The author lived in the group home at 9 Highland Road on Long Island, a wealthy community that did not want the house located there and disgraced themselves in the eyes of many readers by raising hell at public meetings.

The people living at this home did not destroy the community or devalue neighborhood homes. They also tested the patients of the staff. Winerip does a good job explaining the psychiatric problems experienced by each resident and how staff dealt with the daily travails of that environment. The staff are heroes for doing this work for low pay.

The scariest part of the story is Julie, a resident suffering great trauma from childhood horrors and has many personalities to cope with that trauma. One personality takes over the body and when another personality pops out it may not even know where Julie is or how she got there. Apparently, one personality had a social life in New York City doing God knows what. When another personality pops out "she" realizes that the prior personality knows these companions well. But the second personality finds herself trying to converse with people who think they know her, but she doesn't know them. Most of the second half of the book deals with things like this. Scary stuff.