Sara's Reviews > Danger to Self: On the Front Line with an ER Psychiatrist

Danger to Self by Paul R. Linde
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May 16, 11

Read in April, 2011

A well-written book that aspires to contextualize the emergency room procedures for the mentally ill in the legal and social issues they also involve. The narrative voice is clear and for someone who hasn't thought about the non-medical issues surrounding mental illness, this would operate as a decent primer. The chapters on the homeless alcoholic who refuses inpatient care, and the petty drug-dealer eager to con his way into inpatient care are probably the best in terms of offering a realistic picture of the limits involved in creating a viable support network for the mentally ill.

Still, the book was unsatisfying. Anyone in social work, anyone who knows someone with a severe mental illness, will have thought through almost all of the issues Linde brings up -- and in more detail than he does. Oddly missing from the book are portraits of the schizophrenics and acute manic depressives whose flair-ups are the psychiatric emergency room's bread and butter. In fact, this book has nothing to say about the long-term reality of mental illness. Linde keeps saying he's a "cowboy" in the psychiatric world, and if this is true, cowboys have a pretty easy life. Keeping someone from killing themselves in the first 36 hours of a crisis is a cakewalk compared to the daily ins and outs of dealing with mental illness.
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