Why is it so difficult to find meaningful help for the severely mentally ill, including those exhibiting patterns of violence? And why has this question become politicized?

Policy expert and practicing psychiatrist Dr. Sally Satel is not typically a fan of Donald Trump, but she agrees with the president's recent executive order on mental health policy. That order called for "shifting homeless individuals into long-term institutional settings for humane treatment through the appropriate use of civil commitment to restore public order." This issue, she says, should not be about politics but about getting both parties to grapple with the full dimensions of serious mental illness as it relates to public health. In this episode, we talk about what drew Sally to this field, why "harm reduction" can be a flimsy approach, and why we so desperately need more beds in psychiatric units. We also discuss last summer's horrific case in Charlotte, N.C., where a young woman was stabbed to death by a man whose mother had tried to have him committed for psychosis. Guest Bio: Sally Satel, M.D., a senior fellow at the American Enterprise Institute and a practicing psychiatrist and lecturer at the Yale University School of Medicine, examines mental health policy as well as political trends in medicine. Become a paying subscriber to The Unspeakeasy and get lots of perks, including access to monthly hangouts for Founding Members. https://www.theunspeakablepodcast.com/ I'm teaching a Zoom writing workshop in Memoir and Personal Essay, Jan 6 through Feb 24, 2026. Apply by Dec 5. https://www.theunspeakablepodcast.com/p/next-writing-course-starts-jan-6 The Unspeakeasy 2026 retreat schedule has been announced! https://theunspeakeasy.com/retreats Order my book, The Catastrophe Hour: Selected Essays, on Amazon or directly from the publisher https://www.nyrb.com/products/the-catastrophe-hour.

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