Crazy: A Father’s Search Through America’s Mental Health Madness, published in 2006, is a blend of memoir and journalism by author and Washington Post journalist Pete Earley. The book was nominated for a Pulitzer Prize in 2007 and recounts the struggles of Earley’s son, Mike, to receive treatment for his mental illness, which results in Mike’s arrest. Earley juxtaposes Mike’s story with the stories of Miami residents with mental illnesses as they navigate life in and beyond the criminal justice system. The subjects’ stories are woven in with the stories of mental health professionals, advocates, and family members of adults with mental illnesses to show the wide-reaching effect that mental illness has on American society.

Content Warning: Both the source material and study guide deal extensively with themes of mental illness, suicide, drug use, homelessness, incarceration, police brutality, and ableism. There are also references to sexual assault/trafficking, miscarriage and abortion, and antisemitism.

Plot Summary

Earley prefaces the book by acknowledging that despite his decades of work as a journalist reporting on stories dealing with crime and society, he had no idea how difficult it was for people with mental illnesses to navigate complex medical, judicial, and support services. In addition, Earley spells out his intention to tell two stories in the book: his son’s and that of his yearlong investigation into people incarcerated in, and orbiting around, the Miami-Dade County Jail.

Mike’s mental illness begins with erratic behavior while he is attending college in Brooklyn. His family struggles to get him help: Because Mike is legally an adult, he must submit to psychiatric help and take his medication voluntarily. Despite treatment in a psychiatric facility and a diagnosis of bipolar disorder, Mike struggles to take his medication, convinced that his doctors are poisoning him. Eventually, Mike finds himself in serious legal trouble when, during a psychotic episode, he breaks into a stranger’s house. As Mike faces potential felonies, Earley tries his best to support his son but finds that, between the stigma against people with mental illnesses and the twisted nature of the criminal justice system, the road to Mike’s recovery will be far from easy. Mike’s lawyer and Earley battle to have his charges lessened to misdemeanors, but Mike struggles to find a steady job and manage his mental illness even after his day in court.

In Parts 1 and 2, Earley investigates the Miami-Dade County Pretrial Detention Center, where he meets the facility’s chief psychiatrist, Dr. Joseph Poitier. Earley also follows specific incarcerated individuals and community advocates. These include Judge Steven Leifman, a progressive reformer; Ted Jackson, an incarcerated man with bipolar disorder; Freddie Gilbert, an incarcerated man who is mute and has a severe mental illness; and two leaders of a local National Alliance for Mental Health chapter, Rachel Diaz and Judy Robinson, who run separate support groups for family members of people with mental illnesses while advocating for crisis intervention training (CIT) for Miami police officers.

Earley also gives an overview of the history of psychiatric treatment in the United States, particularly the beginning of state-run hospitals. The lack of oversight at these institutions brought about the creation of the National Institute for Mental Health (NIMH) in 1946 as well as deinstitutionalization in the 1960s—when hundreds of thousands of patients with mental illnesses were released, often without the community support they needed. This increased crime and homelessness. Earley juxtaposes this history with the story of Alice Ann Collyer, a woman with schizophrenia who is stuck in a cycle of waiting in jail to stand trial and hospitalization to allow her to stand said trial.

Throughout Parts 3 and 4, Earley meets with Judy Robinson and her son Jeff. He also visits Dr. Poitier on his rounds in the detention center, this time seeing more violent outbursts and interviewing the correctional officers who protect patients with mental illnesses. Gilbert, after months in intensive treatment, is finally recovering and almost unrecognizable. After his release, however, he ends up back on the streets and off his medication. Jackson, who is now out of jail, struggles to adjust to life outside while his behavior grows more erratic and paranoid. Earley also meets April Hernandez, a woman with schizoaffective disorder and a substance use disorder who gives in to her boyfriend’s idea that she does not need to be medicated. Not long after, Hernandez is hospitalized and psychotic once again. Earley then visits Passageway, a halfway house run by the dynamic Tom Mullen. Mullen tells Earley that the secret to his success is creating a community for clients who may not otherwise have any support.

In Part 5, Earley reflects on what he has learned and observed, as well as how fortunate his son was in his interactions with law enforcement. He advocates for the need to invest more in CIT police forces, hospital commitment reform, and support for the families of people with mental illnesses.