Dr. Nasrallah’s observations are accurate for the vast number of patients with schizophrenia who are no longer housed in asylums. However, I hope that the solution is not to move backward.
Psychosocial treatments such as Assertive Community Treatment (ACT) are effective for alleviating the concerns Dr. Nasrallah raises, such as homelessness and poverty. ACT programs—which provide comprehensive, community-based psychiatric treatment, rehabilitation, and support for persons with serious and persistent mental illness—are associated with high patient satisfaction and lower costs. Some in the psychiatric community are not familiar with these evolving forms of therapy or are reluctant to embrace them. Likewise, clients do not know that these programs can make their lives better.
Instead of moving backward, let’s move forward to what professional ethics and research demands of us.
Walter Rush, MD
St. Paul, MN