Within Our Reach: Ending The Mental Health Crisis

by Tom Pyle

Within Our Reach: Ending The Mental Health Crisis, by Rosalynn Carter with Susan K. Golant and Kathryn F. Cade.  New York: Rodale Press, 2010.

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Within Our ReachNot so long ago, in 1947, psychiatric patients at Philadelphia State Hospital (and elsewhere) straggled, squatted, and sat like wretched zombies, naked in cold and empty wards, despoiled in their own incontinent filth, barely surviving conditions comparable to German concentration camps that America had liberated just two years before. (If you don’t believe this, Google “a mental ward exposed” and see for yourself…)

With the introduction of Thorazine in 1955 and the civil rights litigation in the 1960s, hospitals started to empty. But replacement mental health services in the community still were not present. As a result, tens of thousands of discharged patients went untreated and homeless into the streets. Those who remained in hospitals fared little better.

Rosalynn CarterEven 20 years later abysmal conditions continued. In 1966, while campaigning in her husband’s first gubernatorial race, Mrs. Carter met many voters with loved ones in Georgia’s notorious Central State Hospital. Conditions were utterly deplorable. None were receiving treatment. Abuses abounded. Even children were being housed with adults.

Those on the outside were faring no better. Shaking voters’ hands early one morning at a factory gate, Mrs. Carter encountered a weary woman whose daughter had a severe mental illness. The hapless mother told of trading shifts with her husband so to care for their troubled daughter round the clock, without help, often without rest. The brief exchange haunted Mrs. Carter forever thereafter. It sparked her interest in mental health, which ultimately to her glowing career as a major mental health advocate.

As a capstone, Mrs. Carter now offers us Within Our Reach: Ending Mental Health Crisis, an excellent short book on the state of mental illness today. She begins with a sober assessment of mental health care’s rampant insufficiencies. Yes, things may be better than before, but they are far from good enough. She goes on to describe the special mental illness considerations of children, the elderly, disaster victims, and prisoners. Her penultimate chapter records the promise offered by new research. Then, she sends us forth with an inspiring final chapter about recovery as the way of the future.

With clear, crisp, concise words, each section gives us all we need to know, and no more. Mrs. Carter hits all the high notes of this difficult subject’s score, calling us first to account, then to action, and finally to hope and inspiration. This gem of a book is a perfect primer for any family just plunged into the maelstrom of mental illness and for all others helping them who need and would benefit from a sufficient yet succinct overview.

Today, more individuals with severe and persistent mental illness can receive reasonably good care in their communities, enabling them to work, learn, live, and lead productive lives in spite of their disabilities. In no small measure this is due to Mrs. Carter’s lifelong efforts. As the father of a loved one with a psychiatric disability, I am personally grateful for the advocacy of former First Lady Rosalynn Carter. Even now at 85 years old, as Within Our Reach attests, Mrs. Carter remains an ardent champion of the cause of recovery for those with psychiatric disabilities. Surely all in the psychiatric rehabilitation movement must embrace her as a vaunted patron saint of mental illness recovery. Surely she has earned it.

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