compelling as the plot line.
In style Street Crazy is a bit like an episode of ER,
but in content it’s a whole lot more satisfying. This book will
answer most of your questions about the homeless mentally ill
in the US (one it doesn’t answer is what money had to do
with deinstitutionalisation), and some you hadn’t thought to ask.
Best of all, Seager explores more viewpoints than you would have
thought possible in such a moderately sized (197 pages) and accessible
book.

© 2001 Aislinn Batstone

Aislinn Batstone is
a Ph.D. candidate at Macquarie University, Sydney. Her research
interests include metaphysics, philosophy of logic, and the philosophy
of neurobiology and mental illness.

Categories: MentalHealth

Keywords: Homelessness, sociology, Psychology & Psychiatry
Tags: Schizophrenia, Mental Health Policy and Advocacy