Behind New York’s change in mental health, a lonely quest

“He was a very important man,” he said. “I think she died thinking it was true.”

In the 1970s, when the country discharged hundreds of thousands of patients from public psychiatric hospitals, it was the era of “flight over the cuckoo’s nest”, and this decision was hailed as a reform avant-garde. But Dr Torrey warned that many former patients wandered the streets of the city without treatment, describing them in his writings as “a damned inner city legion”.

He recalled a woman he met while treating patients at a homeless shelter in Washington, DC. the hospital where he had worked, after attacking his daughter so brutally that she lost her arm. The woman had refused to take medication after being discharged from the hospital.

“I said, ‘There’s something wrong with this system,'” he said. “How can this woman be completely psychotic again?”

It was unusual for a psychiatrist to take such a vocal stance against deinstitutionalization, celebrated by liberals. In the years that followed, Dr Torrey said, his arguments found more support from conservatives, landing on the opinion pages of The Wall Street Journal.

He then challenged all the centers of power in the profession. He blasted the National Institutes of Mental Health to fund too little research on treatments for debilitating illnesses such as schizophrenia. He fell out with the National Alliance for the Mentally Ill over its advocacy of outpatient commitment. He refused to pay dues to his local chapter of the American Psychiatric Association – an act of protest against his expenses for a lobbyist – and was expelled, he said.

“I’m a longtime friend and colleague of Fuller, but Fuller has caused institutional psychiatry great pain,” said Dr. John Talbott, 87, former president of the American Psychiatric Association. He attributed the friction to deinstitutionalization. “Fuller was one of the few people who said early on that it was a big mistake. In part, he said it because of his sister.