The Elder Statesman

Crazy
A father’s search through America’s mental health madness
By Peter Earley
G.P. Putnam’s Sons Publishers
Hardbound, $25.95

By BILL DUNCAN
The News-Review

Peter Earley, a Washington Post reporter and the author of seven non-fiction books and two novels, was probably like most Americans who felt mental illness was a medical disorder that was someone else’s problem. That is until he came face to face with the ugly reality when his son, Mike, was declared mentally ill.

In 30 years as a journalist the one thing he knew for certain was how to get to the bottom of any story, but he was totally unprepared for what he now found — a maze of contradictions, disparities and Catch-22s that is America’s mental health system.

In today’s budgeting crisis in Douglas County and its threats to the county’s mental health system, this may be one of the most important books in print. Earley gives this warning: "Our nation’s prisons have become our new mental hospitals."

From the beginning of "Crazy," Earley spins a moving narrative when he discovers that his son is bipolar. "Mike’s first psychotic breakdown occurred during his senior year at a university," he wrote. "I have since learned this is not an uncommon time for mental illness to strike young men and women because of the stress."

That information alone is worth the price of the book as we as a nation put more and more pressure on young people.

In the beginning of the book there is a poignant discussion between Earley, his son and a doctor from which this conversation ensues:

"Will you take medicines if I offer them to you?" the doctor asks.

"No," Mike said. "Can I leave now?"

"Yes," the doctor answer.

Earley pleads with the doctor, "My son’s bipolar, he’s off his meds, he has a history of psychotic behavior. You’ve got to do something. He’s sick. Help him, please."

The doctor replies: "Your son is an adult and while he is clearly acting odd, he has the right under law to refuse treatment."

That scenario more than likely happens hundreds of times in America — more than likely it happens right here in Douglas County.

I had read about bipolar disorder, but I didn’t realize that I had worked with a bipolar individual until I learned it was formerly called manic-depressive illness. I was on a year long newspaper assignment with this individual and endured his extreme mood swings. The symptoms are evident when the person feels extremely happy one minute and in the next minute extremely irritable and anxious. My colleague exhibited symptoms by talking too fast and too much, and having an unusual increase in energy and a reduced need for sleep.

I personally knew, he needed help.

What caused his radical behavior?

The symptoms of bipolar disorder are thought to be caused by an imbalance of key chemicals in the brain. The brain is made up of billions of nerve cells that move a constant stream of information from one cell to the other. To keep the information flowing, the cells release chemicals known as "neurotransmitters." Two key neurotransmitters that are needed for brain function are dopamine and serotonin, which play a crucial role in emotional health.

Many scientists believe too much dopamine in certain parts of the brain can cause symptoms such as delusions, while too little dopamine in other parts of the brain can cause symptoms such as a lack of emotion and energy.

In any case, it is an illness that requires treatment, but according to Earley’s research it is too often criminalized. Earley’s book is two fold. It is personal in that he explores the mental illness that literally destroyed his son and then reverts to the investigative reporter to write about the mental health crisis in America. "Crazy," has been called both "a remarkable piece of investigative journalism and a wake-up call.

Earley chose Miami, Florida for his in-depth probe because that city had a most unusual mental health problem after 1980 when Fidel Castro took President Jimmy Carter’s invitation that the United States would provide "an open heart and open arms to refugees seeking freedom from Communist domination." Castro emptied all the jails and mental hospitals in Cuba and sent 125,266 Cubans to the United States, some 90,000 whom remained in Miami. Earley spent a year inside the Miami-Dade County Jail as part of his investigation and gained the confidence and cooperation and unrestricted access from the authorities.

The results of his investigation include interviews with correctional officers, public defenders, prosecutors, judges, mental health care professionals and police. He also talked to parents, siblings, spouses and legislators, all compiled in a well written and documented book, one which actress Patty Duke describes as "a god send." Duke is the co-author of "A Brilliant Madness," with medical reporter Gloria Hochman, in which she discusses her bipolar disorder.

No story, not even one as serious as "Crazy," should end on a down beat. Earley’s ends with his son, Mike, recovered and employed, inviting him to a steak dinner. He is fretting over the fact that there would be no "living-happily-ever-after" on the last page.

His son detects the concern and says:

"You know what your problem is, Dad? You worry too much. Just eat your steak and enjoy this lovely day. Everything is going to work out fine for me, you’ll see. All the stuff that happened is in the past."

Earley knows deep in his heart that "mental illness is a cruel disease.

No one knows whom it might strike or why. There is no known cure. It lasts forever."

He concludes the book saying that for the moment he has his son back, but he knows Mike will "always be dancing on the edge of a cliff."

(Bill Duncan is the editor of The Senior Times. He also write a weekly column on the Opinion page of The News-Review every Thursday.)