Frankly it didn't resemble any psychiatric service provision I've ever seen, from secure unit to day services - most strikingly the patients were bizarre one-dimensional cut-outs with no sense of humanity or even mundanity (psychiatric patients are everyday people after all). Sam Wollaston in the Guardian also notices:
"...a fine performance from Anna Maxwell Martin in the lead - the only convincing "dribbler", actually; the others overdo it, and look like actors pretending to be mentally ill."Many reviewers talk about how this was some unsettling commentary on the modern British mental health system, on mental illness itself, or on 'institutional structures' - since most of the plot depended on unbelievable and contrived devices (e.g. a pathetically engineered 'Catch 22' where you must 'prove' you are mad to get 'MAD money' to fund an appeal to prove you aren't mad, and get you discharged) I think this is a pretty credulous reading.
The one negative review by Andy Boyd on Amazon says something similar:
And another reader responds to him in the way I imagine the author and the book/film's fans would:
"How this book was ever published is hard,very hard to imagine. Allan seems to have had in her mind another "Cuckoo`s Nest" She is no Ken Kesey.
A little research would have gone a long way.I am a Mental Health Project Worker and a user of services.I find her descriptions of mental health issues at the very least down right insulting with one dimensional characters of no substance whatsoever.
She cannot describe the reality of mental ill health,which,I agree has many moments of humour,empathy and understanding comes with it.
I suggest Ms Allan writes about something she remotely understands.This book is a total turn off she cannot explain the benefits system properly and continues a rant all through the book about "MAD" money - her reference to Disability Living Allowance which is irritating and downright wrong!!
At a time when we are trying to de-stigmatise mental illness and raise awareness of it Ms Allan only serves to describe a mental health system that does not exist - get a reality check!!!"
"The author, from what I have read, has a great deal of personal experience of the mental health system. I appreciate your stance, but this is a work of fiction."But this is just a combined appeal to authority with an 'it's just fiction' get-out clause - because the book can't both be a searing indictment of psychiatric services and also a completely innacurate made-up story*, I submit it is the latter, and as such tells us fuck all.
[* it has obviously occured to me that there is supposed to be a 'blurring of reality' thing going on - with the most implausible events not 'real', but that weakens it even more as both a story and a reflection on psychiatry - a much more interesting tale could have been told from the perspective, for instance, of the brushes with psychiatric services of someone diagnosed with a personality disorder, where there are real and interesting questions of both the patient's skewed perceptions of what is going on, and the attitudes and actions of mental health services to these people]