Crazy-Ass Bitches

(a book for families navigating the mental health care system)

A watercolor and ink doodle by me

I’m Writing A Book!

So, catchy title, right? I’m writing to formally announce that I’m working on a book, and I’ll be sharing bits and pieces of it here, plus related stories.

I am the parent of a young adult with “complex mental health issues” that emerged as a serious problem right when COVID (and coincidentally, puberty) hit a few years ago. She’d always been spirited and strong, and kept us very busy (for more on how much fun she was to be with, see the post below).

Great Expectations

Somehow her strong spirit evolved into more dangerous behavior, self-harm, lashing out, delusions, and substance use. By 2020 she was in a cycle of ER/inpatient/residential/home, that was exhausting us and not improving anything. She had a few diagnoses which I won’t list out here, and we are still not sure about what is really going on, because eventually she lost confidence in the medical system and stopped cooperating with them. At 18 we moved her into her own apartment, and a year later she’s moved away on her own. We hope she’s launched, and I am in contact with her every day to make sure things are going well.

But back to a few years ago. When Molly¹ was first showing signs of anxiety and depression, we assumed that one round of a day program (PHP, or Partial Hospitalization Program) would take care of it. I took notes, but figured I’d never have to deal with any of the medical/psychological/logistical pieces again. After a year of Molly popping in and out of various programs though, I was overwhelmed. Everything was new and complicated, every day. There was not much help with the information overload, and it was hard to find the definitions and advice that I needed, and certainly not all in one place. I spent hours every week searching the web, reading books, asking questions in classes and support groups, and talking with other parents, and I started taking better notes.

Why am I doing this?

My professional background is in higher education administration, and my specialty is organizing information, keeping projects moving, and making sense of complex situations. One thing I always stress is that if you can take the complicated stuff and write it down in an clear way that’s easy to get to, you won’t have to waste time and energy recreating it every time you need it. That way, you can focus on what’s important (completing the project, fulfilling the mission, etc.). As things got more and more complicated with Molly’s care, and she needed me more and more as a mom, I realized that I needed to practice the same strategies at home that I practiced at work.

Here’s an example: when we’d check into the ER, Molly would get taken back to a room, and eventually I’d talk to a social worker or nurse. They would ask me questions about treatment history, diagnoses, school and therapist contact information, and medications. The first few times we did this (when I thought that each visit would be the last one because she’d be “cured”), I would fumble through my phone and my purse trying to find all the information, writing things on the form they provided (or worse, dictating it to the person who would write it themselves). It took a while, I was already stressed out, and meanwhile my sometimes-suicidal, sometimes-manic daughter was stressing out in another part of the ER. Especially as the treatment history got longer I got more and more frustrated at having to dig it up.

It took me a couple of years to get there, but eventually I created a one-pager that had all the key information on it. I always had that one-pager up to date, and kept a copy in my go-bag (which I will talk about later). When the nurse or social worker started asking me the questions, I could just hand them the page and say, it’s all there. And I could get to my daughter sooner. Whether or not she actually wanted to talk to me, she’d know I was there to support her. The “mission” in this case is the relationship with my daughter. Any systems I could set up in advance would make it easier to maintain that relationship.

Who Is This Book For And What’s In It?

As I put together my notes, my tips and tricks, and my references, I realized that other families were going through the same struggles that I had been at the beginning. Every family had to search for information about “the system”, what to bring to the hospital, different meds and what they were typically used for, and the different terms and acronyms people kept throwing around. The one-stop resource I could have used at the very beginning of our mental health care journey, I now had and could pass on to others.

The book is part memoir, part advice. It contains lists and tables of useful information, cartoonish illustrations, and stories of our experiences. The point is to give people a head start at figuring the logistics out, in an easy package. It’s candid, humorous, and hopefully helpful. It may not give you all that you need, but it’s meant as a start, and should help get you going towards a system that works for your family.

Where Did The Name Come From?

One thing that has always helped our family through the rough patches in life is maintaining a sense of humor. This is part of keeping the family bonds intact, especially when life is a roller coaster (as it frequently is with an adolescent who is in and out of dual diagnosis facilities). When Molly was in one of her first residential programs, she called home for her daily check-in with us and my husband asked how it was going.

“Dad, this place is full of crazy ass bitches,” she said. And then after a pause: “Crazier than me.”

And she laughed, and we laughed, and then she said, “that can be the name of the book you write about all this: Crazy Ass Bitches.” And so it is.

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1. To protect privacy, I’m changing all names except my own.