Bookreporter.com - VOLUNTARY MADNESS by Norah Vincent

VOLUNTARY MADNESS: My Year Lost and Found in the Loony Bin
Norah Vincent
Penguin
Memoir
Hardcover: 9780670019717
Paperback: 9780143116851

Norah Vincent is the author of the bestseller SELF-MADE MAN. Her writing has appeared in publications such as The Los Angeles Times and The Village Voice. Recently, she was institutionalized in a psychiatric hospital that mainly serves the poor or indigent mentally ill and drug-addicted population of New York City. This, she tells readers in her latest book, VOLUNTARY MADNESS --- a blend of journalistic exposé and memoir --- was for research. But, she also admits, it was for treatment as well.

What makes VOLUNTARY MADNESS so interesting, and at times frustrating, is the gray area between her two explicit goals: to write objectively about the state of mental health hospitals and to record her experiences as a patient who is occasionally in legitimate need of the services such hospitals provide.

Over the course of a year Vincent stayed in three very different hospitals, for a total of about a month. She was inspired to do so after she checked herself into what she calls “the bin” while writing her last book. She had suffered from depression previously, and the intensity of the work she was doing triggered another depressive episode. It was during this time in the hospital that she hit upon the idea of checking herself into a variety of hospital settings for a book. She selected three, in different locales and with different therapeutic approaches, and presented herself with the same set of issues (the ones she actually deals with), though she didn't tell the hospital administrators, caregivers or her fellow patients that in reality she was doing research for a book.

Her first stay was at the aforementioned urban hospital. The care consisted, for the most part, of high doses of medication and a safe place to crash. The caregivers were, in Vincent's opinion, impersonal and distant, and the therapy was essentially non-existent. Her second stay was much different; she checked herself into a small, semi-rural Catholic hospital that was comfortable and homey, with a caring staff and a trusting and kind physician at the helm. Despite the differences, the two institutions were afflicted with many of the same problems, including a revolving door of patients who, once stabilized, are released only to return again presenting the same symptoms.

The third hospital, too, dealt with the same issues. This private facility offered a variety of progressive and traditional therapies and allowed patients to live in private apartments. It promoted exercise and good nutrition. Still, the majority of the patients had been institutionalized several times for either mental health issues or addiction (which, Vincent convincingly suggests, are often two sides of the same coin). Many were there because of court orders, just as in the first hospital. While it was in this third and final place that Vincent had a major therapeutic breakthrough of her own, which she shares with raw honesty, she finds that in the end it was not as different of a place from the other two. The reason, she suggests, has to do not with the quality of care or the mission or goals of a particular hospital or clinic but American cultural ideas about mental illness and addiction. Drug companies and doctors who over-prescribed come under much fire here as contributing to this epidemic problem.

Her thesis seems to slightly shift a few times in the book. And the back and forth movement from objective journalist to patient is less than graceful throughout. The book itself has some interesting ethical dilemmas (going undercover in a mental health facility and playing with prescribed drugs to get a certain outcome, for example). Whether one agrees with all of her ideas or even her methods, VOLUNTARY MADNESS is sure to raise many good questions and become fodder for debate.

--- Reviewed by Sarah Rachel Egelman

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