What is the main conflict in The Shrike by Joseph Kramm?

The Shrike chronicles the experiences of Jim Downs, a middle-aged man who has been placed in a mental hospital after a failed suicide attempt, brought on by a stalled career in the theater. His severe depression and feelings of hopelessness are alleviated, however, when an opportunity presents itself for Jim to revive his career. He insists that he is strong enough to leave the hospital and to live a productive and happy life.