I wanted to read this book because I have two children who suffer from depression but also because I had a brother who was a paranoid schizophrenic who killed himself 27 years ago. My brother who was diagnosed as suicidal after years of psychosis was institutionalized and given an antipsychotic medication that caused him to "see things clearly" and prompted him to kill himself.

The author traces the history of mental illness and treatment, not always in an entirely coherent pattern. But the gist is that historically there has been a split between compassionate and highly interventional care that helps and punitive care that either punishes the sufferer or pretends that there is nothing wrong or that the sufferer is entirely capable of making rational choices such as taking meds even when that person's judgment is without question compromised. Highly interventionist care has been proven to save lives.

I felt that the author was at his best describing the horrific process of deinstitutionalization -- the causes that led to it and the results that we see everyday on the streets and under the highway bypasses of every major city. If you want to see tragedy on a huge scale that breaks your heart, take a look at the underside of the highway bypasses in Austin, Texas. The author points out that California has the largest population of homeless mentally ill and the reasons for it. It was very helpful to read about what went wrong because you wonder as you walk around these people who are they and why are they there.

I don't know about the link between schizophrenia and high intelligence. I was surprised that the author, considering that both his sons ended up schizophrenic, didn't say more about genetic causes. He talks a great deal about stress as a trigger, but not enough about how it is a trigger for those predisposed to be fragile. I think that, as happened with my brother, there is always a tendency to try to find the cause. But often the stresses are things that normal life throws at you. My brother had trouble with socializing with others, as the author's sons seemed to. My brother had trouble with dating and relationships, as the author's sons seemed to. There was almost a spectrumish quality to the problems my brother had and I thought about that when the author described the laser like focus his son Kevin brought to playing the guitar. It sounded a little like Aspergers, not classically, but a little bit. I have wondered if in the end, when researchers delve more into the genetics, if they aren't going to find that these fragile people are in the highly functioning range of that autism spectrum. Just a thought.

I loved the author's suggestions for how to make everyone's lives easier. HIPAA absolutely needs to be reformed to take into account that many of the mentally ill have families who love and care them and need to able to help their relatives. My severely depressed son was denied psychiatric care because he had been to the therapist the same day. That is ridiculous. Fortunately he wasn't in crisis, so he was able to reschedule but what if he had been? No question that needs to be changed. We have found that disability services in various areas differ greatly in their ability to help people in crisis. Fortunately we live in Northern New Jersey with an awesome vocational rehabilitation program. Life saving.

I would much rather work with a child with depression than schizophrenia. Depressives, in my experience, want help and want to change. As the author points out, schizophrenics don't always recognize that the reality they have constructed for themselves does not match the external reality. My brother believed people on television and in the newspaper were talking to him. It is very hard to reason with someone and help them understand that the world is not the way they perceive it. Unfortunately, we all construct our own reality.

And I would end with Pink: Change the voices in your head. Make them like you instead. When my son was very young and under tremendous stress, he heard voices. I hear that song and especially that line and I tear up every time. I feel that our school system and our society is so hard on fragile people, as the author said life is suffering, and I'm not sure that we are doing right by our children by forcing them to try to be like everyone else, to fit in, just to survive. The wealthy have options -- boutique schools, boutique programs -- but my husband and I don't have a lot of money and we watched our children, especially our youngest son, suffer in a system that just didn't tolerate a lot of difference from the norm. The author was able to pull his children and put them in more specialized boutique environments and even that wasn't 100 percent successful. I think we need a lot more research and a lot more answers for these special people. Because Mr. Powers that allowing them to just die devastates and destroys families. My family has not recovered from my brother's death and never will. He haunts all of us.