Former Washington Post reporter Pete Earley had written extensively about the criminal justice system. But it was only when his own son-in the throes of a manic episode-broke into a neighbor's house that he learned what happens to mentally ill people who break a law.
This is the Earley family's compelling story, a troubling look at bureaucratic apathy and the countless thousands who suffer confinement instead of care, brutal conditions instead of treatment, in the "revolving doors" between hospital and jail. With mass deinstitutionalization, large numbers of state mental patients are homeless or in jail-an experience little better than the horrors of a century ago. Earley takes us directly into that experience-and into that of a father and award-winning journalist trying to fight for a better way.
Pete Earley is a storyteller who has penned 13 books including the New York Times bestseller The Hot House and the 2007 Pulitzer Prize finalist Crazy: A Father’s Search Through America’s Mental Health Madness. After a 14-year career in journalism, including six years at The Washington Post, Pete became a full-time author with a commitment to expose the stories that entertain and surprise. His honest reporting and compelling writing helped him garner success as one of few authors with ”the power to introduce new ideas and give them currency,” according to Washingtonian magazine. When Pete’s life was turned upside down by the events recounted in his book Crazy, he joined the National Alliance of Mental Illness to advocate for strong mental health reform on the public stage.
I recently read and reviewed a book similar to this one - about America's incarceration of large numbers of mentally ill individuals. Insane: America's Criminal Treatment of Mental Illness by Alisa Roth. My review: https://reviewsbybarbsaffer.blogspot....
In this book, 'Crazy: A Father's Search Through America's Mental Health Madness', Pete Earley writes about different prisons than Roth, but the basic story is similar. People with mental problems - such as bipolar disorder, schizophrenia, schizoaffective disorder; depression; etc. - can't (or don't, or won't) get appropriate treatments and end up in jail, sometimes for relatively minor offenses.
Author Pete Earley
Then, because the accused are 'not fit' to stand trial; or can't deal with their circumstances; or are horribly mistreated in prison, they stay incarcerated for WAY too long, and often emerge sicker than when they went in.
Earley 'follows' several mentally ill people who were arrested, and documents their progress (or lack thereof) in and out of prison. All of the stories are compelling.....and none of them end well.
Both Roth's and Earley's books emphasize how difficult it is to make any changes in the system, no matter how hard (well-intentioned) people try.
Because the books are similar, I'm not going to write an extensive review of this one. I do, however, want to mention a couple of issues Earley addresses.
- Earley clearly illustrates the struggle to make mentally ill people 'competent' to stand trial. Jail inmates who are considered 'incompetent' are sent to hospitals where they're medicated and 'taught' the basic lessons of jurisprudence: what a trial is; what a prosecutor does; what a defense attorney does; what a jury is; and so on.
Once they're 'competent', the prisoners are sent back to stand trial. Often, the sick people will stop taking their medications and - if they trial doesn't take place very quickly - will forget the lessons. They're then sent back to the hospital.....and a vicious circle ensues.
- Earley also writes about a difficult situation in his own family. Earley's son Michael succumbed to bipolar disorder in college, when he was legally an adult. Earley took his son to the hospital and tried to get him treated, but doctors couldn't medicate Michael without his consent - and Michael didn't think he was ill.
Pete Earley and his son Michael
During a psychotic phase Michael broke into an expensive home, trashed it, and took a bath. The homeowners were furious and frightened - worried that Michael might return when they were home and do who knows what.
Thus the house's residents wanted Michael put on trial (and sent to jail) while Michael's father - who thought his son was a victim of bad laws - wanted the boy treated. The resulting drama went on for many months, with each side being unsympathetic to the viewpoint of the other.
In fact Michael was repeatedly taken to doctors and given prescriptions for anti-psychotics, but it was an uphill battle to convince him to keep taking them.....as is the case with many mentally ill individuals.
Earley's story about Michael is gripping....as well as being instructional for people in a similar situation.
Pete Earley and his son Michael help raise money for mental illness
I'd highly recommend this book to people interested in mental illness and the justice system, and to people who have a mentally ill individual in their family.
When I heard that my city was going to read this book (One Book, One Community), gosh, I got all excited. People with chronic mental illness suffer so much, and are so poorly understood, and their options are so pitifully few: I thought Earley's book would be a great way for people to learn more about the problems they face. Unfortunately, I was less than a chapter in before I wanted to take Pete Earley and shake him until his teeth rattled.
