Insane (Hardcover)

America's Criminal Treatment of Mental Illness

By Alisa Roth

Basic Books, 9780465094196, 320pp.

Publication Date: April 3, 2018

Other Editions of This Title:
Paperback (6/9/2020)

List Price: 28.00*
* Individual store prices may vary.


An urgent exposé of the mental health crisis in our courts, jails, and prisons

America has made mental illness a crime. Jails in New York, Los Angeles, and Chicago each house more people with mental illnesses than any hospital. As many as half of all people in America's jails and prisons have a psychiatric disorder. One in four fatal police shootings involves a person with such disorders.

In this revelatory book, journalist Alisa Roth goes deep inside the criminal justice system to show how and why it has become a warehouse where inmates are denied proper treatment, abused, and punished in ways that make them sicker.

Through intimate stories of people in the system and those trying to fix it, Roth reveals the hidden forces behind this crisis and suggests how a fairer and more humane approach might look. Insane is a galvanizing wake-up call for criminal justice reformers and anyone concerned about the plight of our most vulnerable.

About the Author

Alisa Roth is a former staff reporter for Marketplace and frequent contributor to various NPR programs. A Soros Justice Fellow, her work has also appeared in the New York Review of Books and New York Times. She lives in New York.

Praise For Insane: America's Criminal Treatment of Mental Illness

"This essential exposé, which includes tragic case histories, tells of legions of prisoners put in solitary confinement or subdued with medication...At the heart of the problem, Roth notes, is the changing landscape of mental-health care."—New Yorker

"Chilling...Roth writes movingly of the human toll of incarceration...She convincingly diagnoses the glaring inadequacies of mental health treatment in prison but she is not out for scapegoats...Insane is rife with sharp, brutal details that pull the reader beyond the realms of abstract policy debates."—New York Times Book Review

"50 percent of the mentally ill go untreated-half of them because they can't afford it...The place where the poor are likely to get treated, if anywhere, is prison...With an eye not toward shaming but toward progress, [Roth] gestures at solutions"—Los Angeles Review of Books

"Superb...Roth stresses America's failure to provide the vital community mental health services first promised in the Kennedy years...Some of the most revealing sections of Insane deal with the officers who patrol these wards...Burnout is inevitable."—New York Review of Books

"Alisa Roth's powerful new book...calls into question such simplistic solutions to the current crisis in our mental health-care system...Based on in-depth interviews and observations, the book provides revealing snapshots of conditions at New York City's Rikers Island, the Los Angeles County jail, and Chicago's Cook County jail, the nation's de facto three largest mental health-care providers."—Democracy Journal

"Alarming...Roth's exhaustively researched and well-told story makes it clear that many of the people who have the power to change this brutal system don't appear inclined to make those changes, and that's the true insanity."—San Antonio Express-News

"A searing exposé about the criminalization of mental
illness.... Though the subject matter dictates that much of the book is
relentlessly depressing, the author is such a talented information gatherer and
fluid stylist that the narrative becomes compulsive reading. An eye-opening
book that cries out for change."—Kirkus Reviews, starred review

"Deep, broad and well documented. Roth has provided an eye-opening book about mental health care in the U.S"—Missourian

"Roth strikes a powerful balance between big picture analysis and individual stories to make this searing account of America's misguided treatment of the mentally ill hard to ignore."—Publishers Weekly

"Powerful, heart-wrenching...A summons to action to correct a system that inflicts needless suffering on people in custody."—Times Free Press

"Alisa Roth lays bare the true costs of incarcerating, rather than attempting to help, our nation's mentally ill citizens.... Insane is a sobering and profoundly important read for any American with a conscience."—Heather Ann Thompson, Pulitzer Prize-winning author of, Blood in the Water: The Attica Prison Uprising of 1971 and its Legacy

"With heartbreaking stories of suffering, Alisa Roth shines a much-needed light on the crisis that afflicts the overwhelming number of mentally ill people locked away behind bars, where they are not treated but abused. This is essential reading for anyone who cares about how our country treats its most vulnerable citizens."—David Cole, national legal director of the ACLU, and author of Engines of Liberty: How Citizen Movements Succeed

Alisa Roth's Insane provides an anatomy of our troubled system of dealing with people with mental illness who commit crimes.... Extensively
researched and exquisitely written, Insane
is a must read for policymakers, mental health professionals, mental health
consumers and their families, and the general public."—Elyn R. Saks, author of The Center Cannot Hold

"Alisa Roth's Insane clearly and objectively lays out
the extent and history of our abandonment of the mentally ill while setting
forth thoughtful pathways forward.... This book should be
required reading for any person involved with the criminal justice system or
legislatures."—Thomas J. Dart, sheriff of Cook County, Illinois

"Alarming.... Roth's
exhaustively researched and well-told story makes it clear that many of the
people who have the power to change this brutal system don't appear inclined to
make those changes, and that's the true insanity."—San Antonio Express-News

Coverage from NPR