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Failure to Thrive by Stephen Eide.

Since the 1960s, America has faced an epidemic of serious mental illness that represents a shameful chapter in social policymaking. Hundreds of billions spent on “mental health” programs have left many untreated, fated to eke out a pitiful existence on the institutional circuit of jails, homeless shelters, and psychiatric hospitals. We often take for granted that modern times are gentler than the dark days of the thumbscrew, lynchings, and public executions. Yet we have allowed scores of tormented men and women to suffer and die on city streets every year.

New York City’s Department of Health and Mental Hygiene reckons that 239,000 adult residents suffer annually from “serious mental illness,” defined as “a diagnosable mental, behavioral or emotional disorder (excluding developmental and substance use disorders) that resulted in functional impairment that substantially interfered with or limited functioning in one or more major life activities.” The best-known serious mental illnesses are schizophrenia and bipolar depression—disorders of thought and mood, respectively. In 2012, more than 90,000 of New York’s seriously mentally ill went untreated.

New York mayor Bill de Blasio has made improving New Yorkers’ mental health a priority of his administration, but his ThriveNYC program repeats too many of the mistakes of the past and will deliver too little assistance to those in greatest need. Promising a “comprehensive solution to a pervasive problem,” ThriveNYC relies on an overly expansive definition of mental health and lacks focus. While de Blasio claims that public confusion about the nature of mental health makes matters worse, his plan will increase that confusion by blurring the lines between mental illness in its serious and mild forms, making too much out of “stigma,” and emphasizing prevention over treatment. De Blasio has committed more than $800 million to ThriveNYC, but these resources are spread too thin, across too many priorities. A better approach would focus more on helping the seriously mentally ill and less on ideological and political concerns.


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