Voluntary Madness, By Norah Vincent

An American journalist, Norah Vincent made her name with her 2006 account of the year she spent living as a man, a project requiring her complete "immersion" in the experience. It also saw her locked up in a psychiatric ward by her own volition, after a nervous breakdown. Her time in the psych ward occasioned a second bout of "immersion journalism" and this, her second book, about her experiences. What she found was shocking, if not surprising.

Few things can be more terrifying than surrendering your freedom by voluntarily entering a psychiatric hospital. Vincent's bravery – or is it foolhardiness – takes her first to a public-sector institution called Meriwether, whose name she feels belies its misery and bleakness. Most "inmates", she says, are without medical insurance, are psychotic rather than "depressed", and claim to be the victims of childhood abuse or life on the streets. The staff, it seems to her, treat them contemptuously, and provide little therapeutic help but lots and lots of medication.

What a contrast to her next experience, in the private sector at the caring place that is St Luke's – which, incidentally, costs Vincent's insurance company the same amount of money as the first. Lovely surroundings, regular therapy sessions, caring staff and lots of food for the middle-class addicts who are the bulk of the patients – yet it's still not right.

Like a disturbed Goldilocks searching for the perfect bowl of porridge, it's not until Vincent comes across the alternative therapy project, Mobius, where the emphasis is on therapy, not medication, that she can rest easy.

As an indictment of modern ways of treating insanity, this book is superb. As an account of a woman's breakdown and self-discovery, it is insightful, poignant and hard-hitting, a natural inheritor of those classics, The Bell Jar, Prozac Nation and Girl, Interrupted.

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