The remarkable thing about Is There No Place on Earth for Me? is how easy Sheehan makes it for the reader to empathize with Sylvia. In real life, if confronted by a psychotic woman slathered in makeup and spouting delusional ideas, the average person would make a beeline toward the other side of the street. But by sticking with this story for so long, Sheehan lets the reader see Sylvia not only during her most insane moments, but at those times when she’s lucid, too. At one point, when her medication kicks in and her fantasy world begins to evaporate, Sylvia bemoans the absence of her own delusions. “You know, it was fun believing some of those things I believed, and in a way I hate to give up those beliefs,” she says one day at Creedmoor. “I’ll miss having those fantasies.”

Without an upcoming wedding to Mick Jagger to look forward to, she’s forced to confront the sorry state of her own life: “ I once thought, when I was about to finish medical-secretarial school, before I had a breakdown on the last day of school, that I’d graduate and get a job. I was looking forward to earning my own money, to having a credit card, to being a grown woman in my own right. If you can work and earn money, you can . . . buy new clothes instead of wearing state clothes. And you can have fun. But . . . ” she says. “When you know all those things exist for other people but not for you, sometimes it’s very hard to endure the not having. ”

Moments like these illustrate the true toll that schizophrenia has taken on Sylvia. Her lucid moments allow the reader to see her as something other than a crazy person, which, in turn, make the later scenes—when her illness rears up again, when she is delivering nonsensical diatribes to her fellow patients or screaming about Jesus to her terrified family—all the more devastating.

Back in the late 1970s, before mental illness became a frequent topic of public debate, families with a schizophrenic child had to contend with enormous ignorance and stigma. This, in turn, ensured that the family would often become its own sort of closed institution, not unlike Creedmoor itself. I cannot remember my grandfather ever talking frankly about his daughters’ mental illness. The notion of having a journalist at the dinner table, taking notes with a plan to write about our family’s most taboo topic? It’s impossible to imagine.

And yet as deeply as Sheehan dives into life inside Creedmoor, she goes just as deep in her reporting on the Frumkin family. Sylvia’s parents and older sister are strong presences throughout the book, offering a window into the ways in which severe mental illness can warp every aspect of family relations. Sylvia was hospitalized at Creedmoor for the first time at age 16. By the time Sheehan enters the picture, Sylvia is 30, and the endless ups-and-downs of her illness—the psychotic episodes, the slapping and punching of her parents, the ambulance trips to the hospital, the search for a competent psychiatrist—have thoroughly exhausted everyone.

The Frumkins’ hospitality doesn’t buy them favorable treatment. Rather, Sheehan slices through the denial, shame, and frustration to deliver a brutally honest account of everyone’s shortcomings, whether it’s the mother’s refusal to visit Sylvia in Creedmoor because their relationship had become so toxic, or the father’s insistence that she swallow megadoses of vitamins to try to cure her schizophrenia, though there’s no evidence this works.

One night, when Sylvia is home from the hospital, Sheehan goes over to the Frumkins’s house in Queens for dinner. The conversation turns to a young woman, Sonya Finkel, who had been a patient at Creedmoor on the same ward as Sylvia, and who had recently committed suicide by throwing herself onto the subway tracks. The Finkel parents had always wanted to move to Arizona but didn’t because they didn’t want to leave their daughter when she was so sick. After her death, they relocated to Phoenix. Sheehan recounts the dinner-table conversation:

Jennifer Gonnerman is a contributing writer for New York and Mother Jones. Her book Life on the Outside: The Prison Odyssey of Elaine Bartlett was a finalist for the 2004 National Book Award.