Based on field research in Greek Thrace, this essay examines the problem of deception in psychiatric care, in the context of national psychiatric reform. Over the last 25 years, psychiatric treatment in Greece has shifted from custodial hospitals to outpatient settings, challenging the mentally ill to help care for themselves as they adapt to life “in the community.” I explore the consequent reworking of therapeutic relationships outside custodial institutions through verbal negotiation, as against methods of confinement and constraint associated with inhumane institutional care. I argue that an ambivalent intimacy is fostered in these relationships by suspicions of deceit, which speak as well to a problem of knowledge in contemporary psychiatry globally. Working through the case of a Gypsy outpatient diagnosed with antisocial personality disorder, whose life ended in a drug overdose, I trace suspicions of deceit across multiple terrains: from (neo)liberal reform, to clinical diagnosis, to constructions of minority culture. On these terrains, I do not attempt to determine the truth of speech in the clinic, but to discern the dynamics of suspicion through which that truth comes into question. Rather than clear refusals of responsibility, I show suspicions of deception in community-based care as refractions of psychiatric reform through a constitutive opacity in intimate ethical relations between patients and therapists.