Basically, Earley's problem is this: he is too close to the problem to have the slightest objectivity about the legal or medical issues involved. To Pete Earley, every person with mental illness is his son Mike (who suffers from schizo-affective disorder, and won't take his meds.) Mike breaks into a family's home, pees on the carpet, bathes in the daughter's bathtub, and is arrested. Earley goes to "apologize" to the family - and by "apologize," I mean "talk them into dropping charges." He drips contempt for the mother of the family, who was terrified by the home invasion and is extremely frightened that Mike may repeat the offense, perhaps with violence, a fear that Earley mocks as trivial - "Mike had no history of violence." (Yes, and no history of home invasions, either, until this happened.) Hello, Mr. Earley? This family has now been victimized twice by your family: once by a guy who has the excuse of suffering from a major mental illness, and once, IN PRINT, by his father, who has no excuse whatsoever for treating a crime victim with so little compassion. Earley's solution to Mike's problems is simple: Mike should be remanded to his custody, and Pete should be allowed to force Mike to take his meds.
There are so many problems with this book, I don't even know where to begin. Earley wants law enforcement to be able to compel the mentally ill to take medications, and doesn't seem even slightly interested in the enormous civil rights issues this policy would raise. By Pete's admission, Mike has already been diagnosed (by different doctors) with three separate major mental illnesses (a situation that is extremely common) - should he be treated for diagnosis A, diagnosis B, or all three? Are we really going to say that the mentally ill don't get any say over their treatment? Wait, let me offer an example. A small one. A tiny example of WHAT CAN GO WRONG with relying on a system that has barely scratched the surface of adequate treatment for diseases of the brain.
I personally know a young woman who was hospitalized for depression due to a reaction to her medication. The reaction passed fairly rapidly, but the staff didn't believe her. One day, while eating breakfast, she picked up a packet marked "butter," and checked the ingredients, none of which had any relationship to dairy animals. She laughed and said aloud, "This butter has never even met milk!" and holding her "butter" to her milk glass, said, "Butter, meet milk." A nurse overheard her, and basing her diagnosis on a joke she didn't get, told the psychiatrist that the patient was psychotic - she talks to food! Without any further information, the doctor was immediately ready to prescribe her a heavy-duty anti-psychotic, one that frequently causes permanent neurological damage. The patient was 15.
So, really, Pete Earley? We should trust families and psychiatrists enough to strip people of their civil rights? I cannot agree.
Earley does bring to light some of the devastating effects of mental illnesses on families and on society. So that's good. He rightly points out the tragic lack of public resources available to treat victims of these much-misunderstood illnesses, and some of the obstacles they face in trying to live lives of worth and dignity. It would have been a whole lot better if he could have grappled honestly with the legal dilemmas posed by mental illness - or if he had retained a thread of objectivity.
A sad, sad investigation into the mental health system that is charged with serving one of the most destitute populations in the United States - the mentally ill. He brings a nice mixture of historical context, personal story, and investigative journalism together to create a powerful narrative. I am both personally and professionally interested in the topic since I am a Clinical Social Worker that works with the population he targets in the book. One note: he is a big proponent of providing treatment to mentally ill people even against their will when they are psychotic because they are not thinking clearly and will benefit from the decision in the long-run. While I love the book, this does a slight disservice to the people who actually have to decide in the moment what constitutes psychosis, clarity of thought, intent to harm self/others, and generally bizarre behavior. It also assumes that everyone gets better with treatment. I found myself in an interesting position when reading this book. I understood and have experienced the breaks in the system that he was talking about and investigating; and yet, I cannot wholeheartedly buy into the changes he is advocating, at least not on the full scale. I have made decisions to have someone "helped" against his/her will, and I have allowed people to remain the community who were clearly not able to care themselves or others. All I can say is, it is definitely not as clear-cut as this book would have it be. There are so many gradations of "sick" and "well." Do we commit people with a history of mental illness who stop taking their medication? When do we commit them? What if medication never works? Should they be held in a hospital forever? Or some other environment? This book is a necessary and important resource in beginning the conversation, but I believe it can also go much deeper than what is found in this book. Having said all that, I urge everyone to read it. It provides a real and informational view into the history of the US mental health system, and the pain that accompanies people who have mental health problems and their families. Sorry this is so long.
