The history and politics of community mental health

This is an elementary account of nervous anatomy and physiology and their relation to psychology. The author is a physicist and his somewhat external view of neuroscience is stimulating if sometimes over simple. He describes current theories of controversial subjects such as memory fairly and without too much dogmatism. Biologists will already be familiar with most of what he has to say but may be stimulated by his brief accounts of the relevance for neuroscience of some of the strange ideas produced by physical theory. He leans towards developments of the idea that a "microworld of ceaselessly moving molecules provides fluctuations which, in the case of very delicately poised chaotic systems, are sufficient to intrude on the world of large-scale phenomena". This sort of thinking is obviously tempting for dualists, but the author is careful to avoid committing himself. His discussion of the problems presented by the complexity of the nervous system is interesting but inconclusive. He tells us that "every one of the uncertainties decreed by contemporary science [read 'physics'!] plays a distinctive role in accounting for the phenomenon of consciousness". Nevertheless, "On the question of what biological or other equipment is necessary for the experience of consciousness ... we still have few clues". Murray Levine's book attempts to provide a political history of the community mental health movement in the United States, based almost exclusively on secondary sources, and concentrating on the events of the past two decades. His book is an interpretative essay rather than a detailed narrative account, and as Levine admits at the outset, "may contain more moralizing than many readers will find warranted, or even seemly" (p. 10). Its intended audience is made up of graduate students in psychology, nursing, social work, and public administration, as well as those already working in the field. The book begins rather unpromisingly with two chapters surveying the care of the mentally ill in the United States since the early eighteenth century, and the involvement of the Federal government in mental health matters prior to the Kennedy administration and the passage of the Community Mental Health Centers Act. References to the "zeitgeist of change", "a general air of reform", and ideas whose time had (or had not) come (pp. 5-6) scarcely inspire confidence in the penetration of the analysis that is to come, and although Professor Levine has read much of the relevant secondary literature, he is clearly …