The Atlantic’s May Cover Story: “American Madness”

Jonathan Rosen writes about his childhood best friend’s schizophrenic break, and America’s ongoing failure to help the mentally ill

The Atlantic's May 2023 Cover

Thousands of Americans with severe mental illness have been failed by a dysfunctional system. The writer Jonathan Rosen’s childhood best friend Michael Laudor, who developed schizophrenia in his early 20s, was one of them. Twenty-five years ago, he killed the person he loved most.

In “American Madness,” appearing as the cover story of the May issue of The Atlantic, Rosen writes about the extraordinary turned tragic trajectory of Michael’s life and illness, and makes a broader argument that how we treat people with severe mental illness in this country must change.

Exclusively adapted from his forthcoming book The Best Minds (Penguin Press), Rosen captures his relationship with the larger-than-life Michael as they grew up together outside New York City in the 1970s, and his terrible sorrow as Michael’s illness overtook him. After applying to the top seven law schools, all of which he said accepted him, Michael suffered a psychotic break and wound up in the hospital. He stayed there for eight months before leaving for a halfway house, where he struggled to maintain his grip on reality. Despite this, Michael still attended Yale Law School, where he awed his professors and classmates with his intellect even while having to manage active delusions that convinced him that his room was on fire and that cannibals were out to eat him. After an article in The New York Times made Michael famous for both his brilliance and his mental illness, Michael landed multimillion-dollar book and movie deals to tell his life story. Brad Pitt was going to play him.

But Michael went off his medications, and no one could compel him to go back on them or to check into the hospital, even as his psychotic delusions got worse. When his pregnant fiancée tried to talk him into going back on his medications, he became convinced that she was an alien and brutally killed her. His family had been frantically scrambling to try to help him, but a regime of laws and policies that make it nearly impossible to commit the mentally ill prevented them from doing so in time. Rosen writes, “Delusions were no more a justification for forced medication than refusing medication was a justification for forced hospitalization. The only question was whether Michael was violent.” And those who watched over Michael and Carrie didn’t see him as violent.

More broadly, Michael is a stand-in for the thousands of Americans with severe mental illness who are still being failed by a dysfunctional system. Rosen writes, “Because he was very sick and did not always know it, Michael had refused the psychiatric care that his family and friends desperately wanted for him but could not get. Michael needed a version of what New York City Mayor Eric Adams called for in November, when announcing an initiative to assess homeless individuals so incapacitated by severe mental illness that they cannot recognize their own impairment or meet basic survival needs—even if that means bringing them to a hospital for evaluation against their will … The people Adams is trying to help have been failed by the same legal and psychiatric systems that failed Michael. They all came of age amid the wreckage of deinstitutionalization.”

In deinstitutionalizing treatment for the severely mentally ill without replacing the old asylums with adequate forms of care, Rosen argues that America has failed the mentally ill and their families––not to mention the victims of people like Michael, who in their unmedicated psychosis become violent, dangerous to others and to themselves. As the former executive director of The National Alliance on Mental Illness puts it to Rose, the problem is a system that forces families to “sit and watch someone they love deteriorate, unable to get them help until they are dangerous.” He writes that the programs such as the ones being proposed by Adams and Gavin Newsom in California that make it easier to compel the severely mentally ill into treatment will reduce stigma. It will also keep people alive.

American Madness” is published today at The Atlantic. Please reach out with any questions or requests to interview Rosen about his reporting.

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