For such a keenly personal story, Earley's writing is very dry and not compelling. He is first and foremost a journalist so maybe that's to be expected. When I heard of this title, I didn't know it presented two dovetailing stories: one family's struggle to treat a bipolar son, and the full-scale institutional disorder of a state penitentiary used to hold and treat the mentally ill after they've committed a crime. In the absence of a compassionate hospital system that offers treatment early on before it's too late, that has become our nation's strategy for "care."
3 stars out of 5. Mental illness is not something to be romanticized, and I applaud Earley for writing with the intent to spur social change. Our nation's mental health system is awful. And yet this book still flirts with the sensational, often making mental illness seem dramatic and exciting. The facts presented and the thesis argued are 5 star materials, but the presentation falls flat and works against itself.
Contrary to a negative review you might read at "goodreads," if you have anyone close to you suffering with mental illness, I would highly recommend this book. It was recommended to me by a police officer who was greatly helped in thinking through this tragic issue. And the author, Pete Early is not "too close to the issue" to be objective - it is a very helpful expose of problems on many sides of what the subtitle rightly labels, "America's Mental Health Madness."
Under the over-corrective guise of civil liberties and personal rights - genuine and true concerns, there is now a protocol and system that ties the hands of physicians, psychiatrists, family members and workers in the dangerously small field of mental health so that loved ones impaired and traumatized by admitted irrationality and psychosis cannot be helped - they can only be quarantined temporarily (often with virtually no real care, just "warehousing"), at best - but very quickly released to the streets - unless, they commit a crime, which many do; then they can hang a while in a jail cell - all the while, unmedicated, untreated - possibly transferred to a mental health institution, where they still have to agree to any medication - nothing can ever be "forced" - unless of course, their psychosis drives them to harmful resistance or threatening actions. Thus you have this revolving game of "mental chairs" (a play on 'musical chairs') where people we love are shuffled round and round through jails, relatives homes who are naive enough, or foolish enough - or brave enough to house them for a while, then on the street, then back in jail, then maybe in a psych-ward. Sometimes helped a little, but the cycle repeating itself ad-nauseam - and accidents, suicide, abuse, homelessness, drug addiction, rape - all these good ends - rather than help in a hospital or care facility trained to persevere in this difficult, overwhelming work.
There are no easy answers. But this book not only informs you of some of the bleak realities in the messed up system that prevails currently, it ends up identifying a few substantive helps that we may be able to continue to refine and develop to help those trapped in delusional worlds.
The common mistake of over-correction to past evils in abusive and coercive asylums has now put us in a situation where there is very little that can be done for those suffering with mental illnesses. It's a heart-breaking book; it's real - it matches much of what I have seen in dealing with this tragic reality in our families (my wife's and mine), it lacks a spiritual perspective - I knew that going into it - but not all who are "spiritual" have sound answers either. Christ hasn't promised to heal all our diseases, regardless of their makeup in the complex matrix of psychosomatic origins or causes.
This book is an accurate testimony to the teaching of Scripture (though the author is not intending this) that we live in a cursed and broken world. There are no guarantees. We cry and work as hard as we can to help the people we love. We thank God for every good thing we enjoy, while we have it to enjoy - and we seek to truly love others, seeking what is best for them - even if they dislike it or us at the time, we do it for their good.
Read the book, especially if you have someone you love suffering from diagnosed bi-polar disease, depression, schizophrenia, or the mix of schizoaffective disorder - or whatever other labels they come up with. Let this information fuel your pursuit of greater understanding and I hope that widespread concern leads to more compassionate and sensible care for those who really don't think they have much of a problem.
As a psychiatrist reading this book, I feel ashamed. I'm ashamed I can't help people because the laws prevent it, and ashamed I have to tell family members that I can do nothing for their loved one who is an adult and has the right to refuse treatment that could treat his or her illness. That's when I can talk to family members; most of the time I can't because of HIPAA. If we took just a few days of funds from the war in Iraq and put them into our nation's mental health system, think of the lives that could be saved. Instead we put the mentally ill in jails or leave them on the streets, and chuckle to our friends when we see somebody acting in an odd or bizarre fashion. But by the grace of god it could be you.
