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Crazy in America: The Hidden Tragedy of Our Criminalized Mentally Ill

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In 2006, I became interested in our prisons, as Human Rights Watch did a report regarding the use of dogs as a way to extract prisoners from their cells. Iowa was listed one of seven states who used such inhumane practices. As my work continued I became aware of the United States being one of only four nations in the world that lock our children up and throw away the key. It is no surprise that the mentally ill are another hidden tragedy in our prisons.

"Crazy in America: The hidden tragedy of our criminalized mentally ill" gives us the story of six individuals whose stories transcend throughout our prison system. We have taken people who have been diagnosed with mental illness and put them into a prison that seeks punishment rather than help that is desperately needed. Dollars no longer go into Mental Health but into prison systems that lack the necessary tools to help those with mental illness. Instead, our prison system feeds their psychosis by locking those mentally ill in a cell for 23 hours a day for long periods of time.

This is the book we have been waiting for, a book that is not only beautifully written, but gives us a glimpse of our failing, broken, and inadequate prison system. This book is informative and heartbreaking, but above all, it gives grounds to why we MUST fix our shattered prison system.

Crazy in America: The Hidden Tragedy of Our Criminalized Mentally Ill As a long time staff advocate for the National Alliance on Mental illness (NAMI), I found the book and its multiple story accounts very accurate and heart rendering. For the uninformed, the stories may be so impactful that they will find it hard to understand that a society could mistreat its citizens so badly. Good book.

The author of Crazy in America introduces us to 6 of our brothers and sisters whose lives were devastated by mental illness along with the families that care deeply about them. Three committed suicide while in isolation cells in both jails and prisons. Luke in a Texas jail, Jessica in the New York prison system and Joseph in the California Youth Authority Facility. Two more, Alan and Peter died in separate incidences at the hands of Florida police officers whose very presence exacerbated the symptoms of their illness. The pain and anguish of the five individuals and their families unfolds before your eyes as you read their stories.

The sixth person the author writes about is Shayne, my niece, the focus of my advocacy work and truly a special person and survivor. As I read Shayne's story I grieved for the horror that was unfolding once again before my eyes. The anguish of not being able to stop the crime that landed her in jail and eventually an Iowa prison. The self mutilations of her right eye and two years later her left eye. Six months after blinding herself she dislodged four of her teeth trying to bite off her finger. Visions of this vulnerable and sick woman destroying herself one digit at a time terrified my thoughts as I pleaded and begged for help from whomever would listen. Four months later Shayne tried to bite a whole through her cheek and I wondered if it would ever end. All of these incidences happened while in isolation cells. Shayne has proven, at least to me, that isolation is not treatment. The prison environment was to stressful for her coping skills and she started a downhill slide 1 year into what would be 5 years behind bars.

It is hard to write a review of a book that causes you to feel so much pain and suffering. I do however thank Mary Beth for being the caring and knowledgeable advocate that she is. Shayne and her family are forever grateful that she has used her journalistic talent to tell the stories of these six vulnerable and loved individuals in the hopes that changes will be made before to many more have to suffer being criminalized because of a misunderstood illness.

If countries are judged by the way they treat their most vulnerable citizens than I grieve also for America because our mentally ill are being hidden from view behind prison walls which is where they were 150 year ago. The medications necessary to stabilize symptoms of mental illness are available. The knowledge of what needs to be provided to ensure their success living in the community is known. It will take the will of the people to provide these basic necessities. Call your legislatures and congressmen and tell them to support laws aimed at helping those with disabilities.

The heartbreaking stories in this beautifully written book expose what happens to people with psychiatric disabilities who reach the end of the line after not receiving desperately needed mental health care. Meticulously researched and at the same imbued with deep sympathy, Pfeiffer's case studies detail the journeys of six people as they move inexorably toward catastrophe, finding themselves in brutal interactions with the criminal justice system. With the closure of many psychiatric wards and an ensuing lack of decent, appropriate care in the community, our jails and prisons have been delegated as the mental health facilities of our time. They are utterly inadequate to the task. Behind those walls are hundreds of thousands of ill people who cannot adhere to rules. Many are placed in solitary confinement, where they violently injure themselves or commit suicide. Pfeiffer sensitively reveals the effects of this torture on vulnerable individuals with mental illness.

New York State is on the verge of passing a law that greatly restricts the practice of placing people with psychiatric disabilities in solitary confinement, the first state in the country to do so. We must immediately begin to improve mental health care in the community, so that people do not find themselves in jail as a result of untreated symptoms. Pfeiffer spells out this message unambiguously. Her book should be required reading for anyone with any interest in human rights and assigned as a textbook in every medical school.

For decades we have been talking about the tragic decision that was made in the 1960's when thousands of mentally ill people were turned out of America's institutions and left with no where to go for basic everyday services and mental health care. In her new book, "Crazy in America," Mary Beth Pfeiffer tells us the heart breaking stories of what happened as a result of that decision. We did not build facilities in our communities to care for these people, we did not train people who were capable of working with them and their families and providing the services they needed. What we did do was build more and more prisons where they were locked up for years, often in isolation and treated like criminals of the worst kind.

