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. Individual chapters are devoted to cases illustrating the impact on treatment outcomes of homelessness, substance abuse, racism, family involvement, and early intervention for schizophrenia cases. 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 as a patient, in the family, or as a professional, and it is a must-read for policy makers in this field.