BREAKDOWN: A CLINICIAN’S EXPERIENCE IN A BROKEN SYSTEM OF EMERGENCY PSYCHIATRY

Author: Lynn Nanos, L.I.C.S.W.

Publisher: Lynn Nanos

Published: 10.06.2018

Genre: Non-Fiction > Mental Health > Ethics & Professional Responsibilities > Schizophrenia

Page Count: 296 Pages

ISBN-10: 0692168427

ISBN-13: 978-0692168424

Purchase from Amazon, Barnes & Noble, Booktopia, Books-A-Million, Powell’s, Author’s Website,

My Rating: 5 STARS

Author’s Bio (From Author’s Website):

Lynn Nanos is a Licensed Independent Clinical Social Worker in her eleventh year as a full-time mobile emergency psychiatric clinician in Massachusetts. After graduating from Columbia University with a Master of Science in Social Work, she worked as an inpatient psychiatric social worker for approximately seven years. She is an active member of the National Shattering Silence Coalition that advocates for the seriously mentally ill population. She serves on its Interdepartmental Serious Mental Illness Coordinating Committee committee and co-chairs its Blog committee.

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Amazon Book Description:

When hospitals release seriously mentally ill patients too soon without outpatient follow-up, the patients can end up homeless, jailed, harming others, or even dead. When patients are deemed suitable for inpatient care, they can languish for weeks in hospital emergency departments before placements become available. Meanwhile, patients who fake the need for care are smoothly and swiftly moved to inpatient settings. Breakdown opens a dialogue with anyone interested in improving the system of care for the seriously mentally ill population. This book helps to answer questions such as:

Is inpatient care too inaccessible to those who need it most?

Do mental health professionals discriminate against mentally ill patients?

Are more stringent measures needed to ensure that patients take their medication?

Is borderline personality disorder too serious to be classified as just a personality disorder?

Using vignettes based on real interactions with patients, their families, police officers, and other mental health providers, Lynn Nanos shares her passion for helping this population. With more than twenty years of professional experience in the mental health field, her deep interest in helping people who don’t know how to request help is evident to readers.

A woman travels from Maine to Massachusetts because she was ordered by her voice, a spirit called “Crystal,” to make the trip.

A foul-smelling and oddly dressed man strolls barefooted into the office, unable to stop talking.

A man delivers insects to his neighbors’ homes to minimize the effects of poisonous toxins that he says exist in their homes.

Breakdown uses objective and dramatic accounts from the psychiatric trenches to appeal for simple and common-sense solutions to reform our dysfunctional system. This book will benefit anyone interested in seeing a glimpse of the broken mental health system way beyond the classroom. It can guide legislative officials, family members, mental health professionals, and law enforcement officers toward a better understanding of the system.

My Review of BREAKDOWN: A CLINICIAN’S EXPERIENCE IN A BROKEN SYSTEM OF EMERGENCY PSYCHIATRY by Licensed Independent Clinical Social Worker Lynn Nanos is going to be presented outside of my typical review style. To begin, I am going to write a personal note of accolades to the author:

Lynn, No one can read your book BREAKDOWN and not give this book a 5 Star Review, as well as applaud your knowledge and efforts from your experience, and the factual statistics and vignettes you provide throughout your book unless the reader is in denial. You expertly present your findings in a precise, chronological, and methodical style. Your book is written on a level that the average layperson, without a background in psychiatry, psychology, social work, et cetera, can comprehend. I commend you for your insight, concern, compassion, care, and empathy by writing this book to shine a light on that which has been covered-up and overlooked for far too long; when deinstitutionalization began, it led to severely mentally ill patients being released into mainstream society, thus resulting in a significant increase in homelessness, criminalization, and violence of today.

I have immense respect for you for testifying at the Boston State House in favor of a bill to implement Assisted Outpatient Treatment (AOT). I am appalled after reading your book and digesting the information regarding the number of seriously mentally ill persons that remain untreated living in the United States; this is not only disgraceful to the U.S., but it is also frightening. I would love to see you take your book along with your research to the Senate and testify on behalf of all the mentally ill in our country. An expense I know, but if you could find the means to provide all state Senators with a copy of BREAKDOWN, and pummel them with the data from your extensive research, I believe you could break through deaf ears. I understand you are fighting for Massachusetts, but when I read, “The criteria for meeting the legal definition of insanity vary from state to state,” I was aghast. The criteria, the treatment, the programs should be consistent throughout the United States, no exception. I was not shocked; however, to read “the commonality of a mentally ill patient being diagnosed by multiple psychiatrists with one mental illness and another psychiatrist changing the diagnosis.”

There have been many mental health professionals recommending that all of those involved in the mental health field read BREAKDOWN. However, I believe we have an epidemic, and your book should be read by state Senators and Representatives to pass bills to be mandated in all states, including the criteria for meeting the legal definition of insanity. Your book should also be read by laypersons to understand their responsibility in speaking out to prevent violence and killings that could be prevented. Things will not change until professionals such as yourself, and communities as a whole work to stop this epidemic. Of course, you will have to finesse the backing of The Department of Mental Health (DMH) and the National Alliance on Mental Illness (NAMI). I find it disturbing that these two organizations do not support adherence to psychiatric treatment. It must feel as if you are fighting a fight that cannot be won; however, after reading your book, I believe in your ability to push the critical information and data out to the masses.

