Fourteen-year-old Anna joins her family's journey from Prussia to America in 1871, searching for homesteads and better lives. Anna's mental health journey as an immigrant pioneer spans the next seven decades. Marriage and four children do not slow the progress of increasing auditory and visual hallucinations and bizarre behaviors. Doctors available to her in the late 19th century provide compassion but have little to offer in terms of effective treatment. She states adamantly that nothing is wrong with her. Townsfolk spread gossip; she and her family experience stigma. Anna stabilizes after a first admission to the State Mental Asylum and earns home visitation, renewing her husband's hope. A second admission, six years later, begins the final chapter in her journey, with outcomes that affect her and all members of her family. Her journey remains relevant today, motivating continued efforts for improved access to increasingly effective mental health treatments.