Patients’ plight is no joke

I read Dr. Henry Nasrallah’s editorial about the tragic consequences of deinstitutionalization (“Bring back the asylums?” From the Editor, Current Psychiatry, March 2008) with great enthusiasm.

Since 1981 I have devoted my career to treating chronic mentally ill individuals in community settings. For the past 6 years I have worked for a social service agency that provides on-site services to mentally ill tenants in permanent single-room occupancy housing. This agency serves approximately 1,500 tenants in several buildings. I have had intimate exposure to the experiences of individuals who a generation ago would have been placed in long-term institutions.

My private joke is that my agency runs the largest long-term psychiatric institution in New York state. However, over the past few years this no longer seems like a joke. Seeing the reality of these severely mentally ill persons’ lives—even in this protective setting of supervised housing run by an outstanding agency—is sobering and discouraging. What I see every day thoroughly supports and is living proof of the validity of Dr. Nasrallah’s editorial. It is a relief to have my thoughts validated because among community psychiatrists such thinking is viewed as heresy.

Alexis Brosen, MD
Clinical assistant professor of psychiatry
New York University School of Medicine
New York, NY

I read Dr. Henry Nasrallah’s editorial about the tragic consequences of deinstitutionalization (“Bring back the asylums?” From the Editor, Current Psychiatry, March 2008) with great enthusiasm.

Since 1981 I have devoted my career to treating chronic mentally ill individuals in community settings. For the past 6 years I have worked for a social service agency that provides on-site services to mentally ill tenants in permanent single-room occupancy housing. This agency serves approximately 1,500 tenants in several buildings. I have had intimate exposure to the experiences of individuals who a generation ago would have been placed in long-term institutions.

My private joke is that my agency runs the largest long-term psychiatric institution in New York state. However, over the past few years this no longer seems like a joke. Seeing the reality of these severely mentally ill persons’ lives—even in this protective setting of supervised housing run by an outstanding agency—is sobering and discouraging. What I see every day thoroughly supports and is living proof of the validity of Dr. Nasrallah’s editorial. It is a relief to have my thoughts validated because among community psychiatrists such thinking is viewed as heresy.

Alexis Brosen, MD
Clinical assistant professor of psychiatry
New York University School of Medicine
New York, NY

I read Dr. Henry Nasrallah’s editorial about the tragic consequences of deinstitutionalization (“Bring back the asylums?” From the Editor, Current Psychiatry, March 2008) with great enthusiasm.

Since 1981 I have devoted my career to treating chronic mentally ill individuals in community settings. For the past 6 years I have worked for a social service agency that provides on-site services to mentally ill tenants in permanent single-room occupancy housing. This agency serves approximately 1,500 tenants in several buildings. I have had intimate exposure to the experiences of individuals who a generation ago would have been placed in long-term institutions.

My private joke is that my agency runs the largest long-term psychiatric institution in New York state. However, over the past few years this no longer seems like a joke. Seeing the reality of these severely mentally ill persons’ lives—even in this protective setting of supervised housing run by an outstanding agency—is sobering and discouraging. What I see every day thoroughly supports and is living proof of the validity of Dr. Nasrallah’s editorial. It is a relief to have my thoughts validated because among community psychiatrists such thinking is viewed as heresy.

Alexis Brosen, MD
Clinical assistant professor of psychiatry
New York University School of Medicine
New York, NY