After this promising and even inspiring beginning, the book's focus is lost. The result is a rather loosely related collection of essays of inconsistent relevance and value, many of which only peripherally address the theme. For example, I expected that "Work and Mental Illness" would be a strong, pertinent piece, but found it merely a description of nonquantified results of informal interviews and observations conducted in the Greater New Haven, Connecticut, area just before a systemic change was introduced. We are told at the end that this chapter represents an early version of a paper published ten years ago. Although the authors are articulate and address important issues, readers could have expected the final version of the paper, or an account of the effects of the administrative changes then taking place in New Haven, or at least some rewriting to address a more current state of affairs.