As a prior Anti-terrorism/Force Protection Officer, I have to speak on behalf of the police officers that were charged at by the person with schizophrenia wielding a knife. Deadly Force should never be taken lightly, but when you cannot verbally stop someone coming at you with a knife or any other weapon with the intent of inflicting death or bodily harm to you or others, you, as the one charged in protecting life, are authorized to use deadly force when all other means to do so have failed. I do not believe these police officers had any other choice. However, having shared my opinion on this matter, I do think that we need to do a better job of training our law enforcement personnel in exercising more empathy. Helen Riess, MD, wrote a book titled The Empathy Effect: 7 Neuroscience-Based Keys for Transforming the Way We Live, Love, Work, and Connect Across Differences, and in my review, I recommended her book from the White House down to the family home. If you are interested, you can read my review of The Empathy Effect here.

Thank you again, Lynn, for writing a book filled with crucial information and data. I hope that those who read BREAKDOWN will be affected by the degree of demanding change and inciting a movement for those who have severe mental illness. I am going to share some excerpts from your book in hopes of inspiring more people to read BREAKDOWN. You are doing substantive work, and I applaud all that you have done and continue to do.

Excerpts from BREAKDOWN by Lynn Nanos, L.I.C.S.W.

“We memorialize Sandy Hook Elementary School every year.” – D.B. Moone

“Adam Lanza had killed his mother and then killed twenty children and six adults before killing himself.” “In September 2005, Adam had an emergency psychiatric evaluation at a hospital, but his mother refused to cooperate with the recommendation that he remain there for an additional evaluation by a hospital psychiatrist. He went home instead.” – Lynn Nanos

“Perhaps if his mother would have cooperated, she and twenty-six others would still be alive today.” – D.B. Moone

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“She knew he was on the unit, so I just supportively listened to her concerns. She told me that he had been increasingly distant from her over the past several months, despite her attempts to converse with him, When he did talk to her, she had difficulty understanding what he meant because he was so vague and refused to elaborate. He spent most of his days locked in his bedroom without any structure, occupational productivity, or social ties. Once in the past year, he had slapped her across the face, an action that seemed to her to be unprovoked…Shortly after this patient’s discharge, he used a knife to stab his mother to death.” Lynn Nanos

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“On July 20, 2012, James E. Holmes killed twelve people and injured seventy others at a movie theatre in Aurora, Colorado, while untreated for his mental illness.” – Lynn Nanos

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“On April 16, 2007, twenty-three-year-old Seung-Hui Cho, who was untreated for what probably was schizophrenia, killed thirty-two people and injured seventeen others at Virginia Polytechnic Institute and State University in Blacksburg, Virginia.” – Lynn Nanos

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“Andrew Goldstein, who had unmedicated schizophrenia, pushed Kendra Webdale in front of a subway train, killing her on January 3, 1999.” – Lynn Nanos

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“Research shows that 59 percent of one hundred eighty-five mass shootings in the United States from the years 1900 to 2017 were committed by either mentally ill people or those who showed signs of serious mental illness.” – Lynn Nanos

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“The National Institue of Mental Health estimates that in any one-year period, 40 percent of schizophrenic adults have not undergone treatment.” – Lynn Nanos

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“As of September 2016, researchers estimated that ten times more seriously mentally ill people were in jails and state prisons than in state psychiatric hospitals in the United States. When needed mental health treatment is insufficient or missing, a patient’s judgment declines. When judgment declines, the patient is more likely to commit a crime, intentionally or unintentionally, that leads to an arrest.” – Lynn Nanos

The excerpts provided here do not begin to cover the extensive information and data that Lynn Nanos delivers in her book BREAKDOWN, but my intent with what I’ve shared is to wake up the general populace to why innocent children and adults continue to be slaughtered by those who are mentally ill and unmedicated, and yet we lack the legislative laws to untie the professional’s hands to do anything about the loss of life at the hands of the mentally ill.

I implore those who read this review to share it, whether you reblog this post, tweet it, or share it to Facebook. However, what I would ask more is for you to purchase and read BREAKDOWN by Lynn Nanos, L.I.C.S.W., and then share her book with others. Advocate for mental health reform to tackle this epidemic.

As a last note, Nanos speaks to so much more in her book than the few excerpts I shared to get your attention. You will be shocked at the numbers, the obstacles, and the non-existent laws to keep the public, as well as the mentally ill, safe. I have never given a book my STRONGEST recommendation until now.

I went on the Treatment Advocacy Center’s website, and I was shocked by what I read there, along with the numbers provided regarding those with mental illness and the consequences of non-treatment. You read about some of the consequences in the excerpts from BREAKDOWN by Lynn Nanos, L.I.C.S.W. Read the book and then visit the Treatment Advocacy Center’s website. And then do something to help alleviate this epidemic.

Thank you, Lynn, for being persistent with me to read and review this long overdue and eye-opening book. I am optimistic that the comprehensive research you conducted that led to BREAKDOWN and all those affected by mental illness, whether it be parents, siblings, friends, et cetera, as well as the professionals that read your book will feel compelled to get involved and that your book will become the beginning to an ominous ending.