Review of "Street Crazy"

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.