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Review
Lynn Nanos guides readers in Breakdown: A Clinician's Experience in a Broken System of Emergency Psychiatry through our nation's shameful treatment of Americans with debilitating mental illnesses. Only someone with her in-the-trenches experience can articulate the flaws with such authority. Her dedication to helping throw-away patients trapped on a treadmill of hospitalizations, homelessness and jails is heroic and inspiring.--Pete Earley, Author, Crazy: A Father's Search Through America's Mental Health Madness Lynn Nanos provides a gritty and extremely candid look at our dysfunctional mental health care system. Her extensive experience in this trying environment provides a view of that world that few ever see. If you've ever wondered "Why don't we do more for the mentally ill?" read this book and you'll understand.--Chief Mark K. Leahy (retired), Executive Director, Massachusetts Chiefs of Police Association In Breakdown, Lynn Nanos draws upon years of clinical experience to expose one of our society's most shameful injustices: the neglect of individuals with serious mental illness. By weaving together her own first-person account with historical, political, and legal background, Nanos issues a clarion call for the construction of adequate mental health services for our most vulnerable citizens.--Dominic Sisti, Ph.D., Director, Scattergood Program for Applied Ethics of Behavioral Health Care, Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania; Assistant Professor of Medical Ethics and Health Policy, Philosophy, Psychiatry, University of Pennsylvania Lynn Nanos' book Breakdown is a welcome addition to those that seek to educate the public about America's mental health crisis - one that too many willfully neglect. She offers a valuable perspective from the front lines of a broken treatment system, where psychiatrists and social workers are overwhelmed by people for whom fewer and fewer inpatient treatment beds are available. Many do not even know they are sick and, after being released to the streets, will wind up behind bars. Nanos sees clearly the consequences of failing to treat the most severely ill among us, and she understands why systemic reform is so badly needed, particularly in her state of Massachusetts - one of just three states without an assisted outpatient treatment program - where there is little to prevent the most severely ill from cycling through our emergency rooms, homeless shelters, and jails. "One tragedy should be enough to sound alarms," Nanos writes. Indeed. Yet, human tragedies continue to befall people with serious mental illness and their families at a record clip. I hope that this book will open eyes, ears, and hearts to their suffering, motivating action.--John Snook, J.D., Executive Director, Treatment Advocacy Center Breakdown: A Clinician's Experience in a Broken System of Emergency Psychiatry is yet another excellent example of our badly broken mental illness treatment system. The author, Lynn Nanos, is a psychiatric social worker within the Massachusetts state system which is one of the worst states. She clearly describes the failures of the system and consequent tragedies for the patients. I recommend her well-written book.--E. Fuller Torrey, M.D., Founder, Treatment Advocacy Center; Associate Director of Research, Stanley Medical Research Institute; Author, American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System; Author, The Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens
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About the Author
Lynn Nanos is a Licensed Independent Clinical Social Worker in her eleventh year as a full-time mobile emergency psychiatric clinician in Massachusetts. After graduating from Columbia University with a Master of Science in Social Work, she worked as an inpatient psychiatric social worker for approximately seven years. Nanos is an active member of the National Shattering Silence Coalition that advocates for the seriously mentally ill population. Nanos can be contacted through LynnNanos.com or by emailing her at breakdown@lynnnanos.com.
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Product details
Series: Serious Mental Illness, Psychosis, Reform (Book 1)
Paperback: 296 pages
Publisher: Lynn Nanos (October 6, 2018)
Language: English
ISBN-10: 0692168427
ISBN-13: 978-0692168424
Product Dimensions:
6 x 0.7 x 9 inches
Shipping Weight: 14.2 ounces (View shipping rates and policies)
Average Customer Review:
5.0 out of 5 stars
19 customer reviews
Amazon Best Sellers Rank:
#235,496 in Books (See Top 100 in Books)
Absolutely, positively one of the best books I’ve ever read about the mental health system and the people it affects so deeply, including the book’s author, a licensed, independent mobile emergency psychiatric clinician on the front lines where her decisions can literally mean life or death. Meticulously researched and strongly endorsed by some of the nation’s leading voices for the right to treatment, the writer’s compassion, courage and clear-eyed description of the people who desperately needed inpatient treatment, and the difficulty (or impossibility) of securing that treatment for some of the sickest, had me up all night. On the other hand, she also writes about some of the people (most often homeless and desperate for a warm bed) who try, and sometimes succeed, in getting admitted to inpatient treatment that they don’t need. But this author doesn’t stop with describing the problem. She’s also more than done her homework, citing well-researched and effective programs that, if expanded, could make a huge difference in the lives of people with severe and persistent mental illness, and in the lives of those who love, and/or care about them. If you wonder why, after half a century of deinstitutionalization, we have so many homeless, mentally ill people on the streets and in the jails of America, or if you already know, and want to know more about what needs to be done to reverse the tide, read this book.
