Content Warning: Both the source material and study guide deal extensively with themes of mental illness, suicide, drug use, homelessness, incarceration, police brutality, and ableism. There are also references to sexual assault/trafficking, miscarriage and abortion, and antisemitism.

Pete Earley prefaces the book by acknowledging that despite his decades of work as a journalist reporting on stories dealing with crime and society, he had no idea how difficult it was for people with mental illnesses to navigate medical, legal, and support services. He provides the reader with context for the book by providing both his personal experience and larger societal context. Earley documents discussions with his son, Mike, about the ethics of writing and reporting on his story and discusses Mike’s support of Earley’s decision to write about his struggles. In addition, Earley spells out his intention to tell two stories across the book: his son’s as well as that of his yearlong investigation following people incarcerated in the Miami-Dade County Jail.

This section depicts the early stages of Mike’s mental illness, beginning with his erratic behavior while attending college in Brooklyn. Earley notices when Mike begins experiencing insomnia and displaying odd behavior, including inviting unhoused men to come eat with him, wandering the streets of New York City for hours at a time, becoming convinced he is being sent messages through a movie called Heaven and Earth, crashing his parents’ car, and fixating on a childhood acquaintance to an alarming degree.