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No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America
New York Times-bestselling author Ron Powers offers a searching, richly researched narrative of the social history of mental illness in America paired with the deeply personal story of his two sons' battles with schizophrenia.
From the centuries of torture of "lunatiks" at Bedlam Asylum to the infamous eugenics era to the follies of the anti-psychiatry movement to the current landscape in which too many families struggle alone to manage afflicted love ones, Powers limns our fears and myths about mental illness and the fractured public policies that have resulted.
Braided with that history is the moving story of Powers's beloved son Kevin--spirited, endearing, and gifted--who triumphed even while suffering from schizophrenia until finally he did not, and the story of his courageous surviving son Dean, who is also schizophrenic.
A blend of history, biography, memoir, and current affairs ending with a consideration of where we might go from here, this is a thought-provoking look at a dreaded illness that has long been misunderstood.
From the centuries of torture of "lunatiks" at Bedlam Asylum to the infamous eugenics era to the follies of the anti-psychiatry movement to the current landscape in which too many families struggle alone to manage afflicted love ones, Powers limns our fears and myths about mental illness and the fractured public policies that have resulted.
Braided with that history is the moving story of Powers's beloved son Kevin--spirited, endearing, and gifted--who triumphed even while suffering from schizophrenia until finally he did not, and the story of his courageous surviving son Dean, who is also schizophrenic.
A blend of history, biography, memoir, and current affairs ending with a consideration of where we might go from here, this is a thought-provoking look at a dreaded illness that has long been misunderstood.
360 pages, Hardcover
First published March 21, 2017
About the author
Ron Powers
39 books84 followersRon Powers (born 1941) is a Pulitzer Prize-winning journalist, novelist, and non-fiction writer. His face include White Town Drowsing: Journeys to Hannibal, Dangerous Water: A Biography of the Boy Who Became Mark Twain, and Mark Twain: A Life. With James Bradley, he co-wrote the 2000 #1 New York Times Bestseller Flags of Our Fathers.
Powers won the Pulitzer Prize for Criticism in 1973 for his critical writing as TV-radio-columnist for Chicago Sun-Times about television during 1972. He was the first television critic to win the Pulitzer Prize.
In 1985, Powers won an Emmy Award for his work on CBS News Sunday Morning.
Powers was born in 1941 in Hannibal, Missouri — Mark Twain's hometown. Hannibal was influential in much of Powers' writing — as the subject of his book White Town Drowsing, as the location of the two true-life murders that are the subject of Tom and Huck Don't Live Here Anymore, and as the home of Mark Twain. Powers has said that his fascination with Twain — the subject of two of his books — began in childhood:
"When I was a little boy in Hannibal, he was a mystic figure to me. His pictures and books and images were all over (my friend) Dulany Winkler's house, and I spent a lot of time there. I just wanted to reach out and touch him. Eventually I was able to."
In addition to writing, Powers has taught for the Bread Loaf Writers' Conference, the Salzburg Seminar in Salzburg, Austria, and at Middlebury College in Middlebury, Vermont.
Powers is married and has two sons. He currently resides in Castleton, Vermont.
Powers won the Pulitzer Prize for Criticism in 1973 for his critical writing as TV-radio-columnist for Chicago Sun-Times about television during 1972. He was the first television critic to win the Pulitzer Prize.
In 1985, Powers won an Emmy Award for his work on CBS News Sunday Morning.
Powers was born in 1941 in Hannibal, Missouri — Mark Twain's hometown. Hannibal was influential in much of Powers' writing — as the subject of his book White Town Drowsing, as the location of the two true-life murders that are the subject of Tom and Huck Don't Live Here Anymore, and as the home of Mark Twain. Powers has said that his fascination with Twain — the subject of two of his books — began in childhood:
"When I was a little boy in Hannibal, he was a mystic figure to me. His pictures and books and images were all over (my friend) Dulany Winkler's house, and I spent a lot of time there. I just wanted to reach out and touch him. Eventually I was able to."
In addition to writing, Powers has taught for the Bread Loaf Writers' Conference, the Salzburg Seminar in Salzburg, Austria, and at Middlebury College in Middlebury, Vermont.
Powers is married and has two sons. He currently resides in Castleton, Vermont.
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Displaying 1 - 30 of 693 reviews
November 19, 2019
This is a deeply emotional book about an important topic, and it seems to have found a large audience (judging by the number of holds at my local library if not the number of ratings on Goodreads). It’s a great idea, alternating between nonfiction chapters about the nature and history of mental illness and a memoir of the author’s family, including two sons with schizophrenia. And as a journalist, the author has an engaging writing style that kept me wanting to read on. It is marred, however, by odd choices in structure and focus. In the end, there is far less about mental illness in it than I expected, and the author’s major policy proposal involves disempowering the very people to whom he claims he wants to give a voice.
The larger part of this book is the nonfiction, much of which is history. The author writes a bit about the spiritual roles often held in traditional societies by people who would today be defined as mentally ill, before discussing the history of asylums (they seem to have started out somewhere between prisons and zoos, to be later reformed in the era of Dorothea Dix and then deteriorate again). And other low points: eugenics (Hitler was all about wiping out mental illness through murder, but the U.S. pioneered forced sterilizations), lobotomies (shudder), and deinstitutionalization (the U.S. closed most of its asylums in the 1960s, resulting in many of the mentally ill winding up on the streets or incarcerated). For no reason I could discern, the chapter about the aftermath of WWII comes after the deinstitutionalization chapter, but it’s otherwise roughly chronological.
Powers’s writing style is engaging, and there is useful information here for those who don’t know much about the topic, but the nonfiction portions could have been much better. When the subject is science – what is schizophrenia, or the link between mental illness and creativity – there’s little actual science and lots of authorial speculation; Powers spends more time detailing debunked theories with emotional appeal for him than laying out the facts. When the subject is history, he has a tendency to go off on tangents at best loosely related to the topic of the book: the eugenics chapter goes into detail on how Darwin came to travel on the Beagle, but neglects to mention that forced sterilization went on in the U.S. until the 1970s.
The chapter on antipsychotics is particularly off-base. I expected this chapter to answer such questions as: how effective are antipsychotics? What is it like to be on them? How have these drugs changed in the sixty-odd years since they first became available? What are their disadvantages? Instead we get a history of the development of the precursors to the first antipsychotic drugs, including biographical details of involved scientists, and then a long catalogue of misdeeds by drug companies, often not related to psychoactive drugs at all. There’s even a discussion of the intricacies of patent law that cause medication to be expensive in the U.S. in the first place, and mention of Bernie Sanders bussing seniors up to Canada to buy cheaper meds. As a piece of journalism it’s fine, but that isn’t why I picked up this book.
The memoir portion is equally marked by odd choices of focus. Three-quarters of it takes place before either of the author’s sons begins showing signs of schizophrenia. I understand the author’s desire to focus on the happy events in their lives, and even his drive to include supportive emails he sent his kids over the years. Perhaps one of his goals was to get readers invested in Dean and Kevin as people rather than seeing them as representatives of an illness. But a good writer could have done that while focusing on the years when they were actually sick (they’re still people, which is supposed to be the author’s point, and they’re hardly psychotic all the time). And this structure winds up giving the impression that life ends with schizophrenia, that everything worth telling in his sons’ lives happened beforehand – even though one of them is alive and apparently doing well.
Again, there’s a lot of authorial speculation and tangents here. He theorizes that his older son, Dean, was moody and withdrawn as a teenager because he was in the early stages of the disease, never mind that Dean’s first psychotic episode seems to have come around age 30. He discusses at length the social and judicial consequences of a car accident when Dean was 17, during which it becomes clear that he has a bone to pick with the other teenager’s family (who previously wrote their own book). Dean’s own opinions are noticeably absent. The author will mention that he never asked how Dean felt about a particular event, or doesn’t know some fact from Dean’s life, leaving me wondering why he didn’t just walk downstairs and ask. Memoirists generally have living, non-estranged family members read their manuscripts and share their memory of events, which could only have improved this book.
Finally, though there’s little discussion of specific policy proposals, Powers advocates throughout the book for parents having increased authority to force treatment on their unwilling adult children. Of course, early diagnosis and treatment is extremely important to health outcomes, and it was clearly agonizing for Powers and his wife to watch Kevin go off his meds, insisting that he’d gotten better. But having recently read a horrifying account of involuntary commitment in another memoir, I’m hesitant to say we should do this more, and concerned by the author’s pooh-poohing of civil liberties concerns. A basic tenet of a free society is that adults get to make their own life decisions, even if their judgment is terrible, as long as they abide by the law. If someone is incompetent, the court can appoint a guardian. Powers apparently believes this option is insufficient because there can be delay (in which case the delay is the problem) and, bafflingly, because this is “not a medical hearing, with psychiatrists, but a judicial hearing, with a judge and lawyers.” Um, yes, this is how government works; it’s called due process of law and why courts exist. There’s nothing stopping psychiatrists from testifying in them.
At any rate, the author doesn’t seem to have thought this proposal through. Does he believe in involuntary treatment only during episodes of acute psychosis, or indefinitely once someone has a diagnosis? His experiences make it seem like the latter. In which case, what diagnoses are sufficient? How long does someone have to be stable to get their rights back? Does he think parents should have this power for life, or only while their children are financially dependent young adults? How would he prevent situations like Rosemary Kennedy's, where less conscientious parents choose a treatment that destroys their child in an attempt to make her easier to manage? If the ill person is married, does the spouse get to dictate treatment? Has he considered the ways mental illness already leaves people vulnerable to domestic violence (“you’re crazy, so no one will believe you”)? There's a long history of inconvenient women forced into mental institutions, because people given power over others don't always exercise it well. It doesn’t appear the author has considered the implications of his ideas beyond his own pain, and while his experiences are a valid consideration, the inquiry can’t stop there.
So in the end, while there is some good journalistic writing here and I found the book more engaging than a 2-star rating implies, it falls short of the author’s stated goals. He writes in the introduction that he wants reading the book to hurt, and he wants to give a voice to people with mental illness. The book includes a few tragic stories taken from the news, dealing with police shootings and suicide in prison, and certainly his son’s suicide is one of the most tragic events a family can experience. But far more page time is spent on Powers family vacations and why the author hates Thomas Szasz. And I’m confused as to how he believes he’s given anyone a voice when there’s no indication he interviewed anyone with mental illness for the book; even his own surviving son appears to have had no involvement. Raising awareness is good, but this book is too much of the author’s feelings and too little of anything else. What a wasted opportunity.
EDIT: Happily, people with serious mental illnesses have voices of their own and don't need Powers to speak for them, especially when he's pretty clearly speaking for caretakers instead. Here are some fantastic memoirs that you should read:
The Center Cannot Hold - apparently the schizophrenia memoir
Manic
Gorilla and the Bird
It's been a couple of years now since I read Powers's book and while parts of it were an effective history lesson (the lobotomy section in particular), the memoir aspect seems unfortunate in retrospect and the author's policy proposals even more so. If you care about people with mental illnesses, try reading about what it's like to actually be in their shoes instead.
The larger part of this book is the nonfiction, much of which is history. The author writes a bit about the spiritual roles often held in traditional societies by people who would today be defined as mentally ill, before discussing the history of asylums (they seem to have started out somewhere between prisons and zoos, to be later reformed in the era of Dorothea Dix and then deteriorate again). And other low points: eugenics (Hitler was all about wiping out mental illness through murder, but the U.S. pioneered forced sterilizations), lobotomies (shudder), and deinstitutionalization (the U.S. closed most of its asylums in the 1960s, resulting in many of the mentally ill winding up on the streets or incarcerated). For no reason I could discern, the chapter about the aftermath of WWII comes after the deinstitutionalization chapter, but it’s otherwise roughly chronological.
