March 29, 2006

New Book: Crazy: A Father's Search Through America's Mental Health Madness

There is a new book written by a parent who has stuggled with the mental healthcare system (and as is too commonly the case, also the criminal justice system) in the US.

The book is titled: Crazy: A Father's Search Through America's Mental Health Madness. its written by Pete Earley. Highly Recommended reading for any advocate of the mentally ill.

A brief description of the book is as follows:

Pete Earley had no idea. He'd been a journalist for over thirty years, and the author of several award-winning nonfiction books about crime and punishment and society. Yet he'd always been on the outside looking in. He had no idea what it was like to be on the inside looking out until his son, Mike, was declared mentally ill, and Earley was thrown headlong into the maze of contradictions, disparities, and catch-22s that is America's mental health system.

The more Earley researched, the more he uncovered the bigger picture: Our nation's prisons have become our new mental hospitals. Crazy tells two stories. The first is his son's. The second describes what Earley learned during a yearlong investigation inside the Miami-Dade County jail, where he was given complete, unrestricted access. There, and in the surrounding community, he shadowed inmates and patients; interviewed correctional officers, public defenders, prosecutors, judges, mental-health professionals, and the police; talked with parents, siblings, and spouses; consulted historians, civil rights lawyers, and legislators.

The result is both a remarkable piece of investigative journalism, and a wake-up call-a portrait that could serve as a snapshot of any community in America

Following is a short excerpt of the book:

"A mental-health revolution has occurred in the United States. In 1955, some 560,000 Americans were patients in state mental hospitals. If you took the patient-per-capita ratio in 1955 and extrapolated it out to today, you'd expect to find 930,000 patients in mental hospitals. But there are fewer than 55,000. Where are the others?

More than 300,000 are in jails and prisons. Another half million are on court-ordered probation. The largest public facilities for the mentally ill are jails and prisons. They have become our new asylums.

To find out why, I went to Miami. I chose that city for two reasons. I didn't want to risk irritating local officials in Fairfax by writing about the jail system here, as they would be in charge of deciding Mike's fate. Also, I had been told that Miami has a higher percentage of mentally ill residents than any other big US city. Three percent of the population in most American cities is mentally ill; in Miami, the figure is 9 percent.

In addition to the usual 3 percent, 3 percent come to Miami for the warm weather, and another 3 percent arrived thanks to Fidel Castro. In 1980, Castro released patients from Cuba's mental hospitals into the stream of refugees fleeing to Florida from the port of Mariel.

Miami has been struggling to deal with its mentally ill. Its jail system is the nation's fourth largest. Sixteen percent of its inmates have severe mental disorders. The craziest are housed on the downtown jail's ninth floor in the "suicide watch" cells with plexiglass front walls so officers can watch them.

Dr. Joseph Poitier, the psychiatrist at the Miami jail, took me on his morning rounds. As we entered C wing, I gagged. The air smelled of urine, perspiration, excrement, blood, and discarded food. Prisoners hacked, coughed, groaned. Correctional officers yelled commands. Leg chains clanked as prisoners arrived.

A lot of it was typical jail noises. When I listened more closely, I heard asylum sounds: a prisoner sobbing, another moaning, a third screaming.

Thud, thud, thud. Then louder: THUD. THUD. THUD. An inmate was banging his forehead against a plexiglass cell front.

The inmates peering out in the first cells were naked. There was nothing in their cells except a combination sink and toilet. No chair, no place to sleep. The temperature in each cell hovered in the 60s.

Inmates trembled in the chilly air. A few rocked back and forth on their heels. Some had urinated and defecated on the floor. Most stood at their cell fronts looking out. They had blank expressions, hollow eyes.

"What I do here is triage," Dr. Poitier said.

There is no meaningful treatment, he said. As we moved from cell to cell, Poitier tried to persuade prisoners to take their medication. They had arrived on C wing with no medical records. Many were homeless. Most of their families had given up on them. Psychotic inmates could spend months there. Others would be released only to be arrested within hours on charges related to their illnesses, such as trespassing or being a public nuisance.

If they were charged with a felony, they would eventually be sent to one of Florida's three forensic hospitals. But there was a long waiting list, and even then they wouldn't be treated. Instead, they would be given medicine until they were judged "competent" for trial and returned to Miami. Sometimes it could take five or six trips between jail and hospital before they were stable enough to appear in court.

Dr. Poitier and I paused outside a cell designed for two men but holding six. A prisoner was lying on the floor next to a toilet that another was urinating in. Because the splash was hitting the inmate's face, Poitier asked a prisoner to rouse the man to make certain he was not dead. The inmate raised his head and rolled over.

