The American Psychiatric Association (APA) has updated its Privacy Policy and Terms of Use, including with new information specifically addressed to individuals in the European Economic Area. As described in the Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences.

Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.

×
Book ReviewFull Access

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

Published Online:https://doi.org/10.1176/ps.2008.59.2.214

During a decade when journalists were criticized for attending to corporate rather than community interests, Mary Beth Pfeiffer followed six men and women with severe mental illnesses as they were arrested, incarcerated, and mistreated in the American penal system. By giving account of these six people, Pfeiffer writes as an advocate journalist, providing detailed accounts of the human costs of the criminalization of people with mental illnesses.

Pfeiffer writes with an indignant but determined tone about a penal system that allows persons with mental illness to deteriorate until their death. She writes of Shayne Eggen, a woman in Iowa with schizophrenia, who gouges her own eyes out while in solitary confinement. She writes of Jessica Roger, a 21-year-old believed to have borderline personality disorder who commits suicide while locked inside a New York prison's "box." Pfeiffer invites her readers inside the enclosed and unsafe spaces into which people with mental illnesses are sent.

Although she criticizes criminal justice and mental health professionals alike, Pfeiffer hopes to indict a culture that prioritizes imprisonment over care. While describing the suicide of Joseph Maldonado—an 18-year-old in California who never receives the mental health treatment he requests—she criticizes the overcrowded prisons that keep such an inadequate watch over their charge. As she tells how Peter Nadir, a 31-year-old Floridian treated for bipolar disorder, is asphyxiated by police officers a block from his home, Pfeiffer writes about the inadequate training of police officers and the closing of mental hospitals.

To be sure, Pfeiffer offers sympathetic accounts rather than epidemiological rigor or psychological sophistication. She employs data in an uncritical fashion, but she writes for a general audience. This book is neither a meta-analysis nor a policy statement but an appropriate book from which to select a section, perhaps the story of Shayne, to press upon legislators and students. Pfeiffer clearly tells these stories with the hope that they will galvanize her readers to seek more just treatment for people with severe mental illness.

Dr. Nussbaum is a resident in psychiatry at the University of North Carolina Hospitals, Chapel Hill.