I used the real names of most of the people in this project, with their permission. Despite that permission, I changed a few names and identifying details in circumstances where I felt inclusion could be harmful to certain individuals. I also streamlined quotes for clarity.
On the matter of consent: since med school, I have been working to bring documentary stories about mental illness to public and professional attention. As I wrote this book, I made a film for PBS that documents some of the same patients and doctors profiled here. Long before obtaining consents, I spent roughly two years with Los Angeles County + University of Southern California (LAC+USC) Medical Center and Los Angeles County officials to review our protocol for filming patients responsibly. Our agreed-upon procedure was for the emergency department (ED) staff to first ask a patient and authorize consent before the patient was introduced to me or any member of my team. In all cases in which I followed a patient closely, I spoke with them (and whenever possible with their family members) over the course of at least five years, to ask them repeatedly for their permission to tell their stories. This close, long-term follow-up promoted a unique collaboration: rather than a project about a glimpse of patients and doctors in the ED over a few hours, the project became a close and ongoing collaboration with the doctors, patients, and families to tell their stories as they evolved over the course of time.
Aside from the patients and families, this project also has many collaborators, whom I thank in the acknowledgments. I cannot sufficiently thank my film team, which includes Peter Miller, Bob Richman, Buddy Squires, Jim Cricchi, Enat Sidi, Lynn Novick, and Anthony Simon. Because of the virtuoso and empathic work of my co-producers, Los Angeles cameraperson and director of photography Joan Churchill, and location sound recordist Alan Barker, I was able to record the words and lives of the subjects even when I couldn’t be in L.A. Executive Producer of Independent Lens Lois Vossen, Independent Television Service (ITVS) CEO Sally Jo Fifer, and ITVS Supervising Producer Shana Swanson pushed me to tell the story of our country’s abandonment of persons with mental illnesses that had never been told fully on television. I am indebted to the John D. and Catherine T. MacArthur Foundation Journalism and Media Program, National Alliance on Mental Illness, the American Psychiatric Association, the Los Angeles Department of Health, the Los Angeles Department of Mental Health, the National Institute of Mental Health, the Substance Abuse and Mental Health Services Administration, JusticeLA, Power and Dignity Now, and the many organizations who’ve supported me.
This book would not exist but for the combination of the efforts of my agent and guiding light, Joy Tutela; my editor, Nina Shield, at Avery Publishing (an imprint of Penguin Random House), who brilliantly kept me focused on both the big picture and the details; and my close collaborator, Jessica DuLong, who brought her formidable skills as a gifted writer and conscientious journalist to every aspect of this project. Impeccable fact-checking was done by Elizabeth Sinclair and attorney Brian Stettin, both of whom work at the Treatment Advocacy Center as research director and policy director, respectively.
I am most thankful to the patients, families, and health care providers who opened their lives and hearts to us. I hope our work does justice to their generosity and the trust that they placed in our team. Inspired by the bravery of the people whom we profiled, I decided to share my own story in a way that I never thought possible. For that alone, I am immeasurably grateful.