This book is a combination of autobiography, interviews, history and current policy. It examines severe mental illness in America through a few decades up to current. The book opens up with the author talking about his sister, Merle, who had a severe mental illness that had a long path to treatment. The way this book is structured is...not very well, and I had to reread a few pages to try and figure out what the author was doing. But the information that is given will hopefully help people and might even inspire attempts at change. A lot of it shocked me, but a lot of it, I already knew. I was so glad to read about people who are severely mentally ill, being written about respectfully by the author. ( )

I liked this book, but there was nothing new in here that I haven't already read in many other books. I'm just so disappointed that there's been so little forward movement in making life better for folks with severe (or even non-severe) mental illness. ( )

For a few years now I've been interested in America's mental health crisis and response. How did we go from the mid-century asylums of [One Flew Over the Cuckoo's Nest] and [Girl, Interrupted] to the 21st century's over-crowded prisons, mass shootings, and police killings of unarmed victims? It's clear that the U.S. response to mental health challenges is broken and has been for a long time.

I read this book immediately after reading [Better], which is strikingly similar, but focuses on America's physical health system instead of its mental health systems. Both books are written by a doctor and share personal and professional anecdotes alongside references to case studies and pertinent research. Rosenberg reveals that his sister suffered from mental health issues, his parents were embarassed by this and largely ignored it, and while this led to his pursuing a career in mental health, he also carried that family shame with him into his career, not discussing his sister's diagnosis with colleagues and hiding the reality of her disease from others.

I found this book to be informative yet tragic. There are so many areas of American life impacted by the mental health crisis. It is not only health care and health workers and families, it is also the drug manufacturers and insurance companies, the prison system and policing, it is legislation and our interpretation of American freedoms that are all woven into the difficult subject of mental health. This is a multi-trillion dollar problem with no clear solution. I found the case studies to be heartbreaking, but they also made me want to go out and protest. To stand before lawmakers and make my voice heard. I'm sick of people treating mental issues with shame and secrecy. This needs to be an issue that we care about enough to try tackling it. It is a real "moon shot" and I hope that future politicians and activists make this a priority.

I received this book as an ARC, but I will recommend it to others. I would actually love to re-read it when it has a proper appendix. There were a lot of notations, but the notations just referenced the name of an article or a study. I kept looking to the notations for more information, so I really hope that is fleshed out in the final printing. ( )

Dr. Rosenberg was motivated to pursue psychiatry when his sister, Merle, developed schizophrenia in her early twenties. I was interested in reading this book having worked as an administrator in this system for 32+ years. Using his family's experience as well as other family interviews over a seven year period, he provides an accurate portrayal of what families often encounter when seeking emergency treatment for their family member diagnosed with a serious mental illness (SMI). Problems encountered besides the stigma associated with the disease include difficulty accessing psychiatric outpatient and inpatient care; refusals to take psychotropic medication frequently due to significant side effects; and indiscriminate police procedures, which can exacerbate a crisis situation. The book also details alternative to traditional care including mental health courts, mobile crisis units, outpatient commitments, and assertive community treatment teams. The latter two can be expensive, but empirical evidence exist regarding their effectiveness. The book closes with practical advice for those with SMIs and their families. I would recommend this book for individual with SMIs and family advocates and mental health treatment providers and policy makers. ( )

Kenneth Paul Rosenberg, MD, was inspired by his late sister Merle's severe mental illness (SMI) to pursue a career as a psychiatrist. Although SMI doesn't seem to have been the focus of his own practice, for this book he interviewed patients, psychiatrists, researchers, and family members who deal with schizophrenia and other psychotic disorders on a daily basis.

The narrative is at its best when Rosenberg is telling the stories of real people coping with SMI; it reads more like a term paper when he provides facts, figures, and suggestions for improving the system. Still, this book provides a timely reminder of how broken the mental health system is, and how difficult it can be for those with SMIs to get and stay in treatment. ( )