Martha Crites worked as a mental health counselor for many years. When she decided to write novels, she gave her protagonist another position in the same field. Martha’s two traditional mysteries, Grave Disturbance and Danger to Others, feature Grace Vaccaro, a psychiatric evaluator who determines when a person must be hospitalized against their will.
Danger to Others – October in the Pacific Northwest foothills brings more than a change of season. Psychiatric evaluator Grace Vaccaro is on edge. A field evaluation gone wrong leads to a shooting, Grace’s mother has died, and ghosts from her family past are everywhere. When a young woman says she killed her therapist, Grace suspects it’s delusion and sets out to prove her innocent. Then Laurel escapes from a locked unit, and suspicions abound.
Where do you place your settings—real or fictional locations? My writing is very personal; both setting and plot start from real places. Because privacy is so important in mental health, patients’ stories only give general inspiration. But Harborview Medical Center, Seattle’s old county hospital built in the 1920s, is a rich location. The place is full of odors, basement corridors, and patched together buildings added every few decades. I set scenes everywhere, from the emergency room to psychiatric units, to the morgue. I’m also in love with the Pacific Northwest. Many months a year, the dark and dripping rain strike the perfect mood for mystery. When I first began writing, I had just moved from a rural area to the city. I missed the country and its connection to the natural world, so I set the story in the very house where I used to live. Each day, I could go there in my mind and pull out details that deepened the story. For my third novel, I’m using May as the setting. There will still be plenty of storms but a large dose of hope and rebirth.
What kind of research do you do? Danger to Others explores the difference between the old state hospitals and modern treatment of mental illness—both with their own strengths and weaknesses. Research led me to this story. Writing is never easy for me, but often enough, when I need a plot turn, I find the solution in the news within days. With Danger to Others, I was making progress on the main plot and thought, “I really need a subplot.” By the weekend, the newspaper ran an article about Washington’s Northern State Hospital, a mental institution that closed in 1973.
This was a subplot with my name written all over it. As I was about to save the article for inspiration, I realized just how meaningful the topic was—my father’s mother had died in a state hospital before I was born. Families didn’t talk about mental illness back then. All I’d been told was that she’d had a brain tumor. In my work life, from time to time, when I saw a patient with a brain tumor showing confusion or personality change, I thought, maybe that’s what happened to my grandmother, but my father would never speak of it. So my subplot sent me into research mode.
First, I read every book and watched every movie dealing with historic treatment of mental illness—far more than would ever be incorporated into my writing. I was also fortunate to have the diaries of an aunt that revealed a few mentions of her treatment. Next, I visited Northern State Hospital, where a trail winds through the old dairy farm that supplied food and gave patients meaningful work. The mysterious, collapsing buildings set in the shadow of the North Cascades Mountains inspired several scenes.
At the same time, I sent for my grandmother’s death certificate and learned that there had been no brain tumor. Sadly, she died of a heart attack just 19 days after admission to the hospital. Her death was likely the result of the Insulin Shock Therapy she received. Though it reportedly helped with symptoms, the treatment was so physically hard on patients that its use was discontinued by the 1960s. You can see a portrayal of it in the film, A Beautiful Mind, with Russell Crowe as mathematician John Nash.
My grandmother’s diagnosis was late-onset psychosis, meaning she’d led a normal life. Then and now, families struggle to understand what happens when a loved one experiences mental health problems—especially in a world where mental illness is stigmatized. This springboard for my subplot was fictionalized in Danger to Others. In fiction, my sleuth found people with answers to her questions. Answers don’t exist in my life but resolving my protagonist’s questions satisfied me too. My writing journey led me to learn about my grandmother and how her history, without my knowing, might have led to my career in mental health.
Danger to Others is particularly close to my heart because as I began writing, I realized that what many people know about mental illness and its treatment is based on faulty information. Thus began my mission to humanize people we might find scary or funny in daily life. I aim to decrease the stigma of mental illness by writing fully developed characters who also experience mental illness, all while telling a good story.
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