Pfeiffer gives us in depth case studies of six people with mental illness and their tragic encounters with the criminal justice system. Only one, Shayne Eagan of Iowa, is still alive. She gouged her eyes out while under care of state. Over and over Pfieffer demonstrates how deadly the use of isolation is, not only for the mentally ill, but also for all human beings. Yet this is the response of choice of those in corrections.
The author gives us her list of 10 things that must be done to address this tragic situation. Reading her book should motivate many of us to contact our legislators and urge them to take the steps that are needed to address this scourge on our land and to personally monitor what is happening regarding mental health services and criminal justice in our own states and communities. If you do nothing else: speak out against the building of more prisons.

For years, I have watched the homesless people walk up and down the main streets in the city closest to where I live, the thought crossing my mind that these are the result of budget cuts which closed the nearby psychiatric center. While I'd read about the crisis for this same population, (Many of the articles were written by the same author as Crazy in America, Mary Beth Pfeiffer, an advocate for these people for many years.) the extent and the consequences of this institution's closing, and others across America, was never as clear as they have become as a result of reading this book.
Pfeiffer's heartbreaking case studies document the problem the mentally ill confront within the penal system, a system never intended to deal with this personnel. Through these tragic case studies, the author demonstrates that a system that punishes the mentally ill in the same ways it treats other prisoners is a set-up for these victims. At the same time that her book focuses on and evokes sympathy and compassion for the mentally ill, it also causes the reader to question how our prisons function for anyone in America.
While this book may hold particular interest for workers in the mental health field, it is of importance for employees in our schools, judicial system, and for anyone who has a mentally ill person in his/her family. It seems this book reaches out to everyone, and hopefully, will encourage people to work toward the changes in a system that is broken for a large percentage of the people involved in it. We must watch over those incapable of caring for themselves.
This is a must read for any socially responsible person in America.
As for the author, a superb example of investigative reporting! Well done!!!

I nearly didn't purchase this book. I bought it only because it came with another book ('Street Crazy' by Stephen Seager) which I had to read for a Psychiatric Technician Program that I am going through. I decided an extra book that deals with the type of patiens I will eventually be working with could only help me in the future.

This book was incredible. It is not from a doctors point of view like most books would be, it is from the point of view of the patients themselves and/or their families. The stories are so tragic and you can't help but feel bad for the situations they have had to go through. There are also pictures of each person which only made me feel more for each of them.

For anyone in the mental health field, work in a prison, or are going to work in either of these fields I highly recommend this book. If people were a little more considerate of the homeless and mentally ill maybe some, if not most, of them would not have to die in the streets or commit suicide in prison.

Maybe it's just "in the knick of time" that Mary Beth Pfeiffer comes along and does what no one thus far has done, personalized a national scandal, that being the criminalizing of our mentally ill. She couldn't make this stuff up. Iowa is among the top offenders and she doesn't hold back, something I appreciate as an advocate for prison reform in Iowa for years. Only when the courts forced the issue did Iowa reluctantly begin to address the tragedy. So far she finds, and i agree, there is no real inclination to stem the flow of mentally ill persons into the prisons even though it's proven wrong to continue. Once they get there the "secret society" of the prison administration still assures no improved treatment which the death of a "special needs" offender at the womens prison just a couple of weeks ago, declared as due to "natural causes" at age 47, leaves us with many unanswered questions and doubts of meaningful progress just as this book reveals.

What Mary Beth Pfeiffer reveals will not have an effect on the system unless those ordinary persons who read her book demand change. Officials know the extent of the problem but are not willing to act without a big push from an enraged citizenry. Mary Beth Pfeiffer wants to move us to action.

Mary Beth Pfeiffer has provided a very realistic and shocking look at the extent to which the US utilizes prisons has an alternative to treatment for people with serious mental illnesses. Depicting the history of five people, she states that they were chosen "because they were terribly, tragically, typical" and that while their endings were often extreme, they represent what people with mental illness endure everyday.

On Page 255 she points out that there is always money for jails but not for adequate medical services for people who are ill. In her top 10 list of requirements to keep people out of jail, number 8 is that we should invest in a system of mental health care that includes inpatient and outpatient services to support vulnerable people and keep them out of the criminal justice system.

Her book, by exposing the current situation, provides a service. The US is not alone when it comes to neglect for the mentally ill. The situation in many western countries is similar and the World Health Organization estimates that anywhere from 40 to 70% of people with schizophrenia receive no treatment at all.

Marvin Ross
Author of Schizophrenia: Medicine's Mystery - Society's Shame

True journalism informs and educates. This well researched book does both.
A must read for all who are concerned about an America gone mad
and the industrial prison complexes that grow rich off the backs of human misery. This effects every household in America don't wait until it hits your door to read it.

A grieving mother