Credibility is hard to come by when you are committed to a Psych Ward, so when Hannah insists that two of her fellow patients have been murdered, she is not surprised that no one believes her. In They All Fall Down, Tammy Cohen explores what it might be like to be such a modern-day Cassandra, with the added torture of not knowing if you can trust your own mind and perceptions. The main character in her latest novel, Hannah has been brought to treatment for reasons that are initially hidden from the reader. As the story opens, she has been at the Meadows, a private mental institution, for long enough to have become close friends with the other women there. She certainly knows them well enough to be convinced that neither of the two former patients would have committed suicide. Hannah longs for her release, but the more she digs into her theories, the more convinced her caregivers are that she is experiencing delusional thoughts and behavior. Also complicating her investigations is an omnipresent film crew that is making a documentary, leaving her little privacy to search for answers. Two other characters alternate in the novel as narrators with Hannah- her mother Corrine, and Laura, an art therapist at the Meadows. Soon, it becomes apparent that some of the patients and staff surrounding Hannah are not what they seem. Even Hannah’s own husband may be hiding secrets from her, as Corrine attempts to find out. The novel’s premise of mental illness and its effects on reliability is interesting, but the plot contained too many convenient devices that stretched plausibility. Unfortunately, too many twists, multiple hidden identities, MacGuffins and a good measure of Deus ex Machina weakened what starts out as a promising and unique mystery.