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The Unspeakeasy With Meghan Daum

Should We Bring Back Asylums? with Dr. Sally Satel

The Unspeakeasy With Meghan Daum

Meghan Daum

Society & Culture

4.8784 Ratings

🗓️ 11 November 2025

⏱️ 85 minutes

🧾️ Download transcript

Summary

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.

Transcript

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0:00.0

Los Angeles County Jail is like the biggest mental institution in the country.

0:05.1

And Rikers, I think, is second.

0:07.3

And then the home and then the streets are, you know, maybe third.

0:10.7

And then there are the scarce hospital beds.

0:14.9

But I was always, you know, interested in what called the neo-asylum movement.

0:20.1

Bring back the asylums for heaven's

0:21.7

sakes. Now we have medication, so they would not necessarily be a lifelong residence for some

0:28.3

people, but they might be for years. There's just a minority. It is a minority of these folks

0:34.8

who just don't respond.

0:45.0

Welcome to the Unspeak-Easy podcast.

0:49.6

I'm your host, Megan Dow, and this is the podcast formerly known as the unspeakable,

0:51.7

but it is now the Unspeak-Easy.

0:57.7

Before I introduce this week's guest, Dr. Sally Sattel, a couple of announcements. The first is that I'm teaching a writing workshop early next year. Time to do one again.

1:04.5

This is on Zoom. It's in personal essay and memoir, and it's running for eight consecutive

1:10.4

Tuesdays, January 6th through

1:12.9

February 24th from 3 to 5 p.m. Eastern time. The way these work, they're small, not a lot of

1:19.8

students, but you get a lot out of it. I have many repeat customers, so get your application in. The deadline is December 5th, and you can get all the

1:31.1

info by going to the substack post that is linked in the show notes. You can also find that

1:35.8

at the Unspeakable podcast. That's the Substack link. What else? I should tell you that dates

1:41.1

for our 2026 unspeakasy retreats have been announced.

1:45.7

We've got one in the spring in Los Angeles and several on the East Coast in the fall,

1:51.6

including a three-night women's writing retreat and a two-night co-ed big retreat in the Hudson Valley.

...

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