As we were about to move on, I noticed movement under a steel bunk. Dropping to my knee, I peered through the plexiglass wall. A man was curled up - he had schizophrenia, which can cause hallucinations and confused thinking-and was chewing on orange peels. He smiled and waved.

I checked my watch after we finished the rounds. Dr. Poitier had spoken with or observed 92 inmates. His rounds had taken 19½ minutes.

"A lot of people think someone who is mentally ill is going to get help if they are put in jail," Dr. Poitier said. "But the truth is we don't help many people here. We can't."

You can read the full first chapter of the book on the Author's web site: Chapter 1 - Crazy: A Father's Search Through America's Mental Health Madness

Click on the following link to go to where you can order Crazy: A Father's Search Through America's Mental Health Madness. It will be available in April. We'll announce its availability.

More information on Schizophrenia, Crime, Poverty and Punishment

Other books on the problem of lack of treatment option available for the mentally ill, and how we are putting the mentally ill into jails:

The Northumberland Nightmare: When Justice Ignores Mental Illness

More Books on Schizophrenia and lack of treatment


I just read the first chapter on the website and I am in tears. This is MY son..... we are going through the exact same thing. When WILL the "professionals" realize that our mentally ill loved ones can not keep going through this......WHEN????

Posted by: rustysmom at March 31, 2006 03:12 PM

Can't believe its called "CRAZY" and this is why people with a mental health disability still have to put up with stigma and discrimination, its a shame and sad to see this type of wording still being used in society and to promote a persons personal life.
So so so so Disappointing!!!!

Posted by: Shannon Hawkins at April 6, 2006 12:40 AM

Thank you for putting your experiences in words I can relate to so well. Our family has been slammed up against the walls of this disease and systems put in place because of it. My husband and I have lived with the tortures of his mental illness since we were in our late teens. For 30 yrs. we've been given multiple diagnoses of bipolar, schizo-affective disorder and paranoid schizophrenia. I'm a 46 yr. old mom of four teens - now that's 'crazy'. Our family life is highly functioning. He is a great, loving husband/father, does very well on meds. with a cycle of relapse about every five yrs. Unfortunately, the latest setback was just four wks. ago and again I have considered that I could/should write my own book? Key tools for thriving in the wild ride this has been - good music helps, humor is a necessity, trying to stay as grounded as we can because life does go on. Look forward to hearing from others in this situation and will watch/look forward to getting a copy of your book asap. My thoughts are with you and your family . . .

Posted by: delfinium5 at April 9, 2006 10:35 AM

Regarding the title of the book - I saw a recent interview with the author and he had this to say about the criticism that the use of the word "Crazy" in the title was a bad idea:

The words "crazy" and "madness" are two very loaded terms in the mental health community. Why did you decide to use them in the title of your book?

Well, just your asking that shows that you know more about the mental health system than I did when [my publisher and I] made that choice. Actually, originally we were going to call the book "The Ninth Floor," but my editor felt that was too obtuse. So we came up with "Crazy" -- and the whole point was this idea that the system is crazy, it's broken, it's a mess. Since then, though, I've thought, Gee, it wasn't probably the best choice-- because some people find it offensive and don't look beyond that word, don't see that we're talking about the system.

Partly I'm a newcomer to this, and I didn't realize that some people find the term "the mentally ill" insulting, that it should be people with mental illnesses. But basically, I feel like I've spent three years of my life on this and my motives are pure. I have a son who is [in the mental health system] and this is an issue I care passionately about.

You make a point of repeating that mental illness can happen to anyone. Do you think people's fear of disease is responsible for some of the stigmatizing of people with severe mental illness that goes on in America?

Mental illnesses are so frightening and there's so much ignorance about them that I think it comforts people to think, Oh, well, it happens to these people because they deserve it. I've heard a lot of people, including prosecutors, say, Oh, that person's mentally ill but they got [that way] by taking drugs -- even though the National Institute of Mental Health says that's impossible. Those are the same rationalizations that have been used throughout history, from the time we first started recognizing that some people act differently. We want to blame the individual because we don't want to think it can happen to us. We want to think that the person who's ranting and raving on a street corner and living on the street somehow wants to be that way. That way we can justify walking by them and not caring and reaching out. A lot of what

Posted by: Sz Administrator at April 12, 2006 02:30 PM

My son is 32 yrs. old and have been trying to deal with this sickness for 8 yrs. now and am no closer to getting him help, since we reconizzed the problem. I love my son with all my heart!. Wish laws were different when it comes to chemical imbalances.

