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

Earley decides to find another inmate he can shadow through the Miami jail system. He camps out at the jail’s booking office one night and notes the jail’s intake procedures, as well as the difference between the treatment of an attractive woman by the correctional officers and that of a disheveled-looking woman who was booked at the same time. The disheveled woman tells an officer that her name is Alice Ann Collyer.

When Earley examines her criminal record, he finds out that Collyer has been arrested at least nine times for various instances related to her schizophrenia. It becomes clear she has never received real medical treatment for her mental illness. She was arrested for shoving elderly women at bus stops and is now facing up to five years in prison, but she first was sent to Chattahoochee Hospital so that her schizophrenia could be treated before she went on trial.

To better understand Collyer’s case, Earley speaks to Dr. Alida Renoso at the nearby Women’s Detention Center, where Collyer is being held. While following Dr. Renoso on rounds, Earley sees Collyer pass Dr. Renoso a note that asks that she be released so that she can go and have sex. Dr. Renoso explains that Collyer has been stuck in a loop between the Women’s Detention Center and Chattahoochee, often decompensating before she can stand trial. Dr. Renoso claims that patients like Collyer are no better off today than during the era of state-run mental hospitals. Earley is shocked to discover Collyer has been in this cycle for more than three years.

Stunned by Dr. Renoso’s claims about patients like Collyer being no better off today than they were in the past, Earley examines the case of Sanbourne v. Chiles, a landmark ruling that challenged mental hospital conditions. He contacts Susan Curran, a social worker who was involved with the case. In the late 1980s, she saw the horrendous psychiatric hospital conditions during an inspection and took her findings to the media, attracting the help of civil rights lawyer Alice Nelson. They used the case of a patient (and former legal secretary) named Deidra “DeeDee” Sanbourne to file their lawsuit, which “demanded patients in state hospitals either be given adequate treatment or be released” (188).

DeeDee was excited at the prospect of being released from the hospital. As the lawsuit progressed, however, there were concerns about whether DeeDee, who had been in the hospital for years, would be able to adjust to life outside. The lawsuit was dropped, but when a patient died at the same hospital where she lived, many patients with mental illnesses were discharged, including DeeDee.

In this chapter, DeeDee’s story pivots to DeeDee’s sister, Susan Wagner, and her perspective on the story. Neither sister had an easy childhood, and their relationship soured after DeeDee fell ill. As a young adult, DeeDee seemed happy and successful: She had a job as a legal secretary and had a steady boyfriend. After she experienced a miscarriage, her life suddenly spiraled. She was diagnosed with “schizoaffective disorder, bipolar type, with dependent personality disorder and arterial hypertension” (194-95). DeeDee would eventually threaten her grandfather with a butcher knife, leading a judge to commit her to a state hospital.

Wagner and her family only became aware of the lawsuit for her release after seeing her sister’s name on a flyer on a hospital bulletin board. DeeDee’s family did not feel that releasing her would be a good idea. No one informed them that DeeDee would be discharged until a nurse accidentally mentioned it in passing. Wagner later found her sister’s discharge paperwork, which portrayed her as being far more recovered than she was, ignoring several obvious clues that DeeDee was not properly prepared to be discharged.

DeeDee’s story continues as she moves into an ALF, but she disappears from the facility after a few days. Eventually, she was found and returned to a psychiatric hospital before being released to the ALF. Wagner recalls being unable to reach her sister, and no one at the ALF knew where she was. DeeDee experienced increased delusions and psychotic episodes and was eventually readmitted to the hospital. This cycle continued, frustrating DeeDee’s family, who often could not reach her or would not be informed of where she had been moved. DeeDee died from an obstructed bowel.

Despite her role in a landmark class-action lawsuit, DeeDee died without receiving the “humane” care that Curran and Nelson had fought for. An investigation of the hospital that had discharged her admitted to “less than ideal” medical care (205), but nothing that amounted to a criminal charge. Earley notes that this is an “ugly truth” of Miami’s medical system, which prioritized putting people with mental illnesses out of sight and out of mind in an endless cycle between hospitals and ALFs.