Powers’s writing style is engaging, and there is useful information here for those who don’t know much about the topic, but the nonfiction portions could have been much better. When the subject is science – what is schizophrenia, or the link between mental illness and creativity – there’s little actual science and lots of authorial speculation; Powers spends more time detailing debunked theories with emotional appeal for him than laying out the facts. When the subject is history, he has a tendency to go off on tangents at best loosely related to the topic of the book: the eugenics chapter goes into detail on how Darwin came to travel on the Beagle, but neglects to mention that forced sterilization went on in the U.S. until the 1970s.
The chapter on antipsychotics is particularly off-base. I expected this chapter to answer such questions as: how effective are antipsychotics? What is it like to be on them? How have these drugs changed in the sixty-odd years since they first became available? What are their disadvantages? Instead we get a history of the development of the precursors to the first antipsychotic drugs, including biographical details of involved scientists, and then a long catalogue of misdeeds by drug companies, often not related to psychoactive drugs at all. There’s even a discussion of the intricacies of patent law that cause medication to be expensive in the U.S. in the first place, and mention of Bernie Sanders bussing seniors up to Canada to buy cheaper meds. As a piece of journalism it’s fine, but that isn’t why I picked up this book.
The memoir portion is equally marked by odd choices of focus. Three-quarters of it takes place before either of the author’s sons begins showing signs of schizophrenia. I understand the author’s desire to focus on the happy events in their lives, and even his drive to include supportive emails he sent his kids over the years. Perhaps one of his goals was to get readers invested in Dean and Kevin as people rather than seeing them as representatives of an illness. But a good writer could have done that while focusing on the years when they were actually sick (they’re still people, which is supposed to be the author’s point, and they’re hardly psychotic all the time). And this structure winds up giving the impression that life ends with schizophrenia, that everything worth telling in his sons’ lives happened beforehand – even though one of them is alive and apparently doing well.
Again, there’s a lot of authorial speculation and tangents here. He theorizes that his older son, Dean, was moody and withdrawn as a teenager because he was in the early stages of the disease, never mind that Dean’s first psychotic episode seems to have come around age 30. He discusses at length the social and judicial consequences of a car accident when Dean was 17, during which it becomes clear that he has a bone to pick with the other teenager’s family (who previously wrote their own book). Dean’s own opinions are noticeably absent. The author will mention that he never asked how Dean felt about a particular event, or doesn’t know some fact from Dean’s life, leaving me wondering why he didn’t just walk downstairs and ask. Memoirists generally have living, non-estranged family members read their manuscripts and share their memory of events, which could only have improved this book.
Finally, though there’s little discussion of specific policy proposals, Powers advocates throughout the book for parents having increased authority to force treatment on their unwilling adult children. Of course, early diagnosis and treatment is extremely important to health outcomes, and it was clearly agonizing for Powers and his wife to watch Kevin go off his meds, insisting that he’d gotten better. But having recently read a horrifying account of involuntary commitment in another memoir, I’m hesitant to say we should do this more, and concerned by the author’s pooh-poohing of civil liberties concerns. A basic tenet of a free society is that adults get to make their own life decisions, even if their judgment is terrible, as long as they abide by the law. If someone is incompetent, the court can appoint a guardian. Powers apparently believes this option is insufficient because there can be delay (in which case the delay is the problem) and, bafflingly, because this is “not a medical hearing, with psychiatrists, but a judicial hearing, with a judge and lawyers.” Um, yes, this is how government works; it’s called due process of law and why courts exist. There’s nothing stopping psychiatrists from testifying in them.
At any rate, the author doesn’t seem to have thought this proposal through. Does he believe in involuntary treatment only during episodes of acute psychosis, or indefinitely once someone has a diagnosis? His experiences make it seem like the latter. In which case, what diagnoses are sufficient? How long does someone have to be stable to get their rights back? Does he think parents should have this power for life, or only while their children are financially dependent young adults? How would he prevent situations like Rosemary Kennedy's, where less conscientious parents choose a treatment that destroys their child in an attempt to make her easier to manage? If the ill person is married, does the spouse get to dictate treatment? Has he considered the ways mental illness already leaves people vulnerable to domestic violence (“you’re crazy, so no one will believe you”)? There's a long history of inconvenient women forced into mental institutions, because people given power over others don't always exercise it well. It doesn’t appear the author has considered the implications of his ideas beyond his own pain, and while his experiences are a valid consideration, the inquiry can’t stop there.
So in the end, while there is some good journalistic writing here and I found the book more engaging than a 2-star rating implies, it falls short of the author’s stated goals. He writes in the introduction that he wants reading the book to hurt, and he wants to give a voice to people with mental illness. The book includes a few tragic stories taken from the news, dealing with police shootings and suicide in prison, and certainly his son’s suicide is one of the most tragic events a family can experience. But far more page time is spent on Powers family vacations and why the author hates Thomas Szasz. And I’m confused as to how he believes he’s given anyone a voice when there’s no indication he interviewed anyone with mental illness for the book; even his own surviving son appears to have had no involvement. Raising awareness is good, but this book is too much of the author’s feelings and too little of anything else. What a wasted opportunity.
EDIT: Happily, people with serious mental illnesses have voices of their own and don't need Powers to speak for them, especially when he's pretty clearly speaking for caretakers instead. Here are some fantastic memoirs that you should read:
The Center Cannot Hold - apparently the schizophrenia memoir
Manic
Gorilla and the Bird
It's been a couple of years now since I read Powers's book and while parts of it were an effective history lesson (the lobotomy section in particular), the memoir aspect seems unfortunate in retrospect and the author's policy proposals even more so. If you care about people with mental illnesses, try reading about what it's like to actually be in their shoes instead.
June 8, 2017
This was an extremely painful book to read, not least because I have a history of mental illness in my family. Both my mother and her mother committed suicide—same method, same place—and I grew up visiting the local mental hospital where my mother stayed for long periods of time. She died in 1979, when I was 26. By then she was largely vegetative as a result of over 70 electric shock treatments—she had permanent burn scars on her temples.
And so I found it shocking to read not only the appalling (and, unfortunately, familiar) history of mental health care in my new, adopted country, but that some of these practices are still taking place. Of course, there were no beatings or solitary confinement in my mother's hospital, but mental illness was a stigma and poorly understood. Today, mentally-ill people can be committed to hospital in the UK, something that can only take place in the US if the patient has shown sufficient evidence of an imminent threat to him/herself or others—as Mr Powers intimates, this is often too late for early intervention and treatment. This assumes, however, that there are beds available. For those not able to secure sparse psychiatric care—including thousands of military veterans, the homeless we see on our streets, and many of those in our jails, there is little help, although things may be improving on both the scientific and legislative sides. This help didn't come quickly enough for Mr Powers beloved younger son, Kevin, but I hope with all my heart that his older son, Dean, continues his journey of recovery, if that is the appropriate word.
Please do not let my comments above dissuade you. This is a powerful book that should be read, and Mr Powers deserves our thanks for having the courage to write it.
And so I found it shocking to read not only the appalling (and, unfortunately, familiar) history of mental health care in my new, adopted country, but that some of these practices are still taking place. Of course, there were no beatings or solitary confinement in my mother's hospital, but mental illness was a stigma and poorly understood. Today, mentally-ill people can be committed to hospital in the UK, something that can only take place in the US if the patient has shown sufficient evidence of an imminent threat to him/herself or others—as Mr Powers intimates, this is often too late for early intervention and treatment. This assumes, however, that there are beds available. For those not able to secure sparse psychiatric care—including thousands of military veterans, the homeless we see on our streets, and many of those in our jails, there is little help, although things may be improving on both the scientific and legislative sides. This help didn't come quickly enough for Mr Powers beloved younger son, Kevin, but I hope with all my heart that his older son, Dean, continues his journey of recovery, if that is the appropriate word.
Please do not let my comments above dissuade you. This is a powerful book that should be read, and Mr Powers deserves our thanks for having the courage to write it.
March 16, 2020
The subtitle “the chaos and heartbreak of mental health in america” describes this book perfectly, for Ron Powers probes deeply into a failing system. His personal story, that of two sons diagnosed with schizophrenia, is his heartbreaking front-row seat. As Powers and his wife Honoree Fleming, PhD, face this nightmarish situation, their love for their sons is always in the foreground. Powers introduces his family during his sons' early years. I got to know Dean as the brown-haired boy with hazel eyes that grew to love writing and literature as well as taking an interest in politics. Kevin, the younger brother, blond and blue-eyed, would take an early interest in the guitar and grow to be a virtuoso, becoming almost one with his guitar. When Dean played guitar along with Kevin, writing lyrics and creating music, they seemed like any two young men with the world at their feet.
Powers made me love both these boys. I could feel the love and heartbreak of an entire family as he describes crises, but also special outings, concerts, first dates, and friendships. Dean experiences an event as a teenager that his father believes triggers a prodromal stage of schizophrenia. I think that’s probably the most important thing I learned from reading this narrative. Early intervention in schizophrenia can play an important role in better outcomes later on. Powers includes a quote from “a paper published in 2010 by the National Center for Biotechnology Information,”
“The prodromal period can last from weeks to several years, and comorbid disorders are very common during this period. The prodrome of schizophrenia and other psychotic disorders is characterized as a process of changes or deterioration in heterogeneous subjective and behavioral symptoms that precede the onset of clinical psychotic symptoms.”
My aunt was diagnosed with schizophrenia after the birth of her third child, her only daughter. In recent years, I learned that she had been an unmarried pregnant teenager and her father (my grandfather) hit the roof, going to get the young man and calling for a wedding. After reading Power’s explanation of how stress can play a pivotal role (in schizophrenia) during the vital adolescent years when the brain is undergoing a remodeling event called ‘pruning,’ I realized that my aunt had likely undergone severe stress with this first pregnancy, and thus began a prodromal stage that would later lead to full-blown schizophrenia. Diagnosed in the 1960s, she was treated with electroshock therapy and antipsychotics.
For me, Power’s story was riveting. Interspersed with chapters about his family, Powers presents a history of mental health care, from the London institution known as Bedlam in 1247 to contemporary mental health treatment, unfortunately still sadly lacking. The history of antipsychiatry, lobotomies, and the tragedy of “deinstitutionalization” are all part of the narrative. There are a few good guys along the way. While part of this book is investigative and research-oriented, I found the language easily accessible. This is an important work for anyone interested in mental health, and my guess is that’s most of us. Highly recommended!
Powers made me love both these boys. I could feel the love and heartbreak of an entire family as he describes crises, but also special outings, concerts, first dates, and friendships. Dean experiences an event as a teenager that his father believes triggers a prodromal stage of schizophrenia. I think that’s probably the most important thing I learned from reading this narrative. Early intervention in schizophrenia can play an important role in better outcomes later on. Powers includes a quote from “a paper published in 2010 by the National Center for Biotechnology Information,”
“The prodromal period can last from weeks to several years, and comorbid disorders are very common during this period. The prodrome of schizophrenia and other psychotic disorders is characterized as a process of changes or deterioration in heterogeneous subjective and behavioral symptoms that precede the onset of clinical psychotic symptoms.”
My aunt was diagnosed with schizophrenia after the birth of her third child, her only daughter. In recent years, I learned that she had been an unmarried pregnant teenager and her father (my grandfather) hit the roof, going to get the young man and calling for a wedding. After reading Power’s explanation of how stress can play a pivotal role (in schizophrenia) during the vital adolescent years when the brain is undergoing a remodeling event called ‘pruning,’ I realized that my aunt had likely undergone severe stress with this first pregnancy, and thus began a prodromal stage that would later lead to full-blown schizophrenia. Diagnosed in the 1960s, she was treated with electroshock therapy and antipsychotics.
