Editorial note:

Like many of the hundreds of thousands of nonsurvivors (that Dr. Torrey identifies below), my brother died last year because of his Schizophrenia - perhaps because it took us so long to get him treatment. He and my parents had to suffer for 9 delusional years before he degenerated to the point where he was destroying the house and we could finally get him to the hospital.

Then, as is so often the case, catching a person during that very small window of time when he or she is "a danger to himself or others" - and before they or others are dead - is an overwhelming task with a disease that can fluctuate dramatically in a matter of hours. In our case my parents were taking their first real vacation in years and they just couldn't respond in a couple of hours; how many people can be prepared for their worst nightmare 100% of the time?

If we can get earlier treatment of the severely mentally ill the scientific research shows a much better outcome - and the results with the newest medications are much better than previous generations of medications. Ultimately we all want the best treatment for those who are ill - and right now there are many orders of magnitude more people dying from lack of treatment than from "too much" or inappropriate treatment - as Dr. Torrey points out in the following article. In fact, given the overwhelming trend towards psychiatric hospital closures in the US the potential for "too much treatment" seems more than a little absurd.

Sadly, because those who don't get treatment are usually "outside the system" they rarely get counted. I applaud Dr. Torrey for his efforts in helping the mentally ill. Finally someone is counting...and speaking out for the people that no longer have a voice - the huge population of Nonsurvivors.

ps. The PSYCHIATRIC SERVICES journal identified below is an official journal for the American Psychiatric Association.

PSYCHIATRIC SERVICES_ Feb. 1997 - TAKING ISSUE

Psychiatric Survivors and Nonsurvivors

In a recent workshop, Jay Mahler, representing the California Network of Mental Health Clients, introduced himself as a "consumer-survivor." Since the early 1980s a small number of consumers have identified themselves as "psychiatric survivors," but the term now appears to be becoming respectable, even politically correct. For example, the Center for Mental Health Services, a national model for political correctness, now uses the term "consumers/survivors" in some of its publications.

Let's be clear about what is meant by "psychiatric survivors." Dendron, a vituperative antipsychiatry newsletter, describes itself as for "psychiatric survivors and allies." The most radical organized antipsychiatry group named itself the National Association of Psychiatric Survivors. On the Internet, Shoshanna's Psychiatric Survivor's Guide opens with a quote from Dr. Peter Breggin: "Going to a psychiatrist has become one of the most dangerous things a person can do."

Thus the term "psychiatric survivor" is not being used like "cancer survivor," someone who has had cancer and survived it. Rather, it's being used like "Holocaust survivor," an individual who has been unjustly imprisoned and even tortured. As such, psychiatric survivors strongly oppose psychiatry in general and deny the need for involuntary hospitalization or involuntary medication, even for profoundly disabled individuals who have no insight into their illness or their need for treatment. Many psychiatric survivors also deny that schizophrenia and bipolar disorder are brain disorders, despite overwhelming scientific evidence. For example, psychiatric survivor Al Siebert claims that "what is called schizophrenia in young people appears to be a healthy transformational process that should be facilitated instead of treated."

At the workshop, Jay Mahler said he could not conceive of any circumstance in which he would support involuntary hospitalization or treatment. As he spoke, I calculated the number of people with severe psychiatric disorders who are no longer alive because "psychiatric survivors" like Mr. Mahler along with civil liberties lawyers have made it virtually impossible to treat such patients when they have no insight into their illness or their need for treatment. Given the suicide and accidental death rates for such individuals, including those who freeze to death in cardboard boxes on the streets, at least a half-million persons who were severely psychiatrically ill are now prematurely deceased.

The policies espoused by "psychiatric survivors" have thus led to a large number of nonsurvivors. Political correctness currently focuses on the "survivors." Humane considerations suggest that our focus should be instead on the growing number of nonsurvivors.

--E. FULLER TORREY, M.D., National Institute of Mental Health Neuroscience Center, St. Elizabeths Hospital, Washington, D.C.