No One Cares About Crazy People by Ron Powers, is written by a father whose two sons have been afflicted by schizophrenia. One of his sons committed suicide. The book alternates by chapter between giving a factual history of society’s treatment of the mentally ill and telling the story of his sons’ descent into mental illness. Powers says in the introduction that he initially planned on only writing the factual history of mental illness and leaving his sons’ story out of it. He then realized that he could not tell one story without telling the other. I could not read either of the stories without reflecting on my own or my cousin’s story of mental illness.
Last May my cousin Stefan died by suicide. When my mother told me the news I gasped in horror and I cried, and I grieved but the truth was I was not entirely surprised by Stefan’s death. In fact, I had long feared he would die by suicide. Stefan suffered from schizophrenia. I knew the rate of suicide among those afflicted by schizophrenia was high and I knew Stefan had attempted suicide before.
When I told a friend about Stefan’s death she asked if we had been close. We certainly hadn’t been close geographically, as he lived in Romania and I lived in New Jersey. We had not seen each other since I was twelve and he was eleven, when our families spent a vacation together in the mountains of Romania. We never saw each other again after that vacation and for many years we did not speak to each other either. About two and a half years before his death, we reconnected on Facebook. While we didn’t have some of the more traditional markers of a close relationship, we did form a bond over something we had in common: mental illness. One of the first things he said in his initial Facebook message to me was “I think maybe you and I are the normal ones.” Then he directed me to a song he related to. It was the Gnarls Barkley song “Crazy.”
When Stefan first contacted me, he was in a mental hospital in Romania. I was surprised that he was allowed to use the internet from a mental hospital because that had never been an option for me when I was in mental hospitals. I was even more surprised when he posted pictures of the mental hospital, its surrounding grounds, and the other mental patients with the hashtag “madhouse stories” because in the United States that would be considered a serious breach of privacy. Within the mental health system in Romania, he seemed to have a level of freedom that was unfathomable in the United States. Stefan wondered which system was better and said he would go mad in an American mental hospital.
Stefan read my writing about the time I’d spent in mental health facilities. I’d expressed how isolated and dehumanized I felt by my lack of freedom; I’d been put in solitary confinement for days, I’d lost control over what and how much I ate, I was told that I could not hug my mother when she visited me in my prison. He said I’d been treated like shit and that perhaps I’d been treated worse than he had been. I felt that regardless of how he was treated, he had suffered as a result of his mental illness more than I’d suffered as a result of mine, for he had schizophrenia whereas I had depression. Powers says “But even among the many devastating diagnoses of mental illness, schizophrenia stands unique in its capacity to wreck the rational processes of the mind. It is to mental health as cancer is to physical health; a predator without peer and impervious to cure.” (xv)
I know that many, if not most people with mental illness have been treated much worse than either Stefan or I were. Society is not and never has been kind to the mentally ill. In chapter after chapter of No One Cares About Crazy People, we see just how cruelly the mentally ill were and are treated. We see countless examples of the mentally ill being abused, abandoned, neglected, persecuted, demonized and dehumanized.
We see that contrary to stereotypes of the mentally ill, both of Powers’ sons are kind, caring, charming, intelligent, hard working and talented. I remember how charmed I was by Stefan when he was a child and how devastated I was to learn that he had descended into schizophrenia as an adult. Yet I learned that schizophrenia had not changed his essential goodness and that I was still charmed by who he was as an adult.
A chapter of No One Cares About Crazy People addresses the deinstitutionalization movement. On the surface it seemed like a good idea because many institutions were awful places and this would give the mentally ill a chance at freedom but the movement ended up being a disaster because society failed to provide the mentally ill with appropriate supports in lieu of mental hospitals, so many mentally ill people ended up homeless. Stefan told me he feared ending up homeless one day and could picture himself deliberately getting committed to a mental hospital just so he would have something to eat. Both of us were dependent on and living with our mothers as a result of our mental illnesses and the fear of homelessness has crossed my mind.
I always knew a problem in the treatment of schizophrenia is that schizophrenics often decide that they don’t need to take their medicine because they feel there’s nothing wrong with them but until I read Crazy People I didn’t realize that denial of one’s sickness had a name-anosognosia. Anosognosia can strike after long periods of wellness and compliance with medication. It happened with Powers’ sons and I noticed hints of it in Stefan. He told me he’d been free of symptoms for three months and was preparing to start work again but that he missed his hallucinations because they kept him entertained. He posted statuses and messages that I found alarming, but I felt helpless to do anything about it. Those who are much closer to their schizophrenic loved ones often feel helpless as well.
I cannot begin to fathom the levels of pain Powers must have experienced at losing a son to suicide but losing Stefan was hard for me because I’d lost a flesh and blood connection who knew what it was like to walk the lonely and terrifying road of mental illness. I was furious to learn that the Romanian Orthodox church would not officiate Stefan’s funeral because they considered suicide to be an unforgivable sin. He had died from a very serious mental illness and I couldn’t blame him for his death any more than I could blame a cancer patient for their death.
Powers’ surviving son is doing well now. He has recovered from the worst of his mental illness and in many respects is thriving. I’ve also recovered from the worst of my mental illness and am mostly doing well now but recovery is not an all or nothing linear process and I did end up in the psych ER a few months after Stefan’s death. Once the terror of the episode had passed and I realized I was going to be discharged from the ER and returned to my regular life, a second wave of grief hit me as I thought about Stefan and how he would never have that chance. I do not hear voices in my head like those afflicted by schizophrenia do but as I walked into the sunshine of the hospital parking lot, I could hear eleven-year-old Stefan’s voice ringing out through the mountains of Romania.
In the forward of Crazy People Powers says he hopes you do not “enjoy” the book but are wounded by it. Indeed, it would be hard to enjoy a book that depicts such real and bleak suffering and I did not “enjoy” it, but I am glad to have read it.
The last chapter of the book is titled “Some one Cares About Crazy People” and in it Powers takes a cautiously optimistic tone about advancements in the treatment of and attitude toward the mentally ill. I hope those advancements continue, for the sake of people like Stefan, for the sake of people like me, for the sake of people like Powers’ sons, and for the sake of all those who battle mental illness.