For me, Power’s story was riveting. Interspersed with chapters about his family, Powers presents a history of mental health care, from the London institution known as Bedlam in 1247 to contemporary mental health treatment, unfortunately still sadly lacking. The history of antipsychiatry, lobotomies, and the tragedy of “deinstitutionalization” are all part of the narrative. There are a few good guys along the way. While part of this book is investigative and research-oriented, I found the language easily accessible. This is an important work for anyone interested in mental health, and my guess is that’s most of us. Highly recommended!
April 3, 2017
As a clinical social worker with a special interest in the seriously mentally ill, I very much appreciated Ron Powers' personal and societal exploration of mental illness. As the father of two schizophrenic sons, one who took his own life, he knows the ravages of this disease firsthand. Despite a deep need for his family's privacy, he decided to write this book in order to enlighten others and share the appalling narrative of the way that those who are mentally ill have suffered - from their illness and at the hands of society.
This book is well-researched and it goes deeply into the history of how poorly those with mental illness have been treated throughout time. Seriously mentally ill people don't usually vote and they have no strong lobbies to create and support public policies and laws for their protection, care, and well-being.
Mr. Powers explores the debacle of the Community Mental Health act, signed by President Kennedy in 1963, an act meant to deinstitutionalize the mentally ill. Despite good intentions, this act ended up discharging most mentally ill patients from long-term hospitalization. Community mental health centers were supposed to fill the gap but this never came to fruition. Community mental health centers preferred to treat the 'walking wounded' and those in most need were left uncared for. Our mentally ill citizens have ended up in jail and on the streets.
Powers indicts the harmful effects of some people with powerful influence who spoke and wrote about the myth of mental illness, especially Thomas Szasz and L. Ron Hubbard. Their belief that mental illness does not truly exist led politicians, medical providers, and the public to partake in an anti-psychiatry movement.
The causation of mental illness is complicated and there are many types. We do know that there is a genetic component to Schizophrenia and most likely an experiential or environmental component as well. Genes for bi-polar disease have been found and it is well known that this illness as well as depression run in families. Mental illness research is not well-funded as are some more 'popular' diseases. This is a very serious concern because, as Mr. Powers points out, "one-fourth of the globe's people will experience some kind of mental illness in their lifetimes".
What is most poignant about this book is the toll that mental illness takes on families who love, care for and advocate for their ill family members. Often, resources are scarce and hospitalizations can be like a game of musical chairs with a mentally ill member going into the hospital then being released only to end up back in the hospital again shortly. Anti-psychotic medications can have a long list of unpleasant and sometimes deadly side effects that result in a high degree of non-compliance by the patient.
I thank Mr. Powers for writing this book. In my opinion, it joins the ranks of the most important books about mental illness that are accessible to the public, those by E. Fuller Torrey and Kay Redfield Jamison.
This book is well-researched and it goes deeply into the history of how poorly those with mental illness have been treated throughout time. Seriously mentally ill people don't usually vote and they have no strong lobbies to create and support public policies and laws for their protection, care, and well-being.
Mr. Powers explores the debacle of the Community Mental Health act, signed by President Kennedy in 1963, an act meant to deinstitutionalize the mentally ill. Despite good intentions, this act ended up discharging most mentally ill patients from long-term hospitalization. Community mental health centers were supposed to fill the gap but this never came to fruition. Community mental health centers preferred to treat the 'walking wounded' and those in most need were left uncared for. Our mentally ill citizens have ended up in jail and on the streets.
Powers indicts the harmful effects of some people with powerful influence who spoke and wrote about the myth of mental illness, especially Thomas Szasz and L. Ron Hubbard. Their belief that mental illness does not truly exist led politicians, medical providers, and the public to partake in an anti-psychiatry movement.
The causation of mental illness is complicated and there are many types. We do know that there is a genetic component to Schizophrenia and most likely an experiential or environmental component as well. Genes for bi-polar disease have been found and it is well known that this illness as well as depression run in families. Mental illness research is not well-funded as are some more 'popular' diseases. This is a very serious concern because, as Mr. Powers points out, "one-fourth of the globe's people will experience some kind of mental illness in their lifetimes".
What is most poignant about this book is the toll that mental illness takes on families who love, care for and advocate for their ill family members. Often, resources are scarce and hospitalizations can be like a game of musical chairs with a mentally ill member going into the hospital then being released only to end up back in the hospital again shortly. Anti-psychotic medications can have a long list of unpleasant and sometimes deadly side effects that result in a high degree of non-compliance by the patient.
I thank Mr. Powers for writing this book. In my opinion, it joins the ranks of the most important books about mental illness that are accessible to the public, those by E. Fuller Torrey and Kay Redfield Jamison.
January 23, 2018
This book is personal enough to be review-proof, so I'm giving it a noncommittal three stars even though I thought it had a lot of flaws. I picked it out because of its important topic: mental illness, and bad public policy surrounding mental illness. However, I think Powers's account of the history of mental illness and treatment is far from definitive and he actually doesn't talk about public policy in that much detail. The policy discussion is personal in that the author never seems to acknowledge that some people with mental illnesses have horrible families, who shouldn't be given power over them. He only comes at the question from the perspective of what (in retrospect) might have helped his own family.
The other element of the book is his memories of the happy early lives of his sons, who later suffered from schizophrenia. It's possible to recognize that this is important while admitting that it is about as interesting as looking at strangers' photo albums of family events you weren't present for. Powers portrays his sons as geniuses with what he appears to think is objective rigor, but really he just comes off as an over-indulgent dad. (This is particularly noticeable when he quotes his sons' teenage writing at length.) An indulgent dad, of course, a fine and understandable thing to be, but Powers seems to think that his sons' genius make their story more tragic. I disagree. Mental illness is a scourge whoever suffers from it. I was especially troubled by his account of his elder son's car crash and the victim's family's hostility. Even getting all the details from the Powers family side, I was inclined to sympathize with the victim's family, especially since they had absolutely no way of knowing that the stress of legal proceedings might exacerbate the son's latent mental illness. The author seems set on excusing his son to show that he doesn't deserve what happened to him but, again, I believe it's possible to make mistakes, even terrible ones, and still not "deserve" mental illness, so the exculpatory project just feels dishonest.
Overall, I found the narrative so personal as to be essentially unreliable and I didn't think this book shed light on the medical and policy challenges around mental illness that you wouldn't get from being a regular newspaper reader. I think this book really resonated with some readers because of Powers's struggle to find help for his sons, although that's only a small portion of it. There's another book that I read years ago (about a father with a son and a daughter with mental illness) that covers that part of their lives at much greater length,but I've been totally flummoxed in identifying it called Acquainted with the Night.
The other element of the book is his memories of the happy early lives of his sons, who later suffered from schizophrenia. It's possible to recognize that this is important while admitting that it is about as interesting as looking at strangers' photo albums of family events you weren't present for. Powers portrays his sons as geniuses with what he appears to think is objective rigor, but really he just comes off as an over-indulgent dad. (This is particularly noticeable when he quotes his sons' teenage writing at length.) An indulgent dad, of course, a fine and understandable thing to be, but Powers seems to think that his sons' genius make their story more tragic. I disagree. Mental illness is a scourge whoever suffers from it. I was especially troubled by his account of his elder son's car crash and the victim's family's hostility. Even getting all the details from the Powers family side, I was inclined to sympathize with the victim's family, especially since they had absolutely no way of knowing that the stress of legal proceedings might exacerbate the son's latent mental illness. The author seems set on excusing his son to show that he doesn't deserve what happened to him but, again, I believe it's possible to make mistakes, even terrible ones, and still not "deserve" mental illness, so the exculpatory project just feels dishonest.
Overall, I found the narrative so personal as to be essentially unreliable and I didn't think this book shed light on the medical and policy challenges around mental illness that you wouldn't get from being a regular newspaper reader. I think this book really resonated with some readers because of Powers's struggle to find help for his sons, although that's only a small portion of it. There's another book that I read years ago (about a father with a son and a daughter with mental illness) that covers that part of their lives at much greater length,
December 31, 2017
Exceptional book that provides both valuable information and family insight to mental illness. While Mr. Powers had every right to pour his emotion into this book he did so sparingly, gently, with elegance and grace. Only after his younger son's death did the powerlessness of what he and his lived through really slam me. Then facing the future helping their older son live with the same mental illness.
The other issue or area of this illness, and there are many, was the fine line between genius and creativity. History has shown us so many, and neurologists and others are still studying this phenomenon. I highly recommend this book.
The other issue or area of this illness, and there are many, was the fine line between genius and creativity. History has shown us so many, and neurologists and others are still studying this phenomenon. I highly recommend this book.
February 8, 2018
This is a tough one. I understand the well-intentioned motive of forcing schizophrenics to take their medicine but I dislike the language used in the congressional bills the author supports. Civil liberties is an issue here despite the author’s casual dismissal of that fact. The bill would “expand involuntary outpatient commitment, under which someone with serious mental illness is court-mandated to follow a specific treatment plan, usually requiring medication.”
What qualifies as a serious mental illness? Psychiatry hasn’t been around very long and has a history of making some bad calls, whether it be lobotomies or Thorazine. How many pharmaceutical companies are being sued today because their product worsened the symptoms of some patients? Do we want a court to determine who is and isn’t mentally fit, and then force people to take the latest medications with all the latest side effects? I think forcing people to medicate is a bad idea.
Yes, Schizophrenics would be better off if they took their medication but if they are already paranoid and think the government is trying to control them, will they feel better knowing the government is forcing them to take a pill that controls their thoughts and behaviors? That sounds counter-productive. The big issue for me is that If we force pills on people with schizophrenia, we will inevitably also be forcing pills on people misdiagnosed with schizophrenia. It’s not a good idea.
This was a thought provoking read. Civilization doesn’t have a stellar record in its treatment of the mentally ill but it’s making progress. We may be finally reaching an era where we no longer criminalize, or maybe even no longer stigmatize mental illness. It may not happen in this century but I’m optimistic it could happen in the next two or three.
What qualifies as a serious mental illness? Psychiatry hasn’t been around very long and has a history of making some bad calls, whether it be lobotomies or Thorazine. How many pharmaceutical companies are being sued today because their product worsened the symptoms of some patients? Do we want a court to determine who is and isn’t mentally fit, and then force people to take the latest medications with all the latest side effects? I think forcing people to medicate is a bad idea.
Yes, Schizophrenics would be better off if they took their medication but if they are already paranoid and think the government is trying to control them, will they feel better knowing the government is forcing them to take a pill that controls their thoughts and behaviors? That sounds counter-productive. The big issue for me is that If we force pills on people with schizophrenia, we will inevitably also be forcing pills on people misdiagnosed with schizophrenia. It’s not a good idea.
This was a thought provoking read. Civilization doesn’t have a stellar record in its treatment of the mentally ill but it’s making progress. We may be finally reaching an era where we no longer criminalize, or maybe even no longer stigmatize mental illness. It may not happen in this century but I’m optimistic it could happen in the next two or three.
January 7, 2017
In No One Cares About Crazy People, Ron Powers explores the insidious treatment of the mentally ill throughout history and the social injustice perpetrated against their desperate families. Stigmatized by societies indifference towards the insane, Powers personal account of son Kevin’s slow descent into schizophrenia showcases the incredibly painful process faced while fighting for faster medical treatment. Based on the misunderstanding that schizophrenia can be cured with medication and the choice to cut government funding by misinformed legislators, institutions were closed, forcing the unstable into the streets and, inevitably, on the road to prison, punishment and certain death. Powers account is unfathomable as his oldest son Dean also descends into the dark recesses of the mentally ill. A painful, powerful book, No One Cares About Crazy People is sure to impact the way we see the insane, not as monsters determined to destroy society as we know it, but, as victims of government cutbacks and medical bureaucracy, continually faced with an overall attitude of unworthiness by all who witness their downfall.
April 13, 2018
The title, No Once Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America says it all. Powers skillfully alternates between the current state and history of the treatment of mental illness and his personal and emotional experiences with two mentally ill sons.