Pete Earley's writing is earnest and intelligent, and remains unbiased when writing about the mental health system. I appreciate that he clearly indicates when the book is about his son versus reporting, because the parts regarding his son are emotional and biased by his experiences, as they should be. I learned about the history and restrctions of the mental health system in the United States and plan to learn more about it. Kudos to Mr. Earley, both for exploring his feelings as a parent, and as a reporter for finding out why the system failed his son and so many others.
Wow!This book opened another world for me, the world of mental illness. I never knew for one that mental illness can begin during periods of stress such as that experienced graduating from high school or college. I never knew that legislation can protect an individual's rights to the point that parents can not get help for their mentally ill young adults. Basically if a schizophrenic is in denial of his disease, he can refuse medication or treatment, even if his actions may land him in prison. There are too many parents suffering as they are forced to watch their children descend into hell. When those suffering from mental illness are hauled off to prison, they do not get treatment. They may be seperated from the rest of the prison population and placed in inhumane conditions due to lack of medical staff and programs.
Prisons have become warehouses for all society deems unsightly,our marginalized and oppressed people. It seems anyone we don't want to see or care about is now imprisoned. Prisons are privatized, helping the rich get richer while more people become poor. We (society) behave as the insane and we need to stop the madness.
As a mental health provider, I agree with the idea behind Kendra’s Law, although I have never seen it in practice. Unfortunately mental health care is dictated by insurance not by physician or treatment team recommendations. Our team has seen our share of revolving door syndrome as described in this book. Many members of our community express surprise that mental health care is not mandatory and that a violent act, either to self or others, is “required” for a hospital admission. And then, three or four days inpatient is not enough time to determine if medication adjustments are effective.
The material in the book is outdated but there is enough food for thought to make it a worthwhile read.
What is the fate of a mentally ill person in the United States today? Is treatment and “cure” a matter of luck involving caring families, insurance coverage, a reasonable justice system, and intelligent physicians? Journalist Pete Early’s introduction to the mental illness morass occurs when his son, Mike, became mentally ill and went on a destructive rampage which added criminal and legal issues to further complicate an already complicated and difficult situation. Determined to understand his son’s illness, recovery, legal rights, etc., the author investigates the state of the mentally ill in the United States which results in this incredible narrative of the treatment and punishment of the mentally ill today. This subject is largely ignored until a family member or friend becomes mentally ill and then it impacts everything one does or thinks regarding mental health issues. This is a powerful book that enables the serious reader to begin to understand this complicated issue from the perspective of all actors- the individual, family and friends, lawyers, judges, police, victims, advocates, etc. I am delighted that this book was selected for my reading group as the discussion will be spirited.
Not at all a bad overview of the politics of mental health, and specifically moving factions of patients' rights vs. families' right to get a person labeled incapable of making medical decisions for themselves, as well as where we physically put the chronically (and criminally) mentally ill in this country. Earley is extremely thorough... to the point where I thought, perhaps, he'd made this same point (deinstitutionalization ultimately hurt far more people than it helped, we have no viable replacement of social services in place) persuasively a hundred pages ago. But if you're interested in investigating every angle of that through four different, if somewhat repetitive, case studies, this book is great.
My main gripe is the author's attempt to balance memoir with investigative journalism: the story of his own son, a young man deemed an adult by our legal system who was charged with felonies committed while he was very sick (despite his family trying desperately to get him help), is featured as a sort of prologue, epilogue, and a few intercalary chapters along the way. While the story is humanizing and it's nice to have all the details of a complete case study, it ultimately isn't effective as memoir. We see Earley's interaction with the system mainly in hindsight, rather than really feeling we're experiencing the story in real time with him. And the narrative has no conclusion. Again, I get that this is a form/content thing where maybe you could justify the fact that the story doesn't have a satisfying ending because mental illness is for life, and being stable or functional for 30 years doesn't guarantee being ok tomorrow. But I need some sort of closure. Call me a selfish reader.
1. An author that cannot resist referring to people with mental illness as "mentally ill," "deranged," "crazy" and even, once, "loony" should not be writing books about people with mental illness.
2. Bipolar did, schizophrenia and schizo-affective disorder are not the only three mental illness in the world, despite what the author appears to believe.
