"Anatomy of an Epidemic" Part 1: The central premise

I received my copy of Anatomy of an Epidemic by Robert Whitaker today. Over the coming weeks I will post selected facts and excerpts from the book, with a focus on the statistical results of the studies.

I'm only a few pages in, and the central premise of the book is so clear and in some ways the question seems so obvious that it makes me wonder why no one bothered to ask before:

Given this great advance in care [introduction of psychotropic drugs] we should expect that the number of disabled mentally ill in the United States, on a per-capita basis, would have declined over the past fifty years. We should also expect that the number of disabled mentally ill, on a per-capita basis, would have declined since the arrival in 1988 of Prozac and the other second-generation psychiatric drugs. We should see a two-step drop in disability rates. Instead, as the psychopharmacology revolution has unfolded, the number of disabled mentally ill in the United States has skyrocketed. Moreover, this increase in the number of disabled mentally ill has accelerated further since the introduction of Prozac and other second-generation psychiatric drugs. Most disturbing of all, this modern-day plague has now spread to the nations children.

-- Anatomy of an Epidemic by Robert Whitaker, page 3 (bold emphasis added)

In 1987, there were 1.25 million people receiving an SSI or SSDI payment because they were disabled by mental illness, or 1 in every 184 Americans.

-- Anatomy of an Epidemic by Robert Whitaker, page 6

The Food and Drug Administration approved Prozac in 1987, and over the next two decades the number of disabled mentally ill on the SSI and SSDI rolls soared to 3.97 million. In 2007, the disability rate was 1 in every 76 Americans. That's more than double the rate in 1987, and six times the rate in 1955.

-- Anatomy of an Epidemic by Robert Whitaker, page 7

I think I'm going to like this book.

What else in our society should we blame for mental illness? I think that it is likely that it is an effect of mass media: advertising telling us that we'd be happy if only we owned a Mercedes, TV telling us how we should look and talk, magazines telling is what is too fat or too thin and showing us beautiful freaks of nature that we can compare ourselves to, and on top of it all peer pressure to do the rest. But, mass media has been around since radio was invented. I'm not sure we can simply point to that and blame it for the acceleration in mental illness that we've seen. And certainly, if the drugs worked, then we should see a decline, at least in the second derivative, of mental illness cases as new drugs are introduced and as prescription rates soar.

We're not seeing that, so maybe it is something else...