When Kelly Rindfleisch wrote the words, “No one cares about crazy people,” she never dreamed Pulitzer Prize-winning, New York Times-bestselling author Ron Powers would read them.

“I cannot describe to you the emotion, the shockwave, that hit me when I read that quote,” says Powers, author of No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America, who Kirkus reached at home in Castleton, Vermont.

Rindfleisch, who was Wisconsin Governor Scott Walker’s Deputy Chief of Staff, wrote the hateful words in a 2010 email uncovered by the Milwaukee Journal Sentinel. To her campaign colleagues, she mocked and dismissed the depredations of the Milwaukee County Mental Health Complex, where a woman being treated for bipolar disorder died of starvation. Where workers sexually assaulted and impregnated patients.

“The fact was ungodly abuses happened at the Milwaukee County Hospital that were medieval in nature,” Powers says. “The rape of patients, starvation, naked patients walking around, physical abuse—there it is, in our time. It’s not something you have to look in an encyclopedia to find.”

Powers is an award-winning writer with criticism, narrative nonfiction, and biography to his credit. He is the author of Mark Twain: A Life and coauthor of the No. 1 New York Timesbestseller Flags of Our Fathers, which was adapted into a film directed by Clint Eastwood. He and his wife, Honoree Fleming, a pioneering biochemist, are the parents of two sons, Dean and Kevin, who were diagnosed with schizophrenia in young adulthood.

“This is the book I promised myself I would never write,” Powers writes in No One Cares About Crazy People. “And promised my wife as well. I have kept that promise for a decade—since our younger son, Kevin, hanged himself in our basement, a week before his twenty-first birthday in July 2005, after struggling for three years with schizophrenia.”

No One Cares About Crazy People is a treatise on the state of mental health care in America today—how we arrived at the disgust, hostility, and ignorance embodied by Rindfleisch and her ilk. It’s also the emotional story of the Powers family’s struggle with the fearsome scourge of schizophrenia.

“I did not want to commodify my sons,” Powers says of his hesitation to include his family’s struggles in the book—a decision that came at the behest of his literary agent, encouraged by his editors at Hachette. “I didn’t want to turn them into a profit center, even unconsciously. I didn’t want this to be a ‘poor daddy’ book. There are so many…unworthy motives you could [have] for writing a book like this.”

Powers spent a decade researching nosology, political history, and structures of care and governance of schizophrenia (i.e., how the police and the courts treat the afflicted). In the book, he traces mental health care’s shocking history: from “Bedlam” asylum in London, the scene of centuries’ worth of shocking abuses, through American deinstitutionalization; the deleterious denial enacted by popular figures like Dr. Thomas Szasz, author of The Myth of Mental Illness and L. Ron Hubbard colleague; the noble mental health care initiatives of Presidents Truman and Kennedy and mass defunding by President Reagan; and the consequences for those living with the disease today, bumping up against untrained police, ignorant lawmakers, and fearful neighbors.

“Schizophrenia is different from depression, it’s different from hysteria, it’s different from any kind of bad mood or grudges or the kinds of things we all encounter,” Powers says. “It has a genetic component and it flows through families—probably, almost certainly, has flowed through mine, although no one in my family was ever diagnosed…. It must be understood as different, and it requires different solutions than I think we traditionally apply.”

Forced to bear witness to the inadequacies of our current system, Powers has issued a clarion call to arms: to do better by those with mental illness, their loved ones, and communities; to move toward ameliorative policies that consider their health, well-being, and civil liberties. In short, that we start to care about “crazy people.”

“I hope you do not ‘enjoy’ this book,” Powers writes. “I hope you are wounded by it; wounded as I have been in writing it. Wounded to act, to intervene. Only if this happens, and keeps happening until it needs happen no more, can we dare to hope that Dean and Kevin and all their brothers and sisters in psychotic suffering are redeemed; that they have not suffered entirely in vain.”

Megan Labrise writes “Field Notes” and features for Kirkus Reviews.