Sons, Daughters, and Sidewalk Psychotics

Sociologist Neil Gong explains why mental health treatment in Los Angeles rarely succeeds, for the rich, the poor, and everyone in between.   Drawing on the nuanced experiences of patients and care providers, Sons, Daughters, and Sidewalk Psychotics introduces readers to two drastically different forms of community psychiatric services: public safety net clinics focused on keeping people housed and out of jail and elite private care trying to push clients toward respectable futures. In downtown Los Angeles, many people in psychiatric crisis only receive help after experiencing homelessness or arrest. Public providers engage in guerrilla social work to secure housing and safety, but these programs are rarely able to deliver true rehabilitation for psychological distress and addiction. Patients are free to refuse treatment or use illegal drugs—so long as they do so away from public view. Across town in West LA or Malibu, wealthy people diagnosed with serious mental illness attend luxurious treatment centers. Programs may offer yoga and organic meals alongside personalized therapeutic treatments, but patients can feel trapped, as their families pay exorbitantly to surveil and “fix” them. Meanwhile, middle-class families—stymied by private insurers, unable to afford elite providers, and yet not poor enough to qualify for social services—struggle to find care at all. Examining this divergent treatment of people facing similar mental struggles, Gong raises provocative questions about urban policy, individual freedom, and what it would take to create a fundamentally different psychiatric system—one that will meet the needs of patients, their loved ones, and society at large.

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