I read this book with a sense of dread, knowing what was coming. Powers is an excellent reporter and a brave father. Although it was both painful and terrifying for me to read, I have to give it 5 stars. This is a very important, needed book.
I read this book with a sense of dread, knowing what was coming. Powers is an excellent reporter and a brave father. Although it was both painful and terrifying for me to read, I have to give it 5 stars. This is a very important, needed book.
April 15, 2020
Thoughts soon
April 22, 2017
This text weaves two major threads: an opinionated history of the treatment of mental illness, mostly in the U.S., and a tragic memoir of the author's sons -- gifted and schizophrenic. There's conflict between these threads: I tried to read this as a history and at times felt an excessive number of pages were spent on juvenilia and family emails. This is forgivable, of course; I can't imagine a parent's sense of loss from these events, and it's clear that every scrap of happier times would be treasured.
The book's thesis seems to be that parents should be able to involuntarily commit their adult, mentally ill children to institutions without court order, which I could not agree with. The author believes this power might have spared his family at least some portion of the pain recorded here, but, with all respect for what his family went through, this isn't clear. Much of what the author identifies as the sons' "prodromal phase" wasn't distinguishable from youthful angst and self-discovery; some of the worst events occurred when the sons had already returned to parental care. The author may have been able to build a stronger case by including more individual stories, but the structure of the book, split between the specificity of his own family and a general high-level history, didn't allow for that.
I was forced instead to compare the stories of my own mentally ill friends. I recently had to get a friend to an emergency room after she had a bad episode; knowing her full situation, I would never want her parents to have that power. Should an abusive, disapproving parent be able to involuntarily commit an adult LGBT child to an institution -- even into her 20s or 30s -- mental illness or no? The proposal might make sense for happily nuclear middle-class families like the author's, but families come in all sorts, and I don't trust that the kinds of families recognizable by governments should be given a fast-track to lock away people over the objections of their families-of-choice.
The author doesn't address this very real possibility of abuse, or the mental health costs of institutionalization itself. He mentions he attended a legislative hearing about a similar plan where many mentally ill people and their friends spoke out against it, but in this book's greatest deficit, he gives them no voices here. Instead he avers that the only reason not to grant this power is a "libertarian" perspective, blithely dismissed without review. I'm no libertarian, but I'm certainly cautious about how such powers can be used to harm and limit people, especially marginalized people, abused people, and my own friends.
I'll grant that, if we ever manage to build kind, rehabilitating mental health facilities on a sufficient scale -- and we should try -- they'd be often preferred to the prisons and streets where many mentally ill people live currently. However: many, many mentally ill people flourish anyway, and if they'd all been preemptively locked up, there would have been no way to know who would have succeeded, who would have loved, and who found beauty of the sort that doesn't bloom in even a very large cage.
The book's thesis seems to be that parents should be able to involuntarily commit their adult, mentally ill children to institutions without court order, which I could not agree with. The author believes this power might have spared his family at least some portion of the pain recorded here, but, with all respect for what his family went through, this isn't clear. Much of what the author identifies as the sons' "prodromal phase" wasn't distinguishable from youthful angst and self-discovery; some of the worst events occurred when the sons had already returned to parental care. The author may have been able to build a stronger case by including more individual stories, but the structure of the book, split between the specificity of his own family and a general high-level history, didn't allow for that.
I was forced instead to compare the stories of my own mentally ill friends. I recently had to get a friend to an emergency room after she had a bad episode; knowing her full situation, I would never want her parents to have that power. Should an abusive, disapproving parent be able to involuntarily commit an adult LGBT child to an institution -- even into her 20s or 30s -- mental illness or no? The proposal might make sense for happily nuclear middle-class families like the author's, but families come in all sorts, and I don't trust that the kinds of families recognizable by governments should be given a fast-track to lock away people over the objections of their families-of-choice.
The author doesn't address this very real possibility of abuse, or the mental health costs of institutionalization itself. He mentions he attended a legislative hearing about a similar plan where many mentally ill people and their friends spoke out against it, but in this book's greatest deficit, he gives them no voices here. Instead he avers that the only reason not to grant this power is a "libertarian" perspective, blithely dismissed without review. I'm no libertarian, but I'm certainly cautious about how such powers can be used to harm and limit people, especially marginalized people, abused people, and my own friends.
I'll grant that, if we ever manage to build kind, rehabilitating mental health facilities on a sufficient scale -- and we should try -- they'd be often preferred to the prisons and streets where many mentally ill people live currently. However: many, many mentally ill people flourish anyway, and if they'd all been preemptively locked up, there would have been no way to know who would have succeeded, who would have loved, and who found beauty of the sort that doesn't bloom in even a very large cage.
October 30, 2017
What a moving experience!!! I checked this book from the library,but I’m buying a copy. This book tells two stories: the tale of the author’s two schizophrenic sons, and the history of mental healthcare in the United States.
I don’t know which touched me more. We have a serious problem in my country. The mentally ill are the homeless. No one is there to go take care of them; there are no safety nets. Medication costs are sky high.
Then there is the author who lost one of his his sons to suicide. He’s open about that from the beginning. But it’s the travails that his family experiences that just broke my heart. I admit I cried at the end.
Tim Murphy in 2015 was able to pass an act through congress that assists families in mental health crisis. There is hope. As one who suffers from bipolar disorder I’m not giving up.
I don’t know which touched me more. We have a serious problem in my country. The mentally ill are the homeless. No one is there to go take care of them; there are no safety nets. Medication costs are sky high.
Then there is the author who lost one of his his sons to suicide. He’s open about that from the beginning. But it’s the travails that his family experiences that just broke my heart. I admit I cried at the end.
Tim Murphy in 2015 was able to pass an act through congress that assists families in mental health crisis. There is hope. As one who suffers from bipolar disorder I’m not giving up.
May 17, 2017
Overview of how psychiatric illness has been misunderstood, criminalized, ignored, and treated, with a special emphasis on schizophrenia, the disease that haunts Powers's own family.
Although it clocked in at 15 hours I was able to listen to the entire audiobook over two short days, which helped my momentum and focus. (Explanation: I sped it up to 1.5x the speed, did a lot of walking, and I had an eye-strain headache that meant when I wasn't working I was resting my eyes and listening.)
Ron Powers reads the audiobook himself, and while he does a fine job, I thought the historical/sociological portions of the book were superior to the writing of the personal story. But I cannot and would not judge the personal story, because he's telling a wrenchingly sad tale of his son's descent into schizophrenia and eventual suicide - it's unspeakably painful to imagine.
Two small critical observations, if I may: Powers spends a lot of time describing both of his sons' talents and his fatherly pride in their accomplishments. I got a little annoyed with the proud dad-talk and then I'd chastise myself for being a jerk - because how can I begrudge him that? But this: in these background stories he takes great pains to explain his and his wife's parenting style and devotion to their sons. It's not totally self-aggrandizing, but there was some unnecessary over-explaining, and I almost got the sense he was setting the record down in order to exonerate himself and his wife from responsibility for both sons' mental health problems. But he didn't need to! In the more dispassionate, expository sections of the book Powers carefully explains all the research showing that while schizophrenia has a genetic component it is certainly NOT caused by parents (esp. not the mother), any reader deep into the book or even someone who had read even half of this book would never accuse him of causing or exacerbating the illness.
So I guess I found some imbalance in the book's two approaches, but it was overall excellent: explaining the history of the injustices against the mentally ill, setting the scientific record straight on schizophrenia's causes, and a call to arms to attend to the problem of mental illness in America.
Although it clocked in at 15 hours I was able to listen to the entire audiobook over two short days, which helped my momentum and focus. (Explanation: I sped it up to 1.5x the speed, did a lot of walking, and I had an eye-strain headache that meant when I wasn't working I was resting my eyes and listening.)
Ron Powers reads the audiobook himself, and while he does a fine job, I thought the historical/sociological portions of the book were superior to the writing of the personal story. But I cannot and would not judge the personal story, because he's telling a wrenchingly sad tale of his son's descent into schizophrenia and eventual suicide - it's unspeakably painful to imagine.
Two small critical observations, if I may: Powers spends a lot of time describing both of his sons' talents and his fatherly pride in their accomplishments. I got a little annoyed with the proud dad-talk and then I'd chastise myself for being a jerk - because how can I begrudge him that? But this: in these background stories he takes great pains to explain his and his wife's parenting style and devotion to their sons. It's not totally self-aggrandizing, but there was some unnecessary over-explaining, and I almost got the sense he was setting the record down in order to exonerate himself and his wife from responsibility for both sons' mental health problems. But he didn't need to! In the more dispassionate, expository sections of the book Powers carefully explains all the research showing that while schizophrenia has a genetic component it is certainly NOT caused by parents (esp. not the mother), any reader deep into the book or even someone who had read even half of this book would never accuse him of causing or exacerbating the illness.
So I guess I found some imbalance in the book's two approaches, but it was overall excellent: explaining the history of the injustices against the mentally ill, setting the scientific record straight on schizophrenia's causes, and a call to arms to attend to the problem of mental illness in America.
September 19, 2018
Part memoir, part history of the treatment of mental illness, author Ron Powers draws attention to the plight of millions suffering from mental illness. He illuminates the factors that have led to the current state of chaos, where many mentally ill are no longer institutionalized, but fill our streets and jails, without access to treatment. Both of his sons were diagnosed with schizophrenia, and the memoir portion of this book is a poignant and heart-wrenching account of their descent into psychosis.
The portions related to science and history read more like a thesis, complete with numerous footnotes, while the memoir came across as a heartfelt picture of the impact of mental illness on his family. It passionately illustrated the depths of pain and suffering while feeling helpless to halt the progression of the disease. This book helps explain what has led to the state of mental illness in America, including scientific, economic, political, and cultural aspects. While Powers has ideas about the need to diagnose early and require treatment, there are no easy answers. He outlines his personal views, and what could be done based on his situation. I thought his call to action was effective, but what needs to be done is a little less clear.
Overall, I found it informative and thought-provoking. At the very least, this book raises awareness of an important issue that needs further dialogue leading to action. Highly recommended to those interested in mental health issues.
The portions related to science and history read more like a thesis, complete with numerous footnotes, while the memoir came across as a heartfelt picture of the impact of mental illness on his family. It passionately illustrated the depths of pain and suffering while feeling helpless to halt the progression of the disease. This book helps explain what has led to the state of mental illness in America, including scientific, economic, political, and cultural aspects. While Powers has ideas about the need to diagnose early and require treatment, there are no easy answers. He outlines his personal views, and what could be done based on his situation. I thought his call to action was effective, but what needs to be done is a little less clear.
Overall, I found it informative and thought-provoking. At the very least, this book raises awareness of an important issue that needs further dialogue leading to action. Highly recommended to those interested in mental health issues.
April 1, 2017
This book is very sad, yet the details and research into mental illness are real facts. I like the way the writer writes, and feel lots of empathy toward his life and his sons. I learned a lot reading this and struggle with the truths of schizophrenia as my 33 yr old son has it. As hard as it is for me as a mother, it must be even worse for the ill ones. And if only people would reach out more positively seeing there sensitivity, creativeness, and heart beat just like anyone else, i too believe this world would be a better place! After all its so true the most primal of human urges, the urge to be of use is universal not so hard to understand! Thank you Ron for writing this book and sharing youre story!
April 25, 2020
3.5 for this difficult, but relevant book. It offers both informative and academic information, as well as a close, personal view of how mental illness ravaged a family.
For those who don't know much about mental illness, this gives a comprehensive background on the evolution of how mental illness is seen, how those suffering were treated, and how our views and interventions have changed over time. It's an issue that continues to drag some of our most vulnerable through very muddy water, churned by the usual divide over how best to address their needs.
