The Shame of the States

The Shame of the States is an expose on the conditions of state mental hospitals in the 1940s, written by journalist and social activist Albert Deutsch. Deutsch, praised as a crusader, nevertheless wrote in the preface of this book that "the day of the individual crusader is over." Taking an historically informed approach, he called for a public reform movement as the only way to enact significant change of the state mental hospital system, emphasizing lack of state funding as the cause of the problems he witnessed (mainly the "twin diseases" of overcrowding and understaffing), and pointing towards a lack of public pressure on state representatives as the ultimate reason for the hospitals' limited budgets.

This book was originally published in 1948, after years of research by Deutsch on the history of public welfare, public care of the mentally ill, psychiatry, and public care of veterans in America, and after many other publications on those topics. Having worked the six years previous as a columnist for the New York Post, writing about public health, he was able to use many of his earlier experiences in visiting mental hospitals and speaking with key figures there as source material for this newest book. The book itself was anticipated by both the public health community and general public, as Deutsch's career as a journalist had made him relatively well-known.

The original publication, marked "first edition," was dedicated "to the sick and the sorrowing in the hope that the mists will be lifted and the shame erased." Deutsch also quoted The Philosophy of Insanity on the title page, an autobiographical text by a "Late Inmate of the Glasgow Royal Asylum for the Lunatics at Garnavel." The quote encapsulates one of Deutsch's main goals in writing The Shame of the States—that the public will come to understand that the mentally ill are no less human than themselves, and equally as deserving of basic dignities and care—and is as follows. "Lunacy, like the rain, falls upon the evil and the good; and although it must forever remain a fearful misfortune, yet there may be no more sin or shame in it than there is in an ague fit or a fever."

The Shame of the States was reprinted in 1973, as part of the Arno Press Collection ″Mental Illness and Social Policy: The American Experience.″ Tellingly, the editorial board chose to include this book over of any of Deutsch's other works on American psychiatry and health care.

In the introduction to this book, Dr. Karl A Menninger describes Deutsch as neither a doctor nor psychiatrist, but rather a "scientifically trained student and recorder of social conditions," who, as reporter, "knows how to describe vividly as well as accurately what he sees, and to interpret it in terms which the public understands." He further characterizes Deutsch as familiar with “practical politics,” and thus accurate in his assessment that the system can change if the public knew what was going on and expressed their concern to legislators. Deutsch’s goal in writing this book, he says, is to break the “conspiracy of silence”—to “inform the public and to make the public care.”

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