This is a very flawed book. She has too many characters, I could only keep the groundskeeper and the Main character straight. She relies too much on dialogue and does not include enough description. My reason for reading this book is that I wanted to use the Traverse City State Hospital as a location for my own novel, so I bought all the books I could find that had anything to do with it. But I found myself speed-reading through the dialogue scenes because there was nothing there to slow me down, no actual action. Very late in the book, there was a scene where one of the patients holds a nurse hostage, but it was too little too late.
I cannot recommend anyone read this. In fact, I would recommend the author to rewrite it. But before you do, read some books on plotting, or even websites. And do some reading as well. Read some books by Margaret Atwood, Kristen Hannah, Anne McCaffrey, and Dean Koontz. Notice how they handle characters.
I could give all kinds of advice to this author, but not here I guess.