The author has strong beliefs about systemic practices, based on his own intersection with it on behalf of two sons, which he clearly articulates (it was, understandably, not a happy experience). The extensive background might be too much for some readers, reading more like a textbook (some of that could be skimmed if not important to the reader). But, it does offer a great deal of information about how the system can (and did) fail those who need it most. It also outlines the very difficult dance between protecting the rights of the individual, with protecting the individual from themselves, a slippery slope on a best day. As someone who's volunteered in warming centers, I've seen first hand those who are clearly not in a position to care for their own basic needs, but wander the streets because they cannot be forced to take medication that might increase their functioning. I don't claim to have any answers to go along with my concern.
The chapters that focused on the family, and the eventual slide into mental illness experienced by both of the author's sons were the parts I found most gripping. Again, putting a face on those diagnosed with mental illness helps humanize them; their talents, their dreams, their personalities before many aspects were dulled...these are our sons and brothers and cousins and mothers and aunts. They were us, before being rubbed into something else by forces beyond their control. The book highlights how helpless one can be as a bystander, watching this happen and being unable to do anything about it; having to accept the decisions of the individual even as we know it will come to something unhappy. No amount of love can prevent it.
Reading this book brought back to mind many young people I'd known. I am grateful to the author for sharing this information with others who may have no experience with it, to increase their understanding and compassion. For those who have dealt with this on some level, it may help you feel less alone in the struggle.
For those who don't know much about mental illness, this gives a comprehensive background on the evolution of how mental illness is seen, how those suffering were treated, and how our views and interventions have changed over time. It's an issue that continues to drag some of our most vulnerable through very muddy water, churned by the usual divide over how best to address their needs.
The author has strong beliefs about systemic practices, based on his own intersection with it on behalf of two sons, which he clearly articulates (it was, understandably, not a happy experience). The extensive background might be too much for some readers, reading more like a textbook (some of that could be skimmed if not important to the reader). But, it does offer a great deal of information about how the system can (and did) fail those who need it most. It also outlines the very difficult dance between protecting the rights of the individual, with protecting the individual from themselves, a slippery slope on a best day. As someone who's volunteered in warming centers, I've seen first hand those who are clearly not in a position to care for their own basic needs, but wander the streets because they cannot be forced to take medication that might increase their functioning. I don't claim to have any answers to go along with my concern.
The chapters that focused on the family, and the eventual slide into mental illness experienced by both of the author's sons were the parts I found most gripping. Again, putting a face on those diagnosed with mental illness helps humanize them; their talents, their dreams, their personalities before many aspects were dulled...these are our sons and brothers and cousins and mothers and aunts. They were us, before being rubbed into something else by forces beyond their control. The book highlights how helpless one can be as a bystander, watching this happen and being unable to do anything about it; having to accept the decisions of the individual even as we know it will come to something unhappy. No amount of love can prevent it.
Reading this book brought back to mind many young people I'd known. I am grateful to the author for sharing this information with others who may have no experience with it, to increase their understanding and compassion. For those who have dealt with this on some level, it may help you feel less alone in the struggle.
June 6, 2017
This review is difficult to write. The book was difficult to read. And I am sure Ron Powers found the book difficult to write. My son has schizophrenia. Powers has two sons with the disease, one of whom it killed. The book interleaves Powers’ personal story with the history of mental illness, and reflections on how we treat the mentally ill, and how we ought to.
I was very grateful that Powers chose to write this book. One thing I have learned from our family’s experiences is that mental illness in general, and schizophrenia in particular, have shredded more lives than one tends to think. When I chose to share my story with friends and colleagues, I learned that everyone either has mental illness in their family, or knows someone who does. Schizophrenia is in the room with us, and avoiding eye contact is no less than self delusion.
Every detail of the onset and recurrence of Kevin and Dean’s, Power’s sons, schizophrenia was entirely too familiar. It was nearly as painful to read about as it was to experience. Like my son, both Kevin and Dean were talented musicians and poets. This horrible disease stole their futures from them. As a parent, it is terrible to (justifiably) imagine a brilliant future for your child, and to watch it stripped away. It is horrible when you hope, and hope, and hope that your child will at least be happy, knowing that the disease is always there and that it is very, very likely for the symptoms to return. That is the cycle: medications allow your child something like a normal life, then he decides he has recovered and stops taking the medication, symptoms return with a vengeance, and everything falls apart again. Schizophrenia is a perfect predator. One of the symptoms is anosognosia, unawareness that one has the illness. And every parent’s greatest fear is the outcome that Powers experienced with Kevin.
Historically, the mentally ill had a place in society. Shamans helped society deal with disappointments and with the unconcerned cruelty of life. Artists inspired us and helped us see life in new ways. But in modern times, society has tried various ways to “deal with” the mentally ill, sometimes with cruelty, sometimes with punishment, and usually with isolation so that we can keep our eyes closed. In the US, we have “deinstituitionalized” the mentally ill, by making them homeless or by shutting them up in the most extensive incarceration system in the world, our jails and prisons.
Our politicians don’t fund treatment, food, or housing for the mentally ill because “No One Cares for Crazy People”. The voters don’t. So neither do our representatives. Never mind that a dollar of treatment saves thousands of dollars for incarceration. Never mind the horrible pain of watching your child taken away from you, or the terrible loss and confusion that the schizophrenic must feel as the world stops making sense and as he or she loses control.
This book should be required reading. For parents of pre-teen children, it is important to recognize the warning signs. For parents of the afflicted, it is important to know you are not alone. For the fortunate, it is important to realize that this horror exists, and to develop some sympathy for the afflicted and their families. Voters need to know, in their bones that how we treat the mentally ill is not theoretical or a simple matter of ideology. Everyone should read this book, if only to show that someone, somewhere, does in fact care about crazy people.
I was very grateful that Powers chose to write this book. One thing I have learned from our family’s experiences is that mental illness in general, and schizophrenia in particular, have shredded more lives than one tends to think. When I chose to share my story with friends and colleagues, I learned that everyone either has mental illness in their family, or knows someone who does. Schizophrenia is in the room with us, and avoiding eye contact is no less than self delusion.
Every detail of the onset and recurrence of Kevin and Dean’s, Power’s sons, schizophrenia was entirely too familiar. It was nearly as painful to read about as it was to experience. Like my son, both Kevin and Dean were talented musicians and poets. This horrible disease stole their futures from them. As a parent, it is terrible to (justifiably) imagine a brilliant future for your child, and to watch it stripped away. It is horrible when you hope, and hope, and hope that your child will at least be happy, knowing that the disease is always there and that it is very, very likely for the symptoms to return. That is the cycle: medications allow your child something like a normal life, then he decides he has recovered and stops taking the medication, symptoms return with a vengeance, and everything falls apart again. Schizophrenia is a perfect predator. One of the symptoms is anosognosia, unawareness that one has the illness. And every parent’s greatest fear is the outcome that Powers experienced with Kevin.
Historically, the mentally ill had a place in society. Shamans helped society deal with disappointments and with the unconcerned cruelty of life. Artists inspired us and helped us see life in new ways. But in modern times, society has tried various ways to “deal with” the mentally ill, sometimes with cruelty, sometimes with punishment, and usually with isolation so that we can keep our eyes closed. In the US, we have “deinstituitionalized” the mentally ill, by making them homeless or by shutting them up in the most extensive incarceration system in the world, our jails and prisons.
Our politicians don’t fund treatment, food, or housing for the mentally ill because “No One Cares for Crazy People”. The voters don’t. So neither do our representatives. Never mind that a dollar of treatment saves thousands of dollars for incarceration. Never mind the horrible pain of watching your child taken away from you, or the terrible loss and confusion that the schizophrenic must feel as the world stops making sense and as he or she loses control.
This book should be required reading. For parents of pre-teen children, it is important to recognize the warning signs. For parents of the afflicted, it is important to know you are not alone. For the fortunate, it is important to realize that this horror exists, and to develop some sympathy for the afflicted and their families. Voters need to know, in their bones that how we treat the mentally ill is not theoretical or a simple matter of ideology. Everyone should read this book, if only to show that someone, somewhere, does in fact care about crazy people.
April 29, 2017
This is a heartbreaking and fascinating book about the author's two schizophrenic sons, one of whom survives and relatively thrives, and the other who hangs himself. The book is also an indictment of the mental-health-care system in the United States. Prospects for that don't look very good. The title is a quote from an aide to Wisconsin governer Scott Walker and is typical of the unfeeling political response typifying much of government and the public.
January 16, 2022
There is so much good in this book, Powers' warts and all sharing of his life, his struggles with two schizophrenic sons, including the suicide of one of those boys just days before his 21st birthday, is beautiful, and brave, and does so much to humanize mental illness. In this historical moment when we demonize the mentally ill because of the acts of a few we need to raise understanding of what mental illness is and isn't. I could not be more grateful to Powers for shedding light on the reality of this plague that has affected, sometimes even taken, people I love. Powers also presents a compelling history of mental illness, some of which was new to me and was fascinating.
For me this book was unsuccessful in 2 areas. The first of those areas was totally understandable. Powers spent SO much time talking about his sons' music. Duplicative stories of gigs that did nothing to advance the reader's understanding or the narrative. I know Powers wanted to show that his son was important and more than his illness. That said, I don't think he needed to try so hard and I don't think many readers would have a real interest in where his 17 year old played what. Certainly the truth of his status as a musical prodigy could be told with just a few of those tales, and the fact of his admission to the esteemed programs at Interlochen and Berklee. These many (many!) digressions were simply boring and frequently led me to put down the book. Ditto on the letters home from both sons. A few of them had red flags to be sure, but mostly they were 100% unremarkable letters from well-educated high school and college aged boys to anyone they felt compelled to write. Powers tries hard to stress their extraordinary insight, but I have an 18-year old, and a lot of the observations sound like things he would say or write to me. The most remarkable thing was how little emotion was to be found in the "sane" letters. Maybe Powers left that out? From what was there the relationship seemed very distant without trust or love. These were simply reports on things going on.
My second issue with the book was more serious. Powers makes an argument that it is wrong that parents cannot commit their adult children as a matter of course. Shame on him. The mentally ill adult is an adult who needs to be allowed to make his own decisions. We don't routinely infantilize adults under our laws because it would be morally, ethically and constitutionally wrong to do so. In those instances where it is necessary because a person is not competent, the law allows for conservatorship. Is it difficult to get to conservatorship? Yep. And is should be. Powers tells the story of a person who had a psychotic break the day after his 18th birthday attempting to show that this is a ridiculous line being drawn. But guess what. All lines are somewhat arbitrary. All of us reach our legal majority at the same age though we are at different levels of development. All of us can collect Social Security and Medicare at the same age though many of us are healthy enough to work, and some people need those programs years earlier and cannot access them. A line is drawn based upon averages, means and medians, and traditions. Mentally ill people have the right to live by those same rules unless a threat to themselves or others (at which time there are remedies.) I found this argument offensive and cruel and dangerous, and it made the rest of the book suspect in my eyes. I cannot imagine what Powers' surviving son, Dean, thought of that thesis. I am sad and angry for him. That is not to say Powers didn't love his sons. He clearly adored them. But his desire for the law to make them perpetual children to ease his care-taking is spectacularly arrogant.
For me this book was unsuccessful in 2 areas. The first of those areas was totally understandable. Powers spent SO much time talking about his sons' music. Duplicative stories of gigs that did nothing to advance the reader's understanding or the narrative. I know Powers wanted to show that his son was important and more than his illness. That said, I don't think he needed to try so hard and I don't think many readers would have a real interest in where his 17 year old played what. Certainly the truth of his status as a musical prodigy could be told with just a few of those tales, and the fact of his admission to the esteemed programs at Interlochen and Berklee. These many (many!) digressions were simply boring and frequently led me to put down the book. Ditto on the letters home from both sons. A few of them had red flags to be sure, but mostly they were 100% unremarkable letters from well-educated high school and college aged boys to anyone they felt compelled to write. Powers tries hard to stress their extraordinary insight, but I have an 18-year old, and a lot of the observations sound like things he would say or write to me. The most remarkable thing was how little emotion was to be found in the "sane" letters. Maybe Powers left that out? From what was there the relationship seemed very distant without trust or love. These were simply reports on things going on.