3. Anti psychotics can help "80%" of people with mental illness? I find it hard to believe that a full 80% of people with mental illness experience psychosis at all. Where is the author getting these numbers from?
And that's just scratching the surface of all that's wrong with this book, which alternates between describing the terrible things that happens to people with mental illness when they're forcibly treated or hospitalised with rants arguing that pretty much all people with mental illness ought to be forcibly medicated and hospitalized. Brilliant.
Very informative and eye opening read regarding our mental health system (or lack there of). A must read for anyone who has been touched by mental illness, but one that would be great for anyone to read.
What an absolutely chilling expose of the mental health treatment system in our affluent country. Or should I say "non-treatment system"? Shameful. Tragically, hundreds of thousands of mentally ill people are out on the streets, not receiving treatment thanks to deinstitutionalization. And the ACLU can take much of the "credit" for this.
Earley's pain comes through in his writing, but he has also managed to distance himself enough to present a well-researched and thoughtful book which educates its readers.
Not only are many of those who are chronically mentally ill in denial as to their disease, so too are our society and the healthcare system in denial.
As another reviewer said, the REAL crime was when we stopped helping the mentally ill, under the guise of protecting their civil rights by turning them out of mental hospitals. Not that those "warehouses" are the answer, but neither is prison or living in a gutter.
A tough but incredibly impactful book to read. I appreciated how much of the book was centered around the lives and stories of people afflicted by mental illness; it was a humanistic and empathy-rendering approach to a population that is either neglected or demeaned AT BEST. The author exposed how we need to rethink literally everything we’ve thought since deinstitutionalization. He left us with the feeling that there is a path forward, but it’s so so hard to see.
A decent summary of the recent history of America's wonky mental healthcare system. I think his general conclusions and recommendations (more police mental health training, reinstatement of long-term facilities, reexamination of commitment laws) are quite solid and would be a good step... However, although I generally agree with everything he says, I also feel a slight unease with agreeing wholeheartedly because I think he misses just a bit of the nuance (especially moral) of these recommendations.
Idk don't want to get too deep into this here but the definition of what constitutes mental illness comes to mind-- yes, you can be just a "little" psychotic, so where do you draw the line between someone who can think for themselves and someone who truly needs forcible treatment? When is it permissible to take away someone's right to decide for themselves whether they want treatment ("treatment," if you will), and who gets the right to decide? I literally have no recommendations myself because I feel like it's SO case-by-case, and you can tell that Earley has a more criminal/civil journalism background & not so much psychology because of his unwavering faith in psychiatry; personally (idk is this an unpopular view?) I think psychiatry has done so much good but also it's kind of fucked, and to give psychiatrists the power to make such substantial legal decisions..... I still feel like that could be abused and we'd need to make extreme scientific breakthroughs, significant cultural shifts AND move away from DSM worship to make that work blahblah ok I gotta shut up
I also have issues with his treatment of the idea of public stigma of the mentally ill, & he's a bit too normative for me (i.e. clearly thinks it's bad to be mentally ill (hint hint it would be a bit less bad if society at large stopped thinking it was bad)) ummm idk I feel like this isn't the stuff for a goodreads review and I should just write my own book instead of polluting the internet with my crap haha. Anyway this stuff gets extremely philosophical if you examine the issues to any satisfactory depth (what is it to be "normal"? what are human rights? is there really an ideal way to live?) and my issue is that Earley didn't dig deep enough. But for educating the general public and raising awareness of the arrestingly dark reality people affected by severe mental illness can and do live (very very good things) this book is great!
oh and the homeowner lady literally PISSED ME OFF so much UGHHH
Pretty good account of the sorry state of mental-health care in this country. Much of the backstory will be familiar to anyone was has been paying the slightest attention to the daily drumbeat of crazy people stories in the news. But it does a good job giving an overview of how we came to this pass in this country while at the same time personalizing the reality of the stories through interviews and the plight of his own son. It is a generally discouraging and not very hopeless tale. Yet the author's sympathy so is clearly for the mental health sufferers and not their victims that it actually becomes somewhat irritating at times, especially in his own son's case. He constantly compares mental disease with physical but seems to forget that the mentally ill often commit horrific crimes that naturally erode sympathy for them among their victims. The book describes the history of the how situation evolved over decades and the reality of the broken system is well-supported through data and the revolving-door stories. The journalistic efforts of Pete Earley are really the strength of 'Crazy' as he interviews the diseased themselves, family members, health-care workers, prison guards, doctors, lawyers, and advocates in an effort to present an entire picture of this huge and complex issue. Is the book 'dated' being written around 2006? Well, Atlantic magazine had a piece in May 2021 that I just read that essentially reiterated nearly everything that Pete Earley said in this book, so no not much has changed. 3.5 stars rounded down.
