What papercuts?
Being forced to compromise your domain model. Yes the product has improved this greatly in recent years but it’s still inadequate IMO.
Fluent syntax can at first seem like the product has achieved persistence ignorance nirvana but then you have to compromise a little here, compromise a little there, until some point, if you’re still thinking critically about the design, you realize that you’re writing your app in Entity Framework as much as you are writing it in C#, as I mentioned.
Passing around a large mutable blob (dbcontext) which, if not managed with the utmost discipline by your dev team, can make it necessary to understand what large swaths of the code do before you can adequately understand what any small part of the code does.
In the runup to this, there were stories appearing regularly of people being committed to institutions against their will, and without valid cause. In other words, putting someone away for other people's convenience (or financial benefit).
I interpreted the outflow of mental patients as an unexpected side effect of efforts to halt the above-mentioned abuses. Of course it's also possible that reform of abuses was used as a cover for simple, unintelligent budget cutting.
Bill Maher