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Book Review   |    
Abraham Nussbaum
Psychiatric Services 2008; doi: 10.1176/appi.ps.59.2.214
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by Mary Beth Pfeiffer; New York, Carroll and Graf Publishers, 2007, 336 pages, $15.95

Dr. Nussbaum is a resident in psychiatry at the University of North Carolina Hospitals, Chapel Hill.

During a decade when journalists were criticized for attending to corporate rather than community interests, Mary Beth Pfeiffer followed six men and women with severe mental illnesses as they were arrested, incarcerated, and mistreated in the American penal system. By giving account of these six people, Pfeiffer writes as an advocate journalist, providing detailed accounts of the human costs of the criminalization of people with mental illnesses.

Pfeiffer writes with an indignant but determined tone about a penal system that allows persons with mental illness to deteriorate until their death. She writes of Shayne Eggen, a woman in Iowa with schizophrenia, who gouges her own eyes out while in solitary confinement. She writes of Jessica Roger, a 21-year-old believed to have borderline personality disorder who commits suicide while locked inside a New York prison's "box." Pfeiffer invites her readers inside the enclosed and unsafe spaces into which people with mental illnesses are sent.

Although she criticizes criminal justice and mental health professionals alike, Pfeiffer hopes to indict a culture that prioritizes imprisonment over care. While describing the suicide of Joseph Maldonado—an 18-year-old in California who never receives the mental health treatment he requests—she criticizes the overcrowded prisons that keep such an inadequate watch over their charge. As she tells how Peter Nadir, a 31-year-old Floridian treated for bipolar disorder, is asphyxiated by police officers a block from his home, Pfeiffer writes about the inadequate training of police officers and the closing of mental hospitals.

To be sure, Pfeiffer offers sympathetic accounts rather than epidemiological rigor or psychological sophistication. She employs data in an uncritical fashion, but she writes for a general audience. This book is neither a meta-analysis nor a policy statement but an appropriate book from which to select a section, perhaps the story of Shayne, to press upon legislators and students. Pfeiffer clearly tells these stories with the hope that they will galvanize her readers to seek more just treatment for people with severe mental illness.




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