I had to read this book for my literature class, and usually I don't include books that I was pushed into reading, but because I enjoyed and was thoroughly educated by this book, Crazy, I decided to include it. The books covers several aspects of what is wrong with the US mental health system, and learning about patients with bipolar disorder and schizophrenia and schizoaffective disorder really opened my eyes to these kinds of people. Throughout the book, Pete Earley would talk about his own son's development through his mental illness, so I as the reader could see Earley not just as a reporter, but as a father, which made me empathize for him more. It's been around 10 years since this book has been published, and I am very anxious if anything has changed about how the mentally ill are treated, because the way the book lays it out in prisons makes me want to act for those patients. This book isn't just laying out facts for you like some creative nonfiction books would, it has personality and character and makes you understand the people that are involved in the overall story. If you're ever curious about mental illness, I would direct this book to you.
I'm so glad I stuck with this book, which was at times difficult because of my busy week and the huge amount of details and historical references in the book. However, it was an in debt exposure of mental illness in America-a country with the most advanced healthcare system, and resources, yet the mentally ill are chronically left homeless and untreated. Through his research he discovered the deinstitutionalization in the 80s continues to plague our country, leaving chronic and severe mentally ill people without any options. Medicaid cuts, lack of any state hospitals or treatment centers had created a jail system bulging with unnecessary inmates, often healthy people when on proper medication. The greatest part of the book was identifying the prevalence of mental illness. His college bound sound struck with schizophrenia in his 20s was his primary example. How the stories in our country are of disgust and we think the ill are personally to blaim for an organic brain disorder. Truly informative book I hope to keep with me.
I picked up this book to gain further insight on a project I am working on. Immediately, I found myself engrossed not only by the author's story of him and his son, but by how people like his son have been failed by the system over and over again. I have a better understanding on the complexities and challenges facing the mentally ill, and like with any truly great book, I am left motivated to develop my understanding further. Lastly, as someone in recovery from addiction/substance use disorder, I often found myself drawing parallels between treatment, the system, and being housed in places never intended to help people like me. I recommend this book and would go so far as to hope to one day see it as required reading. The ending was incredible and logical and well spoken. Mahalo for this book!
Having worked and lived with people who have a mental illness, I loved this book. I'm not sure that people realize the insane bang-your-head-against-the-wall situation that is finding healthcare/legal assistance for people in need. And how to do it in a way that doesn't strip people of their dignity and their rights. How many people are in prisons right now because they have no control over what is happening inside their brain? Put in another context, would you punish someone for having cancer? And yet repeatedly, funds for assistance and care of mentally ill adults are cut out of budgets , stripped until there is nothing left. And then what? This is a story about a father who starts to investigate all of this as he learns his own son has an illness. I recommend it very highly.
I can't remember how I heard of this book, but I put it on hold at the library, started reading it last night, and haven't been able to put it down. It's not just a good book for those who know and love people who are taking medication for mental illness. For me it's been a huge eye-opener of how huge numbers of the mentally ill are in jails rather than institutions because so many closed down between the 60's and the 80's. This book clearly illustrates how broken the system is and has been for a long time. The title is perfect...CRAZY.
One of the scariest books I've read in a long time - but defintely worth the time. It is sad that our society chooses to turn its back on the mentally ill. Though some are criminals, many are not - they are wanderers that cannot get the help they need because they lack the ability to do it for themselves, their families cannot, or because the facilities don't exist. Those that have committed crimes may have done so because the legal and political systems were not (and still aren't) in place to provide the care that might have prevented the incident in the first place.
This book probably would have been long enough as an article. While the author is absolutely right that jails aren't the right way to house and treat the severely mentally ill, the more stories he shared undermined his premise that 80% could be permanently rehabilitated like his son. Information about CIT squads on police teams was great, but I would have appreciated more push to change laws for early intervention in cases of breakdowns. However, this is a good spot to start.