Posted by: Gail Hudson at April 17, 2006 10:07 AM


We have followed your career and read your books with the added pleasure of knowing that a former neighbor has "made it"! It was with sadness, however, that I learned just this morning on NPR that your son has Bi-Polar Disorder. We can unfortunately empathize with your plight as Scott is also Bi-polar. He was first hospitalized during college as well (ironically he was hospitalized on the evening of September 10, 2001...he awoke the following morning and wondered if it was he who had caused the World Trade Center towers to be attacked). He had experienced a terrifying psychotic episode that left us reeling and wondering if our son as we knew him would ever re-emerge. One advantge I had during this and future episodes was having a background in the mental health field; I was able to "talk the talk" and received (sadly) more respect than "just a parent". I also have a sister who is Bi-polar, so had been exposed to the mental health world as a family member as well. Thankfully Scott's brushes with the law were not so serious and we were able to help him get his life in order financially and legally. He has been stable for two years and is currently doing very well although my anxiety level is starting to rise since two years has been his pattern of stability followed by another episode. It may not pertain to you and Mike, but one thing I found out that was surprising was how the use of marijuana can lead to psychosis. Scott had been partying heavily during college and it appears this may have contribited to his first manic episode, and maybe the second on as well. I could go on and on, but you already know most of the story having lived it yourself. I have preordered your book and look forward to reading it. Thank you for bringing to light many of the problems our society faces in regards to dealing with people with chronic mental illness.

Connie Callison

Posted by: Connie Callison at April 17, 2006 12:31 PM

Mr. Earley - I heard you on the radio on Tuesday. I am working with the National Alliance on Mental Illness (NAMI). We need your voice to get out message! I am in Casselberry, FL, near Orlando and we are having a NAMIWalk for the Mind of America on May 6. Where do you live? We would love to have you join us! Can send more details.

Posted by: Sandy Phillips at April 19, 2006 01:16 PM

my brother has been sick for the last 2 years. though he is under medication ithe sickness gets relapsed. our family is devasted and helpless . as per the doctor'S PRESCIbtion he uses atidepressant medicines like trikotame and pimidetill last month he was normal but all of a sudden he started seeing visions and he cant sleep during the night.last year he got so violent that he nearly raised his hands at my mom. is there no complete cure for schizos???i love my brothert and i cant see him this way.. i would try my level best to help him out

Posted by: lucky at April 23, 2006 01:16 AM

I also have considered writing a book.Mine will be called NO PLACE FOR JONATHAN.

There is no place for Jonathan,my 21 year old mentally ill son.School,work,jail,,society,mental hospitals ?None of these places really want or accept him because of his illnes.He wants a job,a girlfriend and a friend.He can not obtain nor keep any of them.He is currently in jail because I took him to family DR for emergency treatment of his latest physcotic episode ( there have been several)and when the DR told him he was going to be forcibly commited to the hospital, he tried to escape.In the parking lot his out of control behaviour resulted in a criminal charge of disorderley conduct and resisting arrest.This in turn violated his parole.Now he sits in jail on a (sucide watch )the DR from jail appointed mental health services ordered. This is to continue for three weeks.Jonathan is on parole for borowing a car without permission ( theft over three hundred $).

I attempted to get the mental health service that is state approved to provide care for county inmates) to prescribe his medications.This has taken three weeks.Three weeks of his being punished,beaten and tormented by jail staff and other inmates.

I agree with the title of the book-CRAZY_because dealing with this ridiculous system while your child suffers so inhumanley is enough to make any "sane" person go CRAZY.

Posted by: brenda at July 14, 2006 10:58 PM

Sometimes I feel like our family is all alone however after reading these stories I realize others shear our pain.For 9 years we have tried to get our son stableized thru hosiptal stay's,doctors only now for him to face jail time.My heart is breaking ...for now I know not what to do.Crazy doesn't discribe it.Its much much more.

Posted by: susan at August 6, 2006 07:35 AM


Posted by: cyndibunch at January 31, 2007 05:23 PM

im a father like you son chris was dignost we add had and bipolar with ocpd.from time he was 6 years old. he has been in and out of the court systen and prison. he was sent off this past week for 2years again in prison,when he was first sent to prison they had him on his medication, we was told he could never function in socity and he got to prison he was tooken off his medicine. then released after 2 years, and has been in out of courts since, now he is sentenced again,and i know when he gets out again, he is going to be worse off than what he went in, i love my son very deeply and you being a father as well my heart goes out to your son,and its a shame that we live in.the united states of america,a country so rich but poor at heart,

Posted by: ronald at March 18, 2007 07:57 PM

"Thank You," for writing your book "Crazy" and especially your Son, for agreeing to help others. My Son is 42 and been diagnosed Bi-Polar 8 yrs.ago, after serviceing 14 yrs. in the Navy. From then it has been a Roller coaster ride for him and his family. At present he is staying in a Rescue Mission, close to a VA Medical Center and has been able to stay on his meds. for almost a year. Our struggle to get him help was much like yours and it came to a point that I had to let him go, as I couldn't help him. Several times we have not heard from him for months and then will find him in jail or a friend will see him in some town here on the West Coast. A letter over a year ago to make contact with us has opened the door to almost having my Son back, although he doesn't want to live near his home town or his family. We exchange letters and it is my hope and prayer that he can keep on his meds and can remain doing as well as it seems he is, at the present time.

