Psychiatrist Dr. John A. Talbot championed the care of the mentally ill, especially the homeless and vulnerable. Many of them were forced to fend for themselves on the country's streets, libraries, bus terminals and prisons after the state's large-scale shutdown of psychiatric hospitals — he died on Nov. 29 at his home in Baltimore. He was 88 years old.
His wife, Susan Talbot, confirmed his death.
Dr. Talbot was an early supporter of the movement known as deinstitutionalization, which pushed to replace America's aging psychiatric hospitals with community-based treatment. But he became one of the movement's strongest critics after a lack of funding and political agendas left thousands of people with severe anxiety without proper care.
“People with chronic mental illness have had their lives and care moved from a single poor facility to multiple deplorable facilities,” Dr. Talbot said. I have written Published in the Journal of Hospital and Community Psychiatry in 1979.
Dr. Talbot held numerous leadership positions in his field during a career spanning more than 60 years. He was president of the American Psychiatric Association. He is the director of Dunlap Manhattan Psychiatric Hospital, a large urban psychiatric hospital on Wards Island. He is the chair of the psychiatry department at the University of Maryland, Baltimore. And he was also the editor of three prominent journals. It was the Psychiatric Quarterly, the Psychiatric Service, and the Journal of Neuropsychiatric Disorders, which he was editing at the time of his death.
Dr. Talbot was influential not only as a brain and neuropharmaceutical researcher, but also through his prolific writings, particularly as a hospital leader, scholar, and member of Blue Ribbon Commissions, including President Jimmy Carter's Mental Health Commission. It affected me. He was an astute and muscular debater who wrote, edited, and contributed to more than 50 books.
“I admired his appointment as president of Manhattan State Hospital and his belief that psychiatrists should not only have private practices on the Upper West Side but also take on the difficult tasks.” Dr. E. Fuller Torreythe prominent psychiatrist and founder of the Treatment Advocacy Center in Arlington, Virginia, said in an email.
In 1984, while Dr. Talbott was president, the American Psychiatric Association published its first report. major research Homeless mentally ill people. The study found that discharging patients from state hospitals into unprepared communities was a “grave social tragedy.”
“Most parts of the country, urban or rural, are filled with ragged, sick, hallucinating humans wandering the city streets, huddled in alleyways, sleeping on vents. It has not been able to escape its ubiquity,” the report said. It was estimated that up to 50 percent of homeless people have a chronic mental illness.
Six years ago, Dr. Talbot published a book called “Death of the Asylum,'' in which he excoriated both the broken system of state hospitals and the broken policies that replaced it.
In a 1984 interview with the New York Times, he acknowledged that psychiatrists (including himself) who had championed community-based treatment as an alternative to institutions were partly to blame.
“The psychiatrists who were involved in policy-making at the time certainly oversold community medicine, and I think our credibility today is probably hurt because of that,” he says. .
In a biography of Dr. Talbot published in a medical journal after his death, his former colleague Dr. Allen Francis wrote: It was more frustrating and disappointing. ”
Dr. Francis, chairman emeritus of Duke University's Department of Psychiatry and Behavioral Sciences, said in an interview that Dr. Talbot was a leader in the field of “community psychiatry,” which posits that mental illness is influenced by social context. It was felt that treatment should take into account the patient's living conditions and the range of services available, rather than just biological properties.
Community psychiatry was supposed to be an alternative for patients no longer housed in dilapidated and abusive state hospitals. A new generation of drugs promised to allow patients to live at least semi-independently.
“They were trying very hard to make psychiatry less cheap, less biological, less psychoanalytic, and more social and community-oriented,” Dr. Francis said, referring to Dr. Talbot and the community. He spoke about other people defending psychiatry.
However, the high hopes for enhanced outpatient care in the community were never fully realized. The Community Mental Health Act, a 1963 law championed by President John F. Kennedy, envisioned 2,000 community mental health centers by 1980. Less than half of the facilities had been opened by that time, as funding either did not materialize or was diverted elsewhere.
At the same time, deinstitutionalization reduced the number of patients in state hospitals by 75 percent from 560,000 in 1955 to less than 140,000 in 1980.
Dr. Talbot wrote in 1979, “This disaster has occurred because our mental health delivery system is not a system, but a nonsystem.”
John Andrew Talbot was born on November 8, 1935 in Boston. His mother, Mildred (Cherry) Talbot, 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, who he met during intermission at the Metropolitan Opera in New York and had a career as a nurse and hospital administrator.
In addition to his wife, Dr. Talbot is survived by two daughters, Sieglinde Peterson and Alexandra Morrell. He has six grandchildren. and his 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 Columbia University Center for Psychoanalytic Training and Research.
He was drafted during the Vietnam War and served as a captain in a medical unit in Vietnam in 1967 and 1968. He was awarded the Bronze Star for his work in convincing soldiers to take malaria drugs.
“The reason they didn't take them was because a case of malaria was their ticket home,” he later explained. “Then I gave them an example of what malaria could lead to and really scared them.”
After returning to Japan, Dr. Talbot actively participated in the anti-war movement. He served as a spokesperson for Vietnam Veterans Against the War at the 1968 Democratic National Convention in Chicago. The following year, he helped organize a protest at Manhattan's Riverside Church, where the names of soldiers killed in Vietnam were read aloud by a procession of speakers including Edward I. Koch, Leonard Bernstein, and Lauren Bacall. It was done.
After retiring in 2000 after 15 years as chair of the Department of Psychiatry at the University of Maryland, Dr. Talbot channeled his lifelong appreciation for fine cuisine by contributing to online gourmet sites. He started blogging in 2006, John Talbot's ParisIn it, he recorded the meals he ate during his frequent visits to the French capital.