My second issue with the book was more serious. Powers makes an argument that it is wrong that parents cannot commit their adult children as a matter of course. Shame on him. The mentally ill adult is an adult who needs to be allowed to make his own decisions. We don't routinely infantilize adults under our laws because it would be morally, ethically and constitutionally wrong to do so. In those instances where it is necessary because a person is not competent, the law allows for conservatorship. Is it difficult to get to conservatorship? Yep. And is should be. Powers tells the story of a person who had a psychotic break the day after his 18th birthday attempting to show that this is a ridiculous line being drawn. But guess what. All lines are somewhat arbitrary. All of us reach our legal majority at the same age though we are at different levels of development. All of us can collect Social Security and Medicare at the same age though many of us are healthy enough to work, and some people need those programs years earlier and cannot access them. A line is drawn based upon averages, means and medians, and traditions. Mentally ill people have the right to live by those same rules unless a threat to themselves or others (at which time there are remedies.) I found this argument offensive and cruel and dangerous, and it made the rest of the book suspect in my eyes. I cannot imagine what Powers' surviving son, Dean, thought of that thesis. I am sad and angry for him. That is not to say Powers didn't love his sons. He clearly adored them. But his desire for the law to make them perpetual children to ease his care-taking is spectacularly arrogant.
July 3, 2017
While No One Cares About Crazy People had moments that were very strong and very moving, the book also suffered from major weaknesses.
The first major issue that I had with this book was the structure. The book alternates between chronicling the history of the treatment of people with mental illness and a sort of memoir of the lives of his sons both of which suffer from schizophrenia. These two sections are rarely connected and that makes the book feel disjointed and I think both sections would be stronger if they were in two separate books.
Overall, I found the memoir part of the book weaker than the history of mental health part. Powers spends a lot of time focusing on his sons' youth before they developed schizophrenic symptoms and their music which was probably important for him to write, but wasn't particularly interesting to read and at times came across as bragging. He also spends a lot of time trying to piece together what his sons were doing when he was not present which was again kind of boring. The memoir section is more moving and stronger when Powers writes about his experience and feelings as a parent with a child struggling with mental illness, however there are really only a couple sentences about this.
The history of the treatment illness part of the book was overall stronger than the memoir. Powers is a much stronger when writing about facts than when writing about emotion. However, this section suffers from Powers' faulty thesis. Powers' thesis is that a lot of problems the mentally ill face are caused by deinstitutionalization and the fact that parents of the mentally ill can't medicate or enter their children with mental illnesses into treatment facilities without their adult children's consent.
It is true that deinstitutionalization has had really awful repercussions for the mentally ill, especially those with schizophrenia. However, it is not the only issue the mentally ill face. While Powers does allude to some of the other issues but largely treats them as inconvenient details, when they really are not. He also alludes to the abuses that happened in mid century asylums that led to deinstitutionalization but largely ignores these issues and list the cause of deinstitutionalization as libertarian ideologues and people with mental illness who just don't know what's in their best interest.
I can understand why Powers is frustrated that parents of the mentally ill can't medicate or place their adult, mentally ill children in care facilities without their consent. However, he ignores the abuse that can and has happened when desperate parents try to cure their children of mental illness and mental disabilities (I'm thinking specifically of the lobotomization of Rose Kennedy). In the beginning of the book, Powers notes that our society often silences the mentally ill and that this is an issue, but then he contributes to the silencing of the mentally ill when he dismisses their objections to institutionalization and giving the parents of the mentally ill the power to medicate or place their adult, mentally ill children in psychiatric facilities as just libertarian ideology and the mentally ill just don't know what's in their best interest.
While I did find parts of this book fascinating and moving and devastating, I also found parts of this book self indulgent and slightly offensive and kind of reinforcing some of the issues that people with mental illness face.
The first major issue that I had with this book was the structure. The book alternates between chronicling the history of the treatment of people with mental illness and a sort of memoir of the lives of his sons both of which suffer from schizophrenia. These two sections are rarely connected and that makes the book feel disjointed and I think both sections would be stronger if they were in two separate books.
Overall, I found the memoir part of the book weaker than the history of mental health part. Powers spends a lot of time focusing on his sons' youth before they developed schizophrenic symptoms and their music which was probably important for him to write, but wasn't particularly interesting to read and at times came across as bragging. He also spends a lot of time trying to piece together what his sons were doing when he was not present which was again kind of boring. The memoir section is more moving and stronger when Powers writes about his experience and feelings as a parent with a child struggling with mental illness, however there are really only a couple sentences about this.
The history of the treatment illness part of the book was overall stronger than the memoir. Powers is a much stronger when writing about facts than when writing about emotion. However, this section suffers from Powers' faulty thesis. Powers' thesis is that a lot of problems the mentally ill face are caused by deinstitutionalization and the fact that parents of the mentally ill can't medicate or enter their children with mental illnesses into treatment facilities without their adult children's consent.
It is true that deinstitutionalization has had really awful repercussions for the mentally ill, especially those with schizophrenia. However, it is not the only issue the mentally ill face. While Powers does allude to some of the other issues but largely treats them as inconvenient details, when they really are not. He also alludes to the abuses that happened in mid century asylums that led to deinstitutionalization but largely ignores these issues and list the cause of deinstitutionalization as libertarian ideologues and people with mental illness who just don't know what's in their best interest.
I can understand why Powers is frustrated that parents of the mentally ill can't medicate or place their adult, mentally ill children in care facilities without their consent. However, he ignores the abuse that can and has happened when desperate parents try to cure their children of mental illness and mental disabilities (I'm thinking specifically of the lobotomization of Rose Kennedy). In the beginning of the book, Powers notes that our society often silences the mentally ill and that this is an issue, but then he contributes to the silencing of the mentally ill when he dismisses their objections to institutionalization and giving the parents of the mentally ill the power to medicate or place their adult, mentally ill children in psychiatric facilities as just libertarian ideology and the mentally ill just don't know what's in their best interest.
While I did find parts of this book fascinating and moving and devastating, I also found parts of this book self indulgent and slightly offensive and kind of reinforcing some of the issues that people with mental illness face.
May 7, 2017
Let me start off with saying: I wish this book didn't exist. I wish it was full of falsehoods. But instead it's filled with harsh realities that we as a nation and a culture have to face. This book alternates between chapters of the history of the treatment of mental illness (with a focus on severe mental illnesses) by the government, doctors, and society as a whole and the authors personal story of his journey with two sons who developed schizophrenia. The writing in the informational chapters is eloquent yet not tedious, and much of the subject matter I didn't know the details of already, even though I have a psychology degree. The personal chapters were like seeing into the authors memories, and very emotional. I want to take passages from this book and print them onto billboards across the country. A few that I took note of:
"As mental health research flourishes, mental illness care in the United States remains in chaos. It has always been in chaos, yet in our time the chaos has accelerated and spread. And the chaos and it's effects grow normative, diminishing everyone's civic and private well-being."
"Jail and prison populations swell beyond the limits of health and decency, and the watchdog groups issue statistics and the media report them, and people wonder what can be done, and then they cease wondering."
"NIMH has estimated that two thirds of children with lifetime mental health problems never receive care."
I hope this book reaches some of those who feel that mental illness and it's effects can't touch them. And those who have the power to help come up with and ENACT solutions to further our progress.
"As mental health research flourishes, mental illness care in the United States remains in chaos. It has always been in chaos, yet in our time the chaos has accelerated and spread. And the chaos and it's effects grow normative, diminishing everyone's civic and private well-being."
"Jail and prison populations swell beyond the limits of health and decency, and the watchdog groups issue statistics and the media report them, and people wonder what can be done, and then they cease wondering."
"NIMH has estimated that two thirds of children with lifetime mental health problems never receive care."
I hope this book reaches some of those who feel that mental illness and it's effects can't touch them. And those who have the power to help come up with and ENACT solutions to further our progress.
January 23, 2019
I was and still am extremely compelled and moved by the devastating experiences of the Powers family, and Ron Powers' writing about his sons is elegant, gripping, honorary, and definitely why you should read this memoir.
In many ways, this book is two books, and only about a third of this memoir is actually memoir. The rest is Ron Powers' manifesto: names, dates, and statistics of the sordid history of mental health care. Some of it is interesting, some of it is medical, and some feels like padding. All of it is horrifying and written with the intention, I think, to educate and maybe scare the reader into action. What didn't work for me, though, is that even after reading this book, I still don't have a clear picture of how I could or should act to contribute to the improvement of mental health care in the U.S.
In many ways, this book is two books, and only about a third of this memoir is actually memoir. The rest is Ron Powers' manifesto: names, dates, and statistics of the sordid history of mental health care. Some of it is interesting, some of it is medical, and some feels like padding. All of it is horrifying and written with the intention, I think, to educate and maybe scare the reader into action. What didn't work for me, though, is that even after reading this book, I still don't have a clear picture of how I could or should act to contribute to the improvement of mental health care in the U.S.
July 19, 2018
No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America is a great idea for a book, and it does have a lot of interesting information in it. It’s a book that dives deep into the cruelties of our history in treating the mentally ill, and that argues fiercely for the need for action, particularly for those with schizophrenia. Ron Powers is the father of two sons with schizophrenia, one of whom committed suicide, and there is an autobiographical aspect to this book as he tells the stories of his sons. This book was emotional and gave a lot of information that I don’t want to discount.
Unfortunately, it also has a lot of problems, first with the writing and argument. Powers has a lot of emotion on this subject, which is understandable. But it leads to exaggeration and a love for the dramatic, which leads Powers to writes somewhat misleading and bombastic sentences preluding later arguments. It also makes it difficult for him to empathize with opposing arguments enough to engage them in a useful way that could explain the issue—the best example for me is when he dismisses Szasz with a poor close read of Szasz’s writings rather than try and get at what this man believed and what his followers believed. It makes it difficult to get insight from his discussions about these issues, and isn’t a sign of good argument. His structure can be scattered—he often seems to be introducing a subject that he doesn’t actually go into for another several chapters (he brings up deinstitutionalization at least 3 times pre-the chapter on it). He has moments of bitter humor and sarcasm that often seem out of place and inappropriate for the seriousness of the subjects.
There are also content issues that bothered me. He seems blind to intersectional issues, rarely engaging race and never LGBTQA+ issues. He makes false equivalencies. Understandably, he is over-indulgent when it comes to his sons’ story. I know that sounds cruel, but I have seen memoirs about horrible things written well and in a balanced matter, and this was strangely over-balanced on his sons’ upbringing long before their mental illness, their storyline not well integrated into his forays into history and policy. He is fiercely defensive of his sons in places even where defenses weren’t necessary.
I was extremely turned off by his confusing stance on drugs and alcohol that seems based on only a loose handful of evidence, and that is grounded clearly in his preconceptions. Here are two of those chunks:
“Our sons off in the Middlebury night with their friends and supposed friends. Someone in that group almost certainly was sharing marijuana, a substance that, as we now know, can gravely exacerbate the symptoms of schizophrenia. Several months afterward, we came to believe that the equally destructive LSD had been introduced into the circle. At the time, we remained innocent.”
“These studies appeared too late to trigger warnings in the Powers household that cannabis could induce mental illness, though we tried, without success, to keep our sons from using it anyway. The world at large has remained equally, willfully clueless.”
