Behind New York City’s mental health shift, a lonely quest

“That was a very important man,” he said. “I think she died because she thought it was true.”

In the 1970s, when the country was releasing hundreds of thousands of patients from public mental hospitals, it was the era of One Flew Over the Cuckoo’s Nest, and the move was hailed as a pioneering reform. But dr Torrey warned that many former patients were left roaming the city streets untreated, describing them in his letter as “a legion of inner-city damned.”

He recalled a woman he met treating patients at a Washington, DC, homeless shelter. She looked familiar, so he got out her papers: a decade earlier, while she was psychotic, she had been treated at St Elizabeth’s public psychiatric hospital, where he worked, after he had so brutally assaulted her daughter, that the girl lost her arm. The woman had refused medication after leaving the hospital.

“I said, ‘There’s something wrong with this system,'” he said. “How is this woman allowed to become completely psychotic again?”

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

He continued to challenge all power centers of the profession. He berated the National Institutes of Mental Health too little research to fund to treatments for debilitating diseases such as schizophrenia. He fell out with the National Alliance for the Mentally Ill because of his advocacy for outpatient engagement. He refused to pay dues to his local section of the American Psychiatric Association – an act of protest at their spending on a lobbyist – and was expelled, he said.

“I’m a longtime friend and colleague of Fuller’s, but Fuller has given institutional psychiatry a huge pain in the butt,” said Dr. John Talbott, 87, former president of the American Psychiatric Association. He attributed the friction to deinstitutionalization. “Fuller was one of the few who said from the start that it was a big mistake. Partly he said it because of his sister.”