72 Hour Hold

By Bebe Moore Campbell

Knopf. 319 pp. $24.95

The title 72 Hour Hold will be instantly recognizable to anyone familiar with treatment options for the mentally ill. It refers to the three-day period immediately following an acute episode, during which a person with a mental illness can be held, evaluated and treated against his or her will. In her new novel Bebe Moore Campbell makes the ordeal of living with such a relative painfully real as she guides readers through the hell of a child's disintegration. In the process she presents a powerful case for the universal acceptance and comprehensive treatment of mental illness.

Keri Whitmore is an African American who owns a designer resale clothing shop in Los Angeles. She lives with her daughter, Trina, in the upscale neighborhood of View Park. With a mother's vast pride, she looks forward to Trina's attending Brown University. Accustomed to success, she expects success for her daughter. When Trina, almost 18, clings to her mother like an infant, Keri remains upbeat. The girl is in treatment for bipolar, or manic-depressive, illness. She's taking her pills and attending daily individual and group counseling sessions. She's learning to care for herself and to cultivate the discipline her illness requires -- a good night's sleep, no caffeine, alcohol or drugs, and strict adherence to her medication regimen. If she starts to flounder, Mommy is close by.

But the episodes continue, and once Trina turns 18, Keri is legally powerless to insist upon treatment. Trina subverts her progress by running off with drug addicts and "cheeking" her pills instead of swallowing them. Alternating between little-girl sweetness and bruising attacks that leave Keri depleted, she escapes into the night of her illness. Time and again, Trina is lost, and a desperate Keri tries to follow her.

After seemingly endless journeys through a maze of police interventions and three-day hospital stays, Keri turns to a group of white radicals for help. They operate their own version of the Underground Railroad -- a series of safe houses and clandestine night journeys for parents willing to kidnap their children in a quest for effective treatment. Bethany, a mother Keri knows from her support group, explains it this way: "You got a radical problem, you need a radical solution." A skeptical Keri replies, "When radical white people get tired of being radical they get to be state senators, or they write books, or if push comes to shove they can move to Oregon and hang out for thirty years until the FBI finds them. Radical black people get killed."

Campbell's likening of the mind shackled by illness to the body shackled in slavery strikes a deep chord in African-American communities, where elders often compare contemporary scourges with the horrors of slavery and Jim Crow. Somehow, the enormous suffering wrought by these twin evils should serve to protect their descendants from continued strife. Campbell draws on a collective memory of slavery's traumas -- the loss of identity and of control over one's own body, the grueling labor and constant brutality -- to describe a mind ravaged by disease and a family held hostage to madness. Perhaps slavery's most lasting legacy is the one Campbell never makes explicit but with which her novel is replete: the inability to protect children, to keep them safe and close, to guard them from harm. Keri's personal slavery is having a child she can't protect, and 72 Hour Hold has much to say about the anguish of parenting in a society that trumpets a person's legal rights at the expense of the person. Keri can't help judging herself, "If only I'd tried to work harder on my marriage. If only I hadn't been so busy."

Campbell often writes big-theme books. Her bestselling novel Your Blues Ain't Like Mine (1992) explored the murder of a black youth in pre-civil rights America and the acquittal of his killers. What You Owe Me (2001) told the story of a black hotel maid's friendship with and subsequent betrayal by a Jewish Holocaust survivor. She's written about mental illness before, too, most notably in her children's book Sometimes My Mommy Gets Angry (2003). Her casual conversational style sometimes belies the seriousness of her topics, but her ear for the language and rhythms of urban life remains sharp and true.

In 72 Hour Hold Campbell is particularly compelling in her depictions of substance abuse, attempts to self-medicate and the use of prisons as mental institutions. She seems to be saying to anyone who'll listen: It's biology and chemistry, get it? It's not about demonic possession or bad parenting. It's about accessible, affordable, ample and aggressive health care. To some extent, this is a novel for policymakers. It reveals the pain behind the statistics, the bewilderment of repetitive loss, the ebb and flow of hope against hope and, finally, the necessity of acceptance. It deserves a wide audience and the honest, open discussion that Campbell hopes to encourage. *

Nancy Rawles is the author of "My Jim," a novel about the wife of the slave character from Mark Twain's "Huckleberry Finn."

Bebe Moore Campbell