Crazy: A Father’s Search Through America’s Mental Health Madness

Earley receives a phone call from Jackson, who was awoken by a police officer knocking on his door. Earley recommends calling an attorney who can find out if the police have a warrant out for his arrest. Jackson asks if he can call Earley every night at eight o’clock as a form of check-in, and Earley reluctantly agrees. When Jackson doesn’t call, Earley calls him and realizes that Jackson has more than tripled his dosage of antipsychotic medication.

Over the next few days, Earley receives calls from Jackson at all hours. Jackson has become convinced that Jewish men have put a hit out on him and that the police are after him. He also wants to tell Earley his revelations about Jesus. Jackson refuses to visit his psychiatrist, but he does visit his mother in Ohio despite his fear that the FBI will be waiting for him at the airport. When Earley asks Jackson how he can be sure God talks to him, Jackson tells him it has to be God because “it’s what makes [Jackson] special” (288).

When Earley returns to Miami, he tries to get in touch with April Hernandez only to learn from Gilly that she has been hospitalized once again. Gilly becomes upset as he tells Earley how he and April had decided to get an abortion and how Hernandez became depressed soon afterward. She began to hang out with her old friends who used drugs and told Gilly that she was hearing voices. When he tried to get her to go back on her antipsychotic medication, she refused, eventually returning to the streets. Hernandez’s mother and a psychiatric nurse try to hunt her down on the beach, eventually convincing her to seek treatment.

Earley accompanies Gilly to the hospital on the day that April is discharged. Gilly is still convinced that April can one day be healthy without medication. He claims that they will move to New York and start over again, but April is not convinced. She tells Earley that many of the friends she met on the street aren’t around anymore, claiming that for people like her, “There’s jail, there’s your parents, or you die” (293).

Dr. Poitier tells Earley during his next visit to the jail that an incarcerated man, who was arrested for acting violently in a hospital emergency room while seeking relief from pain, died after being rushed back to the hospital. He investigates to better understand because he feels responsible, saying, “This is no place for someone who is mentally ill” (294). Earley finds out about a former patient of Dr. Poitier’s who was arrested after going off his meds and acting erratically after many years without an issue; he would eventually become paralyzed in jail after getting into an argument with a correctional officer. Dr. Poitier is still reeling from guilt regarding the man’s fate.

Meanwhile, a reporter from the Miami Herald visits the ninth floor and likens it to a “dungeon” in his feature article. An altercation on the ninth floor lands Officer Clem in the hospital with an injured finger and torn ligaments.

Earley shadows mental health coordinator Terry Chavez and her protégé Bart Armstrong, both of whom work for the state’s attorney general’s office and specialize in cases filed against people with mental illnesses. They follow 15 cases at the courthouse over one day.

They run into Sam Konell, a “patient broker” who follows the cases of patients with health insurance who were charged with a felony, offering to help the accused get lesser sentences by convincing them to agree to go to treatment. While many folks Earley talks to have mixed feelings about Sam, his work does mean that more patients receive medical treatment before going to jail. Konell tries to bargain with Chavez about a man about to be charged with a felony. When Earley expresses confusion, Chavez reminds him that Sam makes money off “a hole in our system” (304), ultimately doing more good than bad.

The most important case of the day involves an incarcerated man whom Dr. Poitier wants to forcibly medicate. The man was put in jail without having been formally arrested and charged with a crime. Dr. Poitier alerted the prosecutor’s office to the issue, which would have otherwise gone unnoticed. Ultimately, the judge agrees with Dr. Poitier’s request to medicate the patient, who is determined to be a danger to himself.

While both Chavez and Armstrong impress Earley, he is infuriated by the inadequacy of what he watched happen in the courtroom. He returns to the jail to talk with Dr. Poitier about what he witnessed, but he is intercepted by a social worker who wants to share a piece of news with him about Freddie Gilbert.

Earley goes in search of Gilbert, who, despite receiving exceptional mental healthcare in the hospital for over six months, has returned to the streets. Despite an optimistic prognosis, when Gilbert was released into an ALF, he decompensated for a month. Earley finds him on the street, unkempt again and unable to recognize Earley. Gilbert refuses to speak to him or answer questions.

Driving away, Earley ruminates on the fact that he knew it would be difficult, if not impossible, to find a “success” story in Miami. His high expectations for Gilbert, however, who made remarkable progress with the best possible treatment, get under his skin. He reached out to Rachel Diaz to ask about a Miami treatment program called Passageway that is considered a success. She tells him she is on the board of directors and agrees to help him gain access.