A psychiatrist tells the story of her struggle to help her patients in our broken American mental health care system. In this clinical memoir, Alice Feller brings the reader into the world of serious mental illness using patient vignettes and personal accounts of her work, drawn from medical school, hospital wards, private practice, public clinics, and beyond, spanning a career from the 1970s to the present day. Individual chapters are devoted to cases describing the impact of homelessness, substance abuse, racism, family involvement, and early intervention for schizophrenia cases, on treatment outcomes. Feller identifies specific barriers to care and advocates for reparative strategies that would make the most meaningful and immediate improvements. This book is meant for anyone whose life is touched by mental illness, whether a patient, in the family, or more personally.