Ever since college in the late Fifties, Jay Davidson has been slipping. It started with his rejection by girlfriend Debbie--and his subsequent obsession with her. But the emotional chaos went on: multiple breakdowns; many mental-ward admissions. And his terms on the ward have come to function as yet another society for him: the doctors; the nurses; the therapists, especially a young woman named Gemma whom Jay longs for (but who herself is emotionally involved with another patient); and the fellow patients--like Silas and elegant Hamilton. Then, during one of Jay's stays in the hospital, his Manhattan apartment is temporarily rented by the landlord to two young girls, Nora and Claire; when Jay is released, the three make an apartment-sharing arrangement. This leads, of course, to romantic entanglement--with poor Jay hardly able to handle one girl, let alone two, And so escape finally becomes paramount for Jay--in the form of a cross-country bus trip with Silas and Hamilton. First-novelist Goldman has difficulty organizing all this material into a strong narrative: Jay's fragility builds up no delicacy, only the occasional burst of lyricism; the bus trip seems not quite well-bolted to the rest of the story; and the three-sided Jay/Claire/Nora romance seems perfunctory. But there's impressive verisimilitude here--with the chronic mental patient's revolving-door existence made palpable. (Especially vivid: the fluidity of staff/patient relations.) So, though more promising than satisfying as a fiction debut, this novel will have a distinct, special appeal to those interested in the two-sided frustrations of mental-health care.