Book Reviews

Street Crazy

December 10, 2009

Street Crazy highlights nine years in the life of a psychiatrist, Dr. Seager, while working in a Los Angeles public mental hospital. He writes from his personal experiences to give people an understanding of the plight of more than one million Americans who are mentally ill, homeless and living on the streets. His hope is that understanding will lead people to become actively involved in working to improve the lives of homeless mentally ill individuals.

Dr. Seager is one of those rare psychiatrists who became personally involved with a few of the mentally ill people he came into contact with during his years working in a public mental hospital. His belief is that he was knowledgeable about mental illness diseases but knew very little about the everyday lives of people suffering with mental illness. He records one story of a grandmother and her grandson, Jamal. Even though Jamal’s grandmother had a bad heart, she wanted to gain legal custody of Jamal after Jamal’s mother, addicted to drugs, returned home after abandoning Jamal for years. Dr. Seager personally became involved in the court case related to the placement of Jamal.

In another case Dr. Seager fearfully took a bus into the ghetto and skid row areas of Los Angeles in an effort to find the family of a man who had died. Because of unforeseen circumstances he was forced to spend the night in a homeless shelter. The entire disturbing experience was a defining moment in his life.

Dr. Seager quotes what one policeman said when bringing into the hospital a man who had previously been brought in on multiple occasions. The policeman was overheard as saying, “They should just declare mental illness illegal.” The policeman was making his comment based on his own experiences and observations related to the staggering percentage of mentally ill people in jails and prisons, many of whom upon release became homeless and in some instances ended up in jails and prisons multiple periods of time.

The legal system and its mandates have been hindrances to successfully treat many severely mentally ill persons. Legal decisions have been made based upon protecting the freedom of choice and not on the severe mental illness of the individual. Through personal experiences and documentation over the years, Dr. Seager proved to himself and others who worked with him that when a mentally ill person was given correct medication the vast majority of people significantly improved. The problem lay in the judicial policies that could not keep severely mentally ill people involuntarily committed based upon the mentally ill person’s individual needs. Another judicial policy stated that once a person left the hospital those persons were not required to take their medications. As a result, the hospital often became a revolving door. One patient had been re-admitted 84 times within a four-year period.

The author makes a strong case for looking at homelessness and mental illness, not just as a psychiatric medical problem, not as a civil rights issue but looking at mental illness as a moral issue. He emphatically states, “That the brain-diseased must exist on our streets and eat garbage is a sin. Period.”

In the final chapter of the book, Dr. Seager outlines eight suggestions he and others believe must be taken to insure chronically mentally ill persons are compassionately cared for. His plea is a call to action, a plea for people to become involved in advocating and working together to rethink and take action to improve the mental health system and the lives of people within the system.

Street Crazy by Stephen Seager, M.D. Westcom Press, Publisher, 2000, 197 pgs.