This book is about the promises and failures of community mental health. It is also about hope and recovery. During the past 50 years, the treatment of persons with serious mental illness has undergone a radical transformation. Significant advances in research and the influence of a growing consumer advocacy movement are forcefully shaping a brave new world in community mental health. At the same time, tremendous suffering persists for those afflicted by serious mental illness. A recent chance encounter on a New York City subway with a young woman speaks to the heart of what this book is about. She was seated across from me and recognized.