He is judgmental and one-sided, and never engages the fact, for example, that many mentally ill people actually seem to find peace in cannabis, or that many argue that it is completely safe and non-addictive. He blames his son’s cannabis dependency and surroundings of friends who smoke on a lot—in that early passage, he says that marijuana can exacerbate the symptoms, while later he argues that it could have somehow helped it arrive. He never, by the way, engages LSD again. Considering his discussion of a zero-tolerance policy on drugs and alcohol that he and his wife had for their sons when they were teenagers, and other strange comments blaming his sons’ friends and community for their “dependencies,” this whole argument felt awkward and offensive to me.
All around, I was not a fan of this book and even found myself skimming near the end.
Unfortunately, it also has a lot of problems, first with the writing and argument. Powers has a lot of emotion on this subject, which is understandable. But it leads to exaggeration and a love for the dramatic, which leads Powers to writes somewhat misleading and bombastic sentences preluding later arguments. It also makes it difficult for him to empathize with opposing arguments enough to engage them in a useful way that could explain the issue—the best example for me is when he dismisses Szasz with a poor close read of Szasz’s writings rather than try and get at what this man believed and what his followers believed. It makes it difficult to get insight from his discussions about these issues, and isn’t a sign of good argument. His structure can be scattered—he often seems to be introducing a subject that he doesn’t actually go into for another several chapters (he brings up deinstitutionalization at least 3 times pre-the chapter on it). He has moments of bitter humor and sarcasm that often seem out of place and inappropriate for the seriousness of the subjects.
There are also content issues that bothered me. He seems blind to intersectional issues, rarely engaging race and never LGBTQA+ issues. He makes false equivalencies. Understandably, he is over-indulgent when it comes to his sons’ story. I know that sounds cruel, but I have seen memoirs about horrible things written well and in a balanced matter, and this was strangely over-balanced on his sons’ upbringing long before their mental illness, their storyline not well integrated into his forays into history and policy. He is fiercely defensive of his sons in places even where defenses weren’t necessary.
I was extremely turned off by his confusing stance on drugs and alcohol that seems based on only a loose handful of evidence, and that is grounded clearly in his preconceptions. Here are two of those chunks:
“Our sons off in the Middlebury night with their friends and supposed friends. Someone in that group almost certainly was sharing marijuana, a substance that, as we now know, can gravely exacerbate the symptoms of schizophrenia. Several months afterward, we came to believe that the equally destructive LSD had been introduced into the circle. At the time, we remained innocent.”
“These studies appeared too late to trigger warnings in the Powers household that cannabis could induce mental illness, though we tried, without success, to keep our sons from using it anyway. The world at large has remained equally, willfully clueless.”
He is judgmental and one-sided, and never engages the fact, for example, that many mentally ill people actually seem to find peace in cannabis, or that many argue that it is completely safe and non-addictive. He blames his son’s cannabis dependency and surroundings of friends who smoke on a lot—in that early passage, he says that marijuana can exacerbate the symptoms, while later he argues that it could have somehow helped it arrive. He never, by the way, engages LSD again. Considering his discussion of a zero-tolerance policy on drugs and alcohol that he and his wife had for their sons when they were teenagers, and other strange comments blaming his sons’ friends and community for their “dependencies,” this whole argument felt awkward and offensive to me.
All around, I was not a fan of this book and even found myself skimming near the end.
April 17, 2017
A must for anyone interested in or affected by mental health issues (which is all us, btw). Also happens to be brilliantly written and researched, with nuanced analysis throughout.
For anyone who has dealt with the mentally ill closely, reading Powers' descriptions of his experiences with his sons is transcendent, cathartic, and profound.
For anyone who has dealt with the mentally ill closely, reading Powers' descriptions of his experiences with his sons is transcendent, cathartic, and profound.
April 11, 2018
Well worth reading. The sad title comes from a comment made by a Wisconsin governor Scott Walker staffer in response to a scandal concerning mental health institution abuses. Don't worry about it affecting your career, she advised, because "no one cares about crazy people."
Powers is an accomplished journalist, and in this book he examines the history of treatment for mental illness and the history of attitudes toward the mentally ill through the lens of his own experience as the parent of two sons with schizophrenia, one of whom is dead.
The book alternates between reporting/synthesis and memoir. One basic catch-22 in treating the mentally ill that Powers knows well is that not being able to see that you're ill is part of being mentally ill. Which in turn feeds the paranoia... if the only authority on your illness is outside you, how do you know they aren't out to get you?
Meanwhile, the history of treatment is difficult even for Powers to parse. As he reports, the initial treatments were heavy-handed and quickly co-opted by the marketing departments of the pharma companies (as have been, to be fair, all drugs for all conditions).
But Powers's resentment about this seems a little disproportionate to me. The drugs for MI have offered a great deal of quality of life over the years to many. Yes, there have been many missteps and many side effects. But in the past the mentally ill were dragged to sacred springs, locked in asylums and attics. We have a long way to go, and the suspicion and hostility toward the few treatment protocols that actually can work is not helping.
For example, Powers is outraged that some anti-convulsants are being used off-label for bipolar disorder as if this some sneaky money-making trick. So what? Anti-epileptics are well understood and have been used safely among epileptics for many, many years. They are WORKING for bipolar. In fact, it’s turned out that many epileptics were bipolar all along and their symptoms weren’t manifesting because of the stabilizing effects of the meds they were taking for epilepsy. So it’s no surprise that some of these drugs are now being used, in some cases first-line, for bipolar. They’re cheap and effective and IMO a better choice than the newer atypical anti-psychotics, which really aren’t as well tested, and which can cause weight gain. I don’t think Powers has any business questioning the list of “off-label” uses as if this is all about strongarming by the pharma companies, without first understanding the rationale for this application on the medical side. It’s not as if these drugs—generics almost entirely—are expensive. In fact, there’s a strong push from the pharmas to move away from them and toward the atypicals, which are still branded and more expensive.
What’s interesting to me is that there are many big-gun drugs used against serious medical conditions. Cancer, say. These have SERIOUS side effects. In many cases, side effects far worse than those of psychotropic meds. Some people living with certain kinds of stage 4 cancers have found really long life expectancies—going so far as to have children or launch business—with newer drugs. There isn’t anywhere NEAR the hostility toward the pharma companies for the compromises they’ve have to make living with these awful illnesses and taking these terrible meds. Nor am I saying there should be.
WHY then, are people SO ANGRY at the pharmas for what they offer regarding mental illness? Not only patients are angry, but all of society seems to be angry. Everyone seems to get in the faces of those who are mentally ill… not only does the general public not want to take care of those who are sick in this way, they also don’t want them taking care of themselves. There is a great deal of disapproval of being ill, but there is also a great deal of disapproval of taking meds.
Even Powers doesn’t seem to think that doctors and medical manufacturers can be trusted. And neither do I, wholesale. I mean that in any relationship with medical providers, you have to be your own advocate or find someone you trust to help you. All the same, this ESPECIAL paranoia regarding the treatment of mental illness is something all of society shares, not just the mentally ill.
It’s not helping.
Otherwise, there is a great deal to be learned here. The one weakness of the book is that Powers’s treatment of his family material fails a bit in that he sentimentalizes his memories of his sons. It’s hard to blame him for this. What he aims to do is show the human impact of the collision of issues of around mental illness—the lack of education—the blindness of those who suffer from it, the blindness of parents, the blindness of communities, and the blindness of society at large. The trouble is that he can’t help but go on about what geniuses his children might have been had they not fallen prey to this devastating illness.
And that’s not really the point, is it?
He’s grieving his losses and he wants us to see what he lost. I get it. But what’s important here is not the GIFTS of his children but how they were failed.
It doesn’t matter if they were the next Bob Dylan or Einstein. What strikes a parent to the marrow is the thought that they failed a child. Helping us see how we are all involved in that failure—well, the other chapters have established how the illness works, how the system miscarries, how society colludes. So now, to break our hearts, it’s just a matter of showing how alone the child was.
Powers is an accomplished journalist, and in this book he examines the history of treatment for mental illness and the history of attitudes toward the mentally ill through the lens of his own experience as the parent of two sons with schizophrenia, one of whom is dead.
The book alternates between reporting/synthesis and memoir. One basic catch-22 in treating the mentally ill that Powers knows well is that not being able to see that you're ill is part of being mentally ill. Which in turn feeds the paranoia... if the only authority on your illness is outside you, how do you know they aren't out to get you?
Meanwhile, the history of treatment is difficult even for Powers to parse. As he reports, the initial treatments were heavy-handed and quickly co-opted by the marketing departments of the pharma companies (as have been, to be fair, all drugs for all conditions).
But Powers's resentment about this seems a little disproportionate to me. The drugs for MI have offered a great deal of quality of life over the years to many. Yes, there have been many missteps and many side effects. But in the past the mentally ill were dragged to sacred springs, locked in asylums and attics. We have a long way to go, and the suspicion and hostility toward the few treatment protocols that actually can work is not helping.
For example, Powers is outraged that some anti-convulsants are being used off-label for bipolar disorder as if this some sneaky money-making trick. So what? Anti-epileptics are well understood and have been used safely among epileptics for many, many years. They are WORKING for bipolar. In fact, it’s turned out that many epileptics were bipolar all along and their symptoms weren’t manifesting because of the stabilizing effects of the meds they were taking for epilepsy. So it’s no surprise that some of these drugs are now being used, in some cases first-line, for bipolar. They’re cheap and effective and IMO a better choice than the newer atypical anti-psychotics, which really aren’t as well tested, and which can cause weight gain. I don’t think Powers has any business questioning the list of “off-label” uses as if this is all about strongarming by the pharma companies, without first understanding the rationale for this application on the medical side. It’s not as if these drugs—generics almost entirely—are expensive. In fact, there’s a strong push from the pharmas to move away from them and toward the atypicals, which are still branded and more expensive.
What’s interesting to me is that there are many big-gun drugs used against serious medical conditions. Cancer, say. These have SERIOUS side effects. In many cases, side effects far worse than those of psychotropic meds. Some people living with certain kinds of stage 4 cancers have found really long life expectancies—going so far as to have children or launch business—with newer drugs. There isn’t anywhere NEAR the hostility toward the pharma companies for the compromises they’ve have to make living with these awful illnesses and taking these terrible meds. Nor am I saying there should be.
WHY then, are people SO ANGRY at the pharmas for what they offer regarding mental illness? Not only patients are angry, but all of society seems to be angry. Everyone seems to get in the faces of those who are mentally ill… not only does the general public not want to take care of those who are sick in this way, they also don’t want them taking care of themselves. There is a great deal of disapproval of being ill, but there is also a great deal of disapproval of taking meds.
Even Powers doesn’t seem to think that doctors and medical manufacturers can be trusted. And neither do I, wholesale. I mean that in any relationship with medical providers, you have to be your own advocate or find someone you trust to help you. All the same, this ESPECIAL paranoia regarding the treatment of mental illness is something all of society shares, not just the mentally ill.
It’s not helping.
Otherwise, there is a great deal to be learned here. The one weakness of the book is that Powers’s treatment of his family material fails a bit in that he sentimentalizes his memories of his sons. It’s hard to blame him for this. What he aims to do is show the human impact of the collision of issues of around mental illness—the lack of education—the blindness of those who suffer from it, the blindness of parents, the blindness of communities, and the blindness of society at large. The trouble is that he can’t help but go on about what geniuses his children might have been had they not fallen prey to this devastating illness.
And that’s not really the point, is it?
He’s grieving his losses and he wants us to see what he lost. I get it. But what’s important here is not the GIFTS of his children but how they were failed.
It doesn’t matter if they were the next Bob Dylan or Einstein. What strikes a parent to the marrow is the thought that they failed a child. Helping us see how we are all involved in that failure—well, the other chapters have established how the illness works, how the system miscarries, how society colludes. So now, to break our hearts, it’s just a matter of showing how alone the child was.
May 16, 2017
I wanted to read this book because I have two children who suffer from depression but also because I had a brother who was a paranoid schizophrenic who killed himself 27 years ago. My brother who was diagnosed as suicidal after years of psychosis was institutionalized and given an antipsychotic medication that caused him to "see things clearly" and prompted him to kill himself.
