'Hungry Shoes' raises valuable discussion points on mental health funding, treatment

Maddie and Grace, the protagonists of the absorbing new novel “Hungry Shoes,” are 17 going on 18. They’re kind, intelligent, likable … but broken.

Maggie and Grace are victims of abuse and neglect.

Their psyches have been bruised by the absence of their mothers in their lives, and emotionally injured by deteriorating relationships with their fathers.

Maddie has had a long and constant lifeline of love with her father, Michael, an Old Town jeweler. The lifeline is shredded, when Michael suddenly, insensitively tells her that he’s planning to marry a woman Maddie has never met.

After the marriage, Maddie feels abandoned and transfers her love to a horse.

She becomes the victim of physical and sexual violence at the hands of the new stepmother’s son. The son threatens harm to Maddie if she blabs to anyone that he’s abusing her.

Grace’s unreliable lifeline is with her grifter father, Mitch. He’s a thief and con artist who tries to be protective in his rare sober moments. Grace has pretty much raised herself for years.

Every few months Mitch, with Grace in tow, decides to move to a different city and rely on the kindness of strangers or neighbors.

Most recently, they’ve been renting (when Mitch pays the rent), a dark (until Mitch pays the light bill) apartment in Albuquerque’s International District.

Maddie’s and Grace’s attempts at harming themselves result in their agreeing to be placed in an adolescent psychiatric care unit in Albuquerque.

They meet, become roommates and soon good friends.

The central element of the novel’s story is what co-authors Sue Boggio and Mare Pearl call “the healing journey” of Maddie and Grace.

“Even though we take these girls to some dark places, we don’t leave them there. They come out on the other side,” Boggio said.

Guiding them to find clarity out of chaos are the psychiatric unit’s staff members and other mental health professionals.

The novel, set in 2002, presents a fictional version of milieu therapy — an immersive therapeutic environment — that was in place at the University of New Mexico’s Children and Adolescent Hospital (CPH) in the 1980s and ’90s.

In those decades, Boggio, an Albuquerque resident, was a Registered Nurse and a program manager, and Pearl, of Bosque Farms, was a mental health technician at CPH.

It was a time when CPH had received valued direct funding in the form of a line-item appropriation from the state Legislature.

That (period) was “the hospital’s ‘golden age’ … when length of stay was determined by clinical judgment, not by insurance companies whose imperative is to deny care to save money,” Boggio said.

Pearl added, “We had art therapy, music therapy, recreational therapy. We had games together,” Pearl added. “Everything in the milieu was designed as therapy for kids” in a highly-structured environment.

Likewise in the novel, readers see the value of this interdisciplinary approach to favorably change the behavior of Maddie and Grace, bolster their mentation and self-worth, strengthen their coping mechanisms and develop mutual trust with their parents.

Patients’ stay in that treatment setting could take months, not merely a few days.

Today, young patients are being released with psychotropic medications but with insufficient time to prepare them for life at home and in the classroom, Boggio notes.

These days, she said, “There’s a revolving door at inpatient facilities, including CPH.”

The book’s adolescent psychiatric unit can be seen as an overarching character. There are some graphic episodes, but the story ultimately arrives at a sunny, hopeful ending for both girls.

The book raises valuable discussion points in the nation’s ongoing public debate on mental health funding and treatment.

Boggio and Pearl also cowrote the fictional trilogy “Sunlight and Shadow,” “A Growing Season” and “Long Night Moon.”