This book is, at the least, quite useful as a history of the modern social response to insanity and the gist of professional understanding - and lay opinion - of the matter across different time periods. Torrey and Miller are particularly good at dissecting and countering with logic and studies ideas put out by a number of once-popular and influential thinkers on mental illness and the social response to it (Michele Foucault, Thomas Szasz, Irving Goffman, and others). Chapter topics progress through time but transition between geographic locus to provide an historical survey on England, Ireland, Canada, and the U.S. Of particular interest is coverage of reformers, their social movements, and the motives and process of deinstitutionalization. A summary of theories of causal agents in serious mental illness near the end of the book is also stimulating. While the authors are candid about conclusive data being unavailable, they make a plausible case that serious mental illness has become more prevalent over the past centuries. Of course, I will have to read much more, and widely, to be convinced of this given all the well-known indicators of human life improving on many metrics (see, e.g., the relevant works by the economists Julian Simon and Thomas Sowell, and psychologist Steven Pinker). I plan to also read E.F. Torrey's books 'American Psychosis' and 'The Insanity Offense', both on the topic of treating the seriously mentally ill. Recommended.