E. Fuller Torrey, a research psychiatrist who has spent decades studying serious mental illness, provides a deeply critical account of American mental health policy from the Kennedy administration to the present. The book argues that well-intentioned deinstitutionalization, which emptied state psychiatric hospitals beginning in the 1960s, produced catastrophic consequences because the promised community mental health centers never materialized adequately. Torrey traces how federal legislation designed to create humane alternatives to asylums instead created a system where people with schizophrenia, bipolar disorder, and other serious conditions cycle between emergency rooms, jails, homeless shelters, and the streets. Drawing on extensive research, he documents how America now has more mentally ill people in prisons and jails than in hospitals, effectively criminalizing mental illness by default. The book examines the various constituencies whose interests aligned to produce this disaster: civil liberties advocates who prioritized autonomy over treatment, pharmaceutical companies that overpromised medication's effectiveness, and governments that welcomed cost savings from closing hospitals. Torrey's proposed solutions, including expanded involuntary treatment, remain controversial, but his documentation of the problem commands attention. Readers seeking to understand how America's mental health system reached its current crisis will find here a detailed if polemical historical account that assigns blame with precision.