View source for Voluntary Madness: My Year Lost and Found in the Loony Bin by Norah Vincent

{{infobox1 
|title= Voluntary Madness: My Year Lost and Found in the Loony Bin
|author= Norah Vincent
|reviewer= Nikki Edwards
|genre=Lifestyle 
|summary= A quirky, behind-the-scenes look at what life is like for the patients of the American mental healthcare system.
|rating=3.5 
|buy= Maybe
|borrow= Yes
|pages=304 
|publisher= Vintage
|date= January 2010
|isbn=978-0099513438  
|cover=0099513439
|aznuk=0099513439
|aznus=0670019712
}}

''Voluntary Madness'' is journalist Norah Vincent's account of her visits to three mental health facilities in America. The first is an urban, public hospital that houses mainly homeless, psychotic patients, many of whom are addicted to drugs. In this hospital, the doctors are overworked and jaded and medication is always the answer. Soon, the author finds that her latent depression (which led her to do the book in the first place) is returning. The process of being institutionalised breaks her sense of self-worth down astonishingly fast. Indeed, she suggests that it is the lack of autonomy in institutional life, even for those patients who voluntarily commit themselves, that makes it so hard for them to rebuild independent lives when they finally leave the institution.

The second place Vincent visits is a private, rural clinic that caters principally to middle-class depressives and addicts. Here, she is given more autonomy - the freedom to make snacks and take regular breaks for fresh air. Her wrist isn't tagged and she has a room of her own. It's interesting to see how these small concessions to humanity have an effect on her state of mind but, overall, her experience still seems to be that sitting around with a load of whining, self-indulgent depressives is counter-productive.

The third place Vincent stays is a more progressive facility, keen on individualised therapy as well as exercise and arts and crafts. It is here that the author has her most positive experience. Allowed her own room in a shared apartment and able to make her own meals, she finds herself in a stable environment where she is allowed to get well on her own terms, with personalised support. Even here though, there are more stories of failure than success. Even with the best facilities and caring doctors, most of the patients Vincent encounters have patterns of destructive behaviour that go back many years and most of them don't have much left in their shattered lives to help them to sustain any progress they ''do'' make whilst in hospital. 

You might think that this sounds like a pretty bleak read but there's actually a lot of humour in these pages. Vincent tries not to pity herself, in spite of her depression, and she doesn't let her fellow patients get off lightly either. The people she meets are sometimes kind, sometimes downtrodden, but they can also be irritating and self-obsessed. They aren't objects of pity in this story and, overall, the book is a light, entertaining read, which full of lively characters.

I really have to give the author credit for the way she has put so much of herself into this book. America's oversubscribed, underfunded public hospitals are an easy target if you're looking for an exposé and Vincent admits that she came to the project with an axe to grind, but the end result of her book is a lot more introspective. Her immersive approach to her subject matter allows a lot of insight that wouldn't be possible with a more traditional, objective style of journalism and this is what makes her book work.

It's might not be groundbreaking to say that the way we treat mental health is deeply flawed but the issue is still worth exploring. Vincent provides little in the way of concrete answers but that is perhaps to be expected. ''Voluntary Madness'' is a very personal account of what it's like to be committed - the privations, the challenges and, sometimes, the benefits - so if you're interested in mental health issues, it's worth a read.

I'd like to thank the publishers for sending a copy to The Bookbag. 

If this book appeals then you might also appreciate [[Who Is It That Can Tell Me Who I Am? by Jane Haynes]].

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[[Category:Politics and Society]]