(Critical Survey of Contemporary Fiction)

As the “me”-oriented 1980’s made Americans more narcissistic, a new growth industry capitalizing on fear, guilt, and paranoia happily accommodated them. This was the for-profit mental health care system. Liberally funded by insurance companies, the system filled beds through the use of “guerrilla marketing.” Potential patients were coerced into signing up by “specialists” whose only mission was to increase the roster of paying customers. Treatment continued for as long as the insurance benefits held out.

Abuses were rampant. The familiar 800-number crisis hotlines were connected not to some counseling organization, but to hospital admission offices where callers received high pressure sales pitches. Some individuals were literally kidnapped by these hospitals and subjected to such dubious treatment programs as “the chair,” a technique abandoned by the psychiatric community a half a century ago, in which the patient was strapped in a wooden chair for hours at a time.

All of this was accomplished with the cooperation of police departments, organizations such as Alcoholics Anonymous, school counselors, public hospital emergency room workers, and even clergy. Complicity with the fraudulent purveyors of mental health was good business. The hospitals paid generous bounties for information that would aid in patient recruiting.

Sharkey skillfully traces the conspiracy to its conclusion, to the point where the courts and the government began to take notice. BEDLAM is an infuriatingly good read, and, at a time when health care reform is on the minds of so many Americans, mighty poignant stuff.