An Na has been writing for young readers for almost 20 years; her first novel, A Step from Heaven, won the 2002 Michael L. Printz Award for the best book written for teens. She spoke with PW about her new novel, The Place Between Breaths, which captures the disjointed inner workings of a schizophrenic teen’s mind. Besides discussing the difficulty of writing a book of this nature, she reflected on her personal experience having a brother with mental illness and how attitudes towards mental health disorders are changing.

This book seems like a departure from your other novels. What inspired you to write a book about Grace, a schizophrenic teen?

The book started 10 years ago right after the birth of my daughter, when I learned my brother had committed suicide. He had just been released from a psychiatric hospital when the police found him stark naked in a fountain. Before his hospitalization, my family and I had no idea my brother suffered from mental illness. He was brilliant. He spoke three languages. He was studying to be an archeologist. We knew he had a drug problem, but now I know that drug addiction, used for coping, often masks mental illness.

After my brother’s death, I was filled with grief and I started asking questions. Why? Why him? Why not me? Then I started reading about mental illness, beginning with the book An Unquiet Mind by Kay Redfield Jamison. I went on to read other books. I was especially interested in firsthand accounts written by people suffering with the disease. At the same time, I began reading my brother’s notebooks. It was clear through his writing that he was dealing with some pretty serious demons. It filled me with more grief and writing was a way for me to deal with it.

What was the most challenging part about writing the book and forming the character of Grace?

Trying to make the book real and at the same time acceptable or relatable to readers was hard. So much of the story is disjointed. I needed to thread everything to a center, something that would pull readers in. This center became the train—an image that haunts Grace throughout the novel.

Another thing that was challenging was softening Grace’s character. In the beginning stages of my writing, she was way too angry. That’s the way it is with schizophrenics. There is so much anger, but I had to tone it down to make Grace more approachable to readers. By creating her relationship with her best friend Hannah, who gets pregnant, I could soften Grace, showing she was a caring person.

You leave the book with an open ending. What do you imagine happens to Grace in the future?

In my mind there are so many strands and possibilities of what could happen. I’m more interested in learning what other folks think. I do feel there is hope for Grace, though.

While writing the book, I used three seasons to represent different time periods—past, present, future—then it suddenly occurred to me that there are four seasons and a fourth dimension of time. In the book, the fourth season I added represents the unknown or the voice of fate that can be affected by the power of love and people’s belief in you. That power can keep you going.

Much of the book is about researching treatments for the disease. What are your thoughts about someday finding a cure?

I think it will be a long time in coming. We are still in the beginning stages with trying to identify and understand genes associated with schizophrenia. Schizophrenia has such a widespread pool of genes that it gets really complicated. I hope that some day we can get to the point where effective medication can be developed.

What do you hope readers will gain from the novel?

I hope they get a better understanding of what it means to suffer from mental illness. There is so much shame associated with the disease. People didn’t used to talk about it. We never talked about it in my family even though my grandmother suffered from it. There isn’t even a word in the Korean language for mental illness. But things are better now, especially in America. Discussions about mental illness have become much more prevalent. People are much more open to talking about it.

Thinking back to the first book you wrote, how do you think you’ve evolved as a writer?

You mean how have I devolved as a writer? [laughs] I don’t beat myself up any more for not producing a book a year. I like tinkering with my writing. I like playing with words, so now I allow myself the time to do it.

Are you currently working on anything?

I am. I don’t want to give too much away, but I can tell you it’s a middle-grade book, and the tone is much lighter than it is in The Place Between Breaths.

The Place Between Breaths. An Na. Atheneum/Dlouhy, Mar. 27 $17.99 ISBN 978-1-4814-2225-3