Dr. John A. Talbott, advocate for mental illness care, dies at 88

Dr. John A. Talbott was a psychiatrist who advocated for the care of vulnerable psychiatric patient populations, especially the homeless, who were among those left in the aftermath of the mass closures of state mental hospitals. Many people are forced to fend for themselves in the country’s streets, libraries, bus terminals and prisons. He died on November 29 at his home in Baltimore. He is 88 years old.

His wife, Susan Talbot, confirmed the news.

Dr. Talbot was an early supporter of the deinstitutionalization movement, which pushed to replace America’s dilapidated mental hospitals with community-based treatment. But due to a lack of funding and political will, thousands of deeply disturbed people were denied proper care, and he became one of the movement’s most powerful critics.

Dr. Talbot wrote in the Journal of Hospital and Community Psychiatry in 1979 that the chronically mentally ill patient’s life and care were moved from one bad institution to several bad institutions.

During a career spanning more than 60 years, Dr. Talbot held many leadership positions in his field. He is a past president of the American Psychiatric Association; director of the Dunlap Manhattan Psychiatric Center, a large urban psychiatric hospital on Wards Island; chairman of the Department of Psychiatry at the University of Maryland, Baltimore; and editor of three prominent journals: Psychiatric Quarterly , Psychiatric Services, and the Journal of Nervous and Psychiatric Disorders, which he was editing at the time of his death.

Dr. Talbott exerted influence not as a brain or neurodrug researcher but as a hospital leader, scholar, and member of Blue Ribbon Panels including President Jimmy Carter’s Council on Mental Health, especially through his prolific writings Influence. A clear and powerful debater, he has authored, edited or contributed to more than 50 books.

I admire his work as president of Manhattan State Hospital and believe that psychiatrists should have hard jobs and not just be in private practice on the Upper West Side, said Dr. E. Fuller Torrey, a prominent psychiatrist and treatment advocacy group founder of the Arlington, Virginia, center said in an email.

In 1984, during Dr. Talbots’s term as president, the American Psychiatric Association released the first major study of homeless mentally ill patients. Research has found that the practice of transferring patients from public hospitals to ill-prepared communities is a major social tragedy.

Whether urban or rural, few areas of the country have escaped the prevalence of ragged, sick and hallucinating people wandering city streets, huddled in alleys or sleeping on air vents. It is estimated that up to 50% of homeless people suffer from chronic mental illness.

Six years ago, Dr Talbot published a book, Death in the Shelter, which criticized the broken public hospital system and the policies that replaced them.

In a 1984 interview with The New York Times, he admitted that psychiatrists, including himself, who advocated community-based treatment as an alternative to institutional treatment were partly to blame.

He said community treatment must have been exaggerated by psychiatrists involved in policy development at the time, and our credibility today may be damaged as a result.

After Dr Talbot’s death, his former colleague Dr Alan Francis submitted an account of his career in a medical journal, which he wrote: “A frustrating and disappointing one.”

Dr. Francis, chairman emeritus of the Department of Psychiatry and Behavioral Sciences at Duke University, explained in an interview that Dr. Talbot has been a leader in the field of community psychiatry and believes that mental illness is not only influenced by social conditions, biological tendencies and all The treatment required takes into account the patient’s living conditions and the range of available services.

Community psychiatry was supposed to be an alternative for patients who were no longer locked up in shabby, often abusive public hospitals. A new generation of drugs promises to enable patients to live at least semi-independently.

Dr. Francis said of Dr. Talbot and others who supported community psychiatry that they were trying to make psychiatry less staid, biological, psychoanalytic and more socially and community-oriented.

But high hopes for robust outpatient treatment in community settings have never been fully realized. The Community Mental Health Act, a 1963 law championed by President John F. Kennedy, envisioned the creation of 2,000 community mental health centers by 1980. Less than half of the community mental health centers had opened by then, as funds failed to materialize or were diverted elsewhere.

At the same time, deinstitutionalization reduced the number of patients in state hospitals by 75%, from 560,000 in 1955 to less than 140,000 in 1980.

Dr. Talbot wrote in 1979 that this disaster occurred because our mental health delivery system was not a system but a non-system.

John Andrew Talbott was born on November 8, 1935 in Boston. His mother, Mildred Talbott (Cherry Talbott), was a homemaker. His father, Dr. John Harold Talbot, was a professor of medicine and editor of the Journal of the American Medical Association.

In 1961, Dr. Talbot married Susan Webster, a nurse and hospital administrator whom he met during a halftime performance at the Metropolitan Opera in New York.

Dr. Talbot, together with his wife, leaves two daughters: Sieglinde Peterson and Alexandra Morrel. six grandchildren; and a sister, Cherry Talbot.

He graduated from Harvard University in 1957 and received his MD from Columbia College of Physicians and Surgeons in 1961. He received further training at Columbia Presbyterian Hospital/New York State Psychiatric Institute and the Columbia University Center for Psychoanalytic Training and Research.

He was drafted into the Army during the Vietnam War, serving as a captain in the Vietnam Medical Corps in 1967 and 1968. He received a Bronze Star for persuading troops to take malaria medication.

He later explained that the reason they didn’t bring the drugs was that a malaria case was a ticket home. Then I showed them examples of what malaria could cause, and it freaked them out.

Once Dr. Talbot returned home, he became active in the antiwar movement. He was a spokesman for the Vietnam Veterans Against the War at the 1968 Democratic National Convention in Chicago. The next year, he helped organize a protest at Manhattan’s Riverside Church where a procession read aloud the names of soldiers killed in Vietnam, including Edward Koch, Leonard Bernstein and Lauren Bacall you.

Dr. Talbott, who retired in 2000 after 15 years as chair of the Department of Psychiatry at the University of Maryland, continued his lifelong love of food through his contributions to online food websites. In 2006, he started the blog John Talbotts Paris, where he documented the meals he ate during his frequent visits to the French capital.

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