Floor Nine. Four or five prisoners sit in a cell designed for one person. Naked but for paper gowns the prisoners take turns sleeping on the one bare steel bench per cell or sleep in their own waste. Inmates spend most of their time in near-freezing conditions in their cells. Into this scene of misery steps journalist Pete Earley who has been granted unrestricted access into floor nine of the Miami-Dade Pretrial Detention Centre. Floor Nine is not only the psychiatric unit of the Miami-Dade prison but also serves, according to prison psychiatrist Joseph Poitier, as the largest psychiatric facility in Florida.
Flashback to several months earlier: Earley's son, Mike, who is experiencing delusions, is arrested for breaking into a house to take a bubble bath. Earley tries to find psychiatric treatment for his son however the civil liberties laws prevent such unless Mike poses a tangible threat to himself or another person. Instead, Mike is ushered through the legal system.
This knotted state of affairs prompts Earley, with the support of mental health law reform advocate Judge Steven Leifman, to commence a fevered inquiry into the incidence of the criminalization of those labeled with mental illness. Specifically, Earley "shadows" three prisoners to understand how it is inmates can spend many months in the crammed Miami-Dade prison unfit to go to trial despite efforts to be "made competent". His search leads him to the NAMI, independent advocates, the police, halfway houses, courtrooms, the streets, state hospitals; all in a rickety orbit around Miami-Dade prison.
Earley provides an extraordinary analysis of the policies and practices that create entities like the ninth floor and argues passionately for Crisis Intervention Training for the police, stricter civil liberties laws, and proper psychiatric treatment. Much like Australian journalist Anne Deveson's book Tell Me I'm Here, Crazy has the potential to contribute to dramatic changes to civil liberties laws in America. This poses a tremendous quandary and not only for ethical reasons.
Earley writes with an assured tone yet in our times of coercion within the psychiatric industry, as attested to by authors like the late Loren Mosher and other critical psychiatrists, it is hard to imagine a system that truly does allow people to "die with their rights on". Or, more accurately, there may be urgent reasons why people enter a willingness to die with their rights on and for which illness alone may not be sufficient explanation. For example, while Earley discusses the difficult side-effects of the psychotropic medications which may limit "compliance" with treatments plans, the extent of the difficulty has possibly been seriously understated, as doctors and researchers like Peter Breggin and Australian Richard Gosden point out.
While this reviewer remains hesitant about some of the conclusions Earley reaches, Crazy is a gripping account and an important book for anyone who is interested in current issues surrounding mental health law reform and why prisons have become the "new asylums". Crazy is particularly essential reading for workers in the police force as the sections regarding Crisis Intervention Training are particularly poignant appeals for change that can be acted upon immediately.
© 2008 Maria Christoforatos
Maria Christoforatos, a poet, apprentice perfumer, and scholar (University of QLD), currently resides in Australia.
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