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We avert our eyes when we meet them on the street: homeless mentally ill people with their hand-scrawled signs, shopping carts, and cardboard boxes. Because of our fear and revulsion or the guilty relief we feel at our own relative good fortune, we fail to see any human connection with them. Still, we're curious. How did they end up on the street? How do they survive such a life? What combination of biological vulnerabilities, childhood traumas, drugs, mental disorders, and financial devastation brought them down? And how do some manage, against all odds, to climb out of this desperate situation? Former commissioner of mental health Robert Okin spent two years on the street meeting and photographing homeless individuals with mental illness to find answers to these questions. He masterfully brings these people to life through intimate and gritty stories and images. This second edition offers an expanded history of homelessness among people with mental illness and a more extensive discussion of the causes of homelessness and solutions to the problem.