Posted by: Charlene at April 21, 2007 10:33 AM

Thank you for your book. I was captivated and compelled to finish it in only a few sittings. I have come across many who deal with mental illness, and I suffer with depression that I often think is part of a low level bipolar illness as well. I do my best. I also work for ANAD - National Association of Anorexia Nervosa and Associated Disorders. Much like your son's illness, I deal with women and men who cannot receive validation for their illness on a continual basis. Eating Disorders are mental illnesses that affect a surprisingly LARGE segment of society, and yet they are still very invisible and not taken seriously. Many individuals cannot receive treatment due to insurance limitations and the lack of mental health parity laws in their state. Individuals are starving themselves to death and purging themselves to death and many onlookers blame only these individuals. They say their behavior is self induced and often just a phase of life...but much like with your son, how is it that these people are able to justify that those with eating disorders are responsible for something they cannot think clearly about. I have met many young women whose lives have been altered due to these ao-called "phases" that continued for years and years. I feel that our society is just passing the money around from one cause to another. If mental illness is at that forefront of legal issues for a segment of time, well, it will never fail; our society will next move onto the next hot topic. I guess the only constant is that we advocates will always have something to fight for....yet, this obviously brings NO solace. Bless you for gathering the knowledge to better understand your son's condition and bless you for putting your epiphanies on paper. You are not alone.

Posted by: Amanda at April 26, 2007 10:42 AM

My son was a college basketball player destined for a bright future. He ranked high in his college entrance tests, a bright boy. We called him a gentle giant. He was looked up to by many, yet he was so humble. Being famous for his athletic skills, he was approached by fans everywhere he went. He was congratulated for his talent daily.

He was visiting a foreign country when the phone call from him came. He was disoriented, confused and so far away. When I finally got him home, he was paranoid, afraid that we were being followed. He curled up in the back seat of my car all the way to hospital. It was a two hour drive.

That was eight years ago. Now my son is a stranger. I grieve our loss daily. My mommy guilt says if I were a good enough mother I could fix him. My children miss him. The shell is left, but my precious boy is gone. The bright future is dulled by the glare of our new reality. Now my daughters are afraid of him and my other son carries guilt that somehow he should have been a better brother and maybe, just maybe.... Would have, could have, should have. God bless us all who have this monster of mental illness on our shoulders.

Posted by: Lori at May 11, 2007 07:10 AM

Why can't we unite for change.....we need serious changes in the areas of mental health systems, legal systems and government run systems whom are making erratic decisions in regard to our loved ones lives.....why are jails the modern day answer to behavioral health issues rather than medical intervention???? we need to flood the airwaves and demand answers.......

Posted by: Nancy at August 15, 2007 07:23 AM

I'm so sad about my son schizophrenia paranoid he is 28 years old i want to help him with housing we live in miami florida but there is no help in this city.he can't live with me because his sister and my husband is afraid of him I'm so devastated I don't know what to do.

Posted by: isabel at October 9, 2007 01:47 PM

To: Pete Earley 11/3/07
I heard you speak yesterday at the Hilton, Mental Health Awards. I was going to see if I could get a chance to speak with you, but I figured that you were busy enough. I went through a lot of the things that you were sharing about your son. Eight years locked up, several hospitals stays "Involuntary, 2 P.C." That was before they closed the hospitals down. I'm working in the PROS Program now, not Clubhouse another Mental Health agency on long island. I would like to put together a book someday. Kind of been through a bit , 8 yrs. Max security, escape from state mental hospitals before it was easy to get out. Eventually learned how to control things and became a Credentialed Alcohol and Substance Abuse Counselor & Certified Relapse Prevention Specialist. Usually I don't tell people any more then they need to know and most don't suspect either the mental health part or the 8 yrs, 5 in Sing Sing and 3 in Clinton Dannemora. If you get a chance maybe we could talk. Hope you get this. John Dawson CASAC, CRPS

Posted by: John J. Dawson CASAC,CRPS at November 3, 2007 05:20 PM

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