I know what you mean, to think of abuse of the mentally ill, you'd think the perpetrators would have to be psycho. Ironically, just before I read the book (not knowing anything about it) I finally found the date of my grandfather's death, cause and where. He had been committed to a psych hospital in NJ because as a field worker for the Dept of Environment, had been spraying for mosquitos in the swamps that were later cleared to make way for the interstate. He was lost and wandered several days in the swamps, then spent 12 years in the psych hospital before dying of cerebral hemorrhage. Now all I can think of about him is how much or whether he went through the tortures LeHane writes about. Pesticide inhalation? Overexposure to the elements, to the mosquitos, snakebite? There are no records to explain why he was committed. It was a big family secret.