I had a very personal interest in reading Breakdown, by Lynn Nanos, because I have a family member with schizophrenia. Along with many others, I have felt intensely frustrated with every aspect of the mental health care system, including hospitals and their staff. I needed to find out what she had to report from her own professional experiences as a mobile emergency psychiatric clinician, with the special skills and ability to orchestrate involuntary hospital admissions.The book is well written, heart-wrenching in many of the real patient stories. I could well imagine the author going home each night, still worrying about the safety and continuum of care (or lack of it) for those she evaluated each day. And in the current times we live in, with such a severe shortage of hospital beds in psychiatric wings, I was shocked to learn from her research that up to 12% of those admitted for emergency psychiatric care are what the mental health care industry calls “malingerers.â€These are folks who don’t fit the criteria for gravely ill when they are evaluated, but they work the system so they can gain admission and have a nice all-expenses paid mini-vacation in a hospital. This is also at the expense of so many desperate people who really do need the care, but there are no beds available for them. My own family member once spent five days in the E.R. at USC Medical Center, waiting for placement and continuing to deteriorate each passing day.Even more frustrating was the author’s confirmation from her own documentation, the frequency with which the hospitals discharge psychiatric patients before they are stable. This is just one of many ways in which the broken mental health care system actually encourages relapse and sabotages recovery for the most seriously mentally ill.On the up side, it was very comforting to know that there are such dedicated professionals like Ms. Nanos, working on behalf of those with little-to-no capacity to help themselves. An underlying theme in Breakdown also addresses the touchy issue of involuntary treatment. We live in a nation where many people maintain the myopic view point that a person has the right to be as psychotic as they want to be (until they harm someone.) Both inside and outside the mental health care industry, there are very powerful and vocal opponents of involuntary treatment because they claim that a person’s rights would be violated.The case studies and research done for Breakdown make it very clear that we need to intervene for those who don’t have the capacity to make rational, safe choices for themselves. A temporary suspension of personal “freedoms†may just save a life, or many lives, and actually provide enough treatment for a person to gain some insight and eventually experience a higher quality of life.A copy of Nanos’ book should be read by every mental health policy maker in the country. I recommend Breakdown to anyone who wants to understand more of the process and circumstances under which a seriously mentally ill person gets hospitalized, including those who are homeless or without family members to help them.
I have a family member who suffered jails, prisons, homelessness instead of continuous treatment for his mental illness. He died behind a dumpster, alone. He is why I became an advocate decades ago. Unfortunately, I know the tragic, unjust realities span our nation.THANK YOU LYNN NANOS!!! She bravely shares the realities our loved ones with serious mental illness suffer. They have been ignored and allowed to languish in their illnesses for decades. Major changes need to happen NOW!It is a great idea to share Breakdown with all your law and policy makers, law enforcement and advocates working to assist the seriously mentally ill.
Anyone interested in understanding the failures of America’s approaches to helping people with schizophrenia and other psychotic disorders should read Lynn Nanos’ superb book. Nanos’ years as a psychiatric social worker in Massachusetts give the reader an up close look at the lives impacted by misguided policies; her composite presentations of individuals struggling with untreated psychosis show us what horrors ‘human rights’ activists create when their ill-informed beliefs leave profoundly ill people ‘free’ to choose if they want treatment.Nanos’ book is also a carefully researched account of the impact of the psychiatric survivor movement and the overly empowered peer movement in blocking access to necessary services for people with psychotic disorders.I’ve been worried about trends in the education of social workers that seem to lead too many to undermine medically necessary treatments. Nanos’ solid knowledge about mental illnesses and wise use of her experiences helps us know that there are social workers doing the right things.This is an extremely valuable resource for anyone wanting to fix the US mental health system.
A heartbreaking, maddening look at why those who most need help are turned away. Lynn Nanos is to be commended for telling the real reasons those with severe mental illness are turned out to the streets, the jails and prisons, and the morgue. As the mother of a son with a severe mental illness, I highly recommend this book for those who cannot fathom why our loved ones don't get the treatment they need and deserve. Why day after day the news has stories of tragedy before treatment. Follow the money, eye opening. Thank you Lynn Nanos.
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