The author traces the history of mental illness and treatment, not always in an entirely coherent pattern. But the gist is that historically there has been a split between compassionate and highly interventional care that helps and punitive care that either punishes the sufferer or pretends that there is nothing wrong or that the sufferer is entirely capable of making rational choices such as taking meds even when that person's judgment is without question compromised. Highly interventionist care has been proven to save lives.
I felt that the author was at his best describing the horrific process of deinstitutionalization -- the causes that led to it and the results that we see everyday on the streets and under the highway bypasses of every major city. If you want to see tragedy on a huge scale that breaks your heart, take a look at the underside of the highway bypasses in Austin, Texas. The author points out that California has the largest population of homeless mentally ill and the reasons for it. It was very helpful to read about what went wrong because you wonder as you walk around these people who are they and why are they there.
I don't know about the link between schizophrenia and high intelligence. I was surprised that the author, considering that both his sons ended up schizophrenic, didn't say more about genetic causes. He talks a great deal about stress as a trigger, but not enough about how it is a trigger for those predisposed to be fragile. I think that, as happened with my brother, there is always a tendency to try to find the cause. But often the stresses are things that normal life throws at you. My brother had trouble with socializing with others, as the author's sons seemed to. My brother had trouble with dating and relationships, as the author's sons seemed to. There was almost a spectrumish quality to the problems my brother had and I thought about that when the author described the laser like focus his son Kevin brought to playing the guitar. It sounded a little like Aspergers, not classically, but a little bit. I have wondered if in the end, when researchers delve more into the genetics, if they aren't going to find that these fragile people are in the highly functioning range of that autism spectrum. Just a thought.
I loved the author's suggestions for how to make everyone's lives easier. HIPAA absolutely needs to be reformed to take into account that many of the mentally ill have families who love and care them and need to able to help their relatives. My severely depressed son was denied psychiatric care because he had been to the therapist the same day. That is ridiculous. Fortunately he wasn't in crisis, so he was able to reschedule but what if he had been? No question that needs to be changed. We have found that disability services in various areas differ greatly in their ability to help people in crisis. Fortunately we live in Northern New Jersey with an awesome vocational rehabilitation program. Life saving.
I would much rather work with a child with depression than schizophrenia. Depressives, in my experience, want help and want to change. As the author points out, schizophrenics don't always recognize that the reality they have constructed for themselves does not match the external reality. My brother believed people on television and in the newspaper were talking to him. It is very hard to reason with someone and help them understand that the world is not the way they perceive it. Unfortunately, we all construct our own reality.
And I would end with Pink: Change the voices in your head. Make them like you instead. When my son was very young and under tremendous stress, he heard voices. I hear that song and especially that line and I tear up every time. I feel that our school system and our society is so hard on fragile people, as the author said life is suffering, and I'm not sure that we are doing right by our children by forcing them to try to be like everyone else, to fit in, just to survive. The wealthy have options -- boutique schools, boutique programs -- but my husband and I don't have a lot of money and we watched our children, especially our youngest son, suffer in a system that just didn't tolerate a lot of difference from the norm. The author was able to pull his children and put them in more specialized boutique environments and even that wasn't 100 percent successful. I think we need a lot more research and a lot more answers for these special people. Because Mr. Powers that allowing them to just die devastates and destroys families. My family has not recovered from my brother's death and never will. He haunts all of us.
The author traces the history of mental illness and treatment, not always in an entirely coherent pattern. But the gist is that historically there has been a split between compassionate and highly interventional care that helps and punitive care that either punishes the sufferer or pretends that there is nothing wrong or that the sufferer is entirely capable of making rational choices such as taking meds even when that person's judgment is without question compromised. Highly interventionist care has been proven to save lives.
I felt that the author was at his best describing the horrific process of deinstitutionalization -- the causes that led to it and the results that we see everyday on the streets and under the highway bypasses of every major city. If you want to see tragedy on a huge scale that breaks your heart, take a look at the underside of the highway bypasses in Austin, Texas. The author points out that California has the largest population of homeless mentally ill and the reasons for it. It was very helpful to read about what went wrong because you wonder as you walk around these people who are they and why are they there.
I don't know about the link between schizophrenia and high intelligence. I was surprised that the author, considering that both his sons ended up schizophrenic, didn't say more about genetic causes. He talks a great deal about stress as a trigger, but not enough about how it is a trigger for those predisposed to be fragile. I think that, as happened with my brother, there is always a tendency to try to find the cause. But often the stresses are things that normal life throws at you. My brother had trouble with socializing with others, as the author's sons seemed to. My brother had trouble with dating and relationships, as the author's sons seemed to. There was almost a spectrumish quality to the problems my brother had and I thought about that when the author described the laser like focus his son Kevin brought to playing the guitar. It sounded a little like Aspergers, not classically, but a little bit. I have wondered if in the end, when researchers delve more into the genetics, if they aren't going to find that these fragile people are in the highly functioning range of that autism spectrum. Just a thought.
I loved the author's suggestions for how to make everyone's lives easier. HIPAA absolutely needs to be reformed to take into account that many of the mentally ill have families who love and care them and need to able to help their relatives. My severely depressed son was denied psychiatric care because he had been to the therapist the same day. That is ridiculous. Fortunately he wasn't in crisis, so he was able to reschedule but what if he had been? No question that needs to be changed. We have found that disability services in various areas differ greatly in their ability to help people in crisis. Fortunately we live in Northern New Jersey with an awesome vocational rehabilitation program. Life saving.
I would much rather work with a child with depression than schizophrenia. Depressives, in my experience, want help and want to change. As the author points out, schizophrenics don't always recognize that the reality they have constructed for themselves does not match the external reality. My brother believed people on television and in the newspaper were talking to him. It is very hard to reason with someone and help them understand that the world is not the way they perceive it. Unfortunately, we all construct our own reality.
And I would end with Pink: Change the voices in your head. Make them like you instead. When my son was very young and under tremendous stress, he heard voices. I hear that song and especially that line and I tear up every time. I feel that our school system and our society is so hard on fragile people, as the author said life is suffering, and I'm not sure that we are doing right by our children by forcing them to try to be like everyone else, to fit in, just to survive. The wealthy have options -- boutique schools, boutique programs -- but my husband and I don't have a lot of money and we watched our children, especially our youngest son, suffer in a system that just didn't tolerate a lot of difference from the norm. The author was able to pull his children and put them in more specialized boutique environments and even that wasn't 100 percent successful. I think we need a lot more research and a lot more answers for these special people. Because Mr. Powers that allowing them to just die devastates and destroys families. My family has not recovered from my brother's death and never will. He haunts all of us.
July 18, 2024
No One Cares about Crazy People is really two books in one - it is a father's memoir about raising his two sons, both of whom came to be diagnosed with schizophrenia, and it is also a brief and thoughtful history of civilized society's approach to mental health care, which basically requires a stunning rebuke of its tragic inadequacy.
Powers' younger son Kevin, a promising young guitarist, committed suicide several years after his diagnosis. His oldest son, Dean, lives with his parents in their home in Vermont, and with treatment is doing pretty well, though it has not always been so. This book is deeply personal and is not meant to be an unbiased evaluation of mental health care in our country, so if that's what you're seeking look elsewhere. I listened to the audiobook which Powers reads himself and I got choked up on more than one occasion. Working in a public library I encounter people nearly every day that I know or strongly suspect have schizophrenia; some of them have a family like the Powers family, which cares about them, helps them, and supports them. Others do not. For those who don't I worry about their safety, their ability to survive, and what it says about the soul of our country that we allow so many of them to stagger through life hanging on by such meager threads.
I think this could make a good book club selection for those looking for a nonfiction selection. There would be a lot to discuss.
July 2024 update: I read this a second time to discuss with my Senior book club at work and we had a fascinating, excellent discussion. I had several new attendees who came just for this book, and many people shared personal stories of the ways that serious mental illnesses have touched their lives and the lives of those they love. Once of the best book discussions I've ever facilitated.
Powers' younger son Kevin, a promising young guitarist, committed suicide several years after his diagnosis. His oldest son, Dean, lives with his parents in their home in Vermont, and with treatment is doing pretty well, though it has not always been so. This book is deeply personal and is not meant to be an unbiased evaluation of mental health care in our country, so if that's what you're seeking look elsewhere. I listened to the audiobook which Powers reads himself and I got choked up on more than one occasion. Working in a public library I encounter people nearly every day that I know or strongly suspect have schizophrenia; some of them have a family like the Powers family, which cares about them, helps them, and supports them. Others do not. For those who don't I worry about their safety, their ability to survive, and what it says about the soul of our country that we allow so many of them to stagger through life hanging on by such meager threads.
I think this could make a good book club selection for those looking for a nonfiction selection. There would be a lot to discuss.
July 2024 update: I read this a second time to discuss with my Senior book club at work and we had a fascinating, excellent discussion. I had several new attendees who came just for this book, and many people shared personal stories of the ways that serious mental illnesses have touched their lives and the lives of those they love. Once of the best book discussions I've ever facilitated.
August 3, 2017
This was both heartbreaking and informative - Ron Powers lost one of his sons, Kevin, to suicide, a fact with which he opens the book. His other son, Dean, is still alive, but struggles with schizophrenia. My own interest in mental health comes both from my own experiences and from working in several different institutions where it is a primary concern -- libraries, schools, and prisons. Powers gives a fairly thorough overview of how mental illness has been treated over the last hundred years, being careful to acknowledge that he is a concerned and heartbroken layman rather than a psychiatrist, psychologist, or neuroscientist -- but the fact that he is none of these things makes the book more accessible, particularly when the history and theory get a little dry.
Any dullness is tempered by Powers' ability to recount with vivid detail his memories of his son(s) and the way their illness manifested over time. Some of Kevin and Dean's writing, like their e-mails and song lyrics, find their way into the book, at times working more effectively than others. I can't fault a father for wanting to share every word his son wrote, but I do think that a little less of this writing placed a little more strategically would make this already deeply affecting book even moreso.
On an unexpected note, I gained a great deal of respect for Harry S. Truman and his attempts at establishing a national healthcare system that was also concerned with mental health. Who knew?! (Okay, historians probably knew. But I'm not one of them, so let me enjoy my newfound information.)
Overall, an excellent - if difficult - read.
Any dullness is tempered by Powers' ability to recount with vivid detail his memories of his son(s) and the way their illness manifested over time. Some of Kevin and Dean's writing, like their e-mails and song lyrics, find their way into the book, at times working more effectively than others. I can't fault a father for wanting to share every word his son wrote, but I do think that a little less of this writing placed a little more strategically would make this already deeply affecting book even moreso.
On an unexpected note, I gained a great deal of respect for Harry S. Truman and his attempts at establishing a national healthcare system that was also concerned with mental health. Who knew?! (Okay, historians probably knew. But I'm not one of them, so let me enjoy my newfound information.)
Overall, an excellent - if difficult - read.
July 9, 2017
I found this book to be considerably overrated. Roughly half of the book is a memoir about Powers' own struggles with the mental illness of his two sons, and half is a history of U.S. policies around mental illness. The latter part does provide a reasonable overview of the subject, but doesn't seem very different from what's available in other sources. The first part is certainly powerfully affecting, but the tone often grated on me. Powers seems afraid that he will be blamed for his sons' struggles, and so devotes a good deal of space to countering this hypothetical accusation. His frequent words of praise for his sons --- including reproducing old emails that he sent to them, or they exchanged --- also didn't sit well with me. I understand that he loves them, but I don't necessarily want to be convinced that I should love them. I'm more interested in understanding their story.
April 23, 2017
Very possibility the most harrowing book you may ever read. Sad, desperate and a scene that is every parent's worst nightmare. Not for the faint of heart but an important subject told with sad courage.
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