Read this book for school, but really enjoyed it. Pete writes from his personal experience of dealing with his son’s mental illness, but his journalism background brings so much to us. This really opened my eyes & changed my perspective on the mentally ill. A lesson everyone should remember is that no one chooses to have an illness, be kinder.
Right now I do not think I can say anything about this book that will do it justice. However, I can say it was an amazing, sobering, upsetting book and when the sting of it is not so fresh, I will discuss it.
“Three simple truths. The first and second were intertwined. Nothing in life is guaranteed. And much in life isn’t fair. (and …) Mental illness is a cruel disease. No one knows whom it might strike or why. There is no known cure. It lasts forever.” – Pete Earley, Author
Rating: 4 stars for drawing America's attention to an interaction of mental health and social infrastructure that is epidemically toxic in nature.
“Crazy” is not the kind of book that you can read and then just walk away from. It’s the kind of thing that haunts you afterwards, and not in a bad way, but still because of the badness and the sadness that is written about inside it.
I’d first heard about this book when I was in my Issues in Mental Health class last semester, because my friend and classmate had done a report on it. We swapped books and neither of us read them until recently. Once I started though, it was hard to put down. “Crazy” is a two part creation. On one hand, you have the personal narrative of the author’s experience with his son, who suffers a mental breakdown and is diagnosed with first bipolar disorder, then schizoaffective disorder. Earley (the author) efficiently puts a face and a personal twist on the experience and trauma that is mental illness. Many times, when you think about the person on the street corner or “that one” that you know, it’s easy to think about them in black and white terms. It’s easy to be repulsed by their appearance, their behavior, their disease; the disease is all we see. The author illustrates in great detail the prejudicial nature of our society on a political, institutional, and personal scale that comes from only seeing the disease.
On the other hand, Earley writes from an investigative perspective – he is a news reporter, after all – on the state of our nation’s current institutional infrastructure and how we deal (or rather don’t deal) with mentally ill patients. If you think there isn’t a problem, then you definitely want to read this book. It used to be that the states used mental institutions (asylums) to intern and treat patients. Unfortunately a slew of abuses, civil rights cases, and financial issues in the 60’s – 70’s brought about a national deinstitutionalization (meaning the institutions were effectively cut off or shut down, and the mentally ill reintroduced into society). The jails and prisons then became the primary sources for housing the criminally mentally ill, and clinics other facilities were what dispensed pills.
The civil rights of the mentally ill, if you’re wondering, include the right to refuse treatment. That is what was fought for, and it is the policy that our nation inherited. Statutes that were meant to protect the welfare of our ill; unfortunately the reality is that many of those that were once in institutions getting treatment (not perfect, by my understanding, but treatment) are now living homeless, or are getting in trouble with the law and treated as criminals.
Our jails are the new institutions for the mentally ill, and Earley, by running a case study of Miami’s prison system, paints a stark reality that is certainly no benefit to the people it detains. Here, he describes the “C Wing” of the Miami Jail, which is dedicated to the mentally disturbed and suicidal individuals.
"The first six “suicide” cells each contained a combination sink and stainless-steel commode. They also held a bright blue hard-plastic bed that was built so prisoners could be strapped spread-eagled onto it. There were no sheets in these cells, no blankets, no pillows, no other creature comforts. …. A prisoner had nothing to do except sleep or watch the world outside the cell. The remaining thirteen … had thin mattresses, sheets and wool blankets. These cells had been built to hold two inmates, but on most days they held at least three and sometimes four prisoners crowded inside them. In those instances, two inmates claimed the bunks. The others sat and slept on the floor. … Tiny holes had been punched into the front of each cell front near the ceiling so the air could slip through. But after several inmates threw urine and feces through these airholes at employees, the openings were sealed. This trapped the frigid air inside, causing temperatures to dip into the low fifties in the cells. But even before these holes were closed , the cells had been kept colder than anywhere else in the building. Administrators claimed the freezing temperature reduced the spread of germs. But there was another reason. It was done to keep inmates huddled under their blankets. “That way they’re too D*** cold to cause any trouble,” an officer chuckled."
Policy and civil rights advocacy closed down the federal and state mental health institutions because of abuse, and inhumane conditions – a national scale problem. However, when I read about the jail conditions, and in fact the lifestyles of the mentally ill in our current society, I failed to see how what we have now is any improvement!
