As Conrad returns home from being hospitalized after his suicide attempt, he faces stigma from his mother and coach and copes with the trauma of being in a psychiatric hospital. While he mentions the friends he made like Robbie and Karen, he also recounts seeing rats scurrying in the halls and the lack of supervision that resulted in Robbie self-immolating.

Contemporary readers might be shocked to read about rats in a hospital, but Ordinary People takes place in the 1970s, a period of change for mental healthcare in the United States. Mental health facilities have a long history of inadequate care and abuse, from pre-20th-century “asylums” that functioned like prisons to abusive 20th-century facilities that performed procedures like lobotomies and involuntary sterilizations. Institutions were often overcrowded and unsanitary. By the 1960s, investigations into institutional abuse led to pushes for reform within hospitals and deinstitutionalization more widely. Some of the worst facilities were shut down, like Willowbrook State School and Letchworth Village. Advocates for deinstitutionalization argue that other methods of intervention like community care and supportive housing are more effective than long-term stays in mental health facilities.

Along with unsafe conditions in the hospital, Conrad contends with stigma when he returns home.