Earley does this really good job of putting a face on mental illness, and not just by telling his son’s story. He does it by shadowing individuals from various situations who ended up in jail or on the streets because of their condition. Highlighted throughout the book are questions that look like they should have obvious answers; things regarding how accountable a mentally ill person is if they committed a crime, or should someone who can’t think properly be entitled to refuse medication or treatment? There are others, but at times they get lost in the emotional tidal wave.
I’m not saying that “Crazy” is a book that relies solely on pulling heart strings – it’s not. There is some string pulling when Earley tells his own story, but it takes a very jaded and cold person to not be affected by just the facts of what our society is doing to these people.
When I finished this book, I felt a lot of things. I felt angry, because after so many years and so many cultural ‘advancements’ the mentally ill are still living in ways that seem subhuman, all for the name of civil liberties and saving money. I felt sad, because there doesn’t seem to be any rhyme or reason to these diseases – I hate the fact that people suffer in that way, and I hate that we can’t find a cure for these things. I felt fear, because of the (as Earley puts it,) “randomness” of mental illness. It could strike anyone I know; It could strike me. And worse, our society, our culture, our minds don’t really even know how to deal with that. We definitely don’t know how to separate the person from the disease.
This book is a powerful one. As I said, it’s not the kind of thing that you can just put down and walk away from the message once you’ve read it; you feel… accountable. As a counselor in training I’m glad to have done it, but it also highlights the enormity of what I’m trying to do by choosing this profession- you can’t cure mental illness, but I want to. You can’t create a perfect society or a perfect world, but I wish I could. You can’t evade confronting the worst in yourself, too, but I want to… because that came out in the last thing I felt – fear. But not of the illness or the randomness of it all; I felt fear of the people with the diseases… of the reality. And riding on that fear is a little bit of the aversion that makes us all refuse to make eye contact with the homeless man or woman on the street, the discomfort that comes from getting “too close” to them. It’s the worst in us, but if we can face it, deal with it, perhaps we can bring out the best.
“We lock up the mentally ill because they terrify us. We are afraid of them and even more frightened of what they symbolize. We want to believe they did something that caused their insanity. That is why we can justify housing them in inhumane conditions and punishing rather than treating them. The federal government says mental illness is a chemical imbalance, and because of that it’s a sickness … But deep down, we really don’t want to believe that’s true. Because if we did, we would have to admit: It could happen to us. It could happen to me.” – Pete Earley, Author
A must-read for anyone interested in the greatest human rights disaster in America today. Pete Earley, a former Washington Post reporter, chronicles the wasteland that is the American mental health system today. “Crazy” (the title refers to the system, not the people) is an incredibly well-researched book by a man with an admittedly very personal stake. Earley wrote the book after his son was arrested in the aftermath of a psychotic episode from his bipolar disorder.
There aren’t many glimmers of hope in this book. The author meticulously documents the dismantling of mental hospitals (deinstitutionalization) and the resulting shift of mentally ill people into prisons and homeless shelters. There’s a sad irony here: the first asylums were built after Dorothea Dix witnessed the horrors suffered by mentally ill people in prison. Today, in the twenty-first century, we have somehow regressed back to that horrific era. The largest mental health provider in America is the LA County jail.
Hope may be lacking in this book, but Earley at least makes a valiant stand for common-sense reforms: more community mental health resources, extra training (CIT) for police, relaxed commitment laws, and mental hospitals for severely chronically ill consumers. He also manages to convey respect and dignity for the people that he is writing about, which requires a measure of humanity and grace that not many observers of the mentally ill seem to possess.
Thought provoking on several fronts. The author builds the case that, while the issue is VERY complicated, there should be some mechanism for forcing schizoaffective individuals to receive treatment of some kind. Pete Earley seems to understand the controversial territory he has entered, and does a sound job approaching his position from all angles. The prison - the hospital - the street - the family - the advocacy group. While he obviously has a stake in this fight (his son Mike) I still got the sense that his journalism was honest - if not objective.
While I am still not sure what to think or feel about the variety of "solutions" proposed by the individuals in this book - I know that reading it has made me think differently about my interactions with people on the street. Reading Crazy made me a more thoughtful, empathetic person - and for that I am grateful.