Poppy Shakespeare, Clare Allan's Orange shortlisted novel, takes a terrifying, wry and witty look at the current state of mental health care. Related in the semi-literate vernacular of N, one of the patients on the Dorothy ish day ward of the Abaddon mental hospital, it follows events when a new patient, Poppy Shakespeare, is admitted as a new day patient. Poppy insists she has not got any mental health problems, but this is nothing new in psychiatry - denial and lack of insight are well recognised traits in psychiatric patients. But it soon becomes apparent that Poppy really shouldn't be there - and N embarks on a long course of action to help her get free. Thus a Catch 22-type chain of events is set in motion - Poppy can only prove she is not mentally ill by pretending to be mentally ill. Meanwhile, the system drags her to rock bottom and she develops - you've guessed it - symptoms of psychiatric illness.
Clare Allan has a sharp and perceptive insight into what goes on in psychiatric hospitals, and when related deadpan, it DOES sound risible. Yes, patients DO sit about chain-smoking all day, yes, in an under-resourced and over-burdened system, interaction with nurses and doctors really CAN be as rare as Allan conveys, yes, some older anti-psychotics drugs really DO induce vile side effects that reduce patients to twitching zombies, and so lack of compliance and abuse of drug regimes IS common. And Allan captures spot-on the paradoxes and sheer idiocies of a political system that puts targets before patients and sells off health care to the highest bidder. Although events and constructions are clearly fictional, they are not THAT far-fetched - a Mad Tzar, after all, is only one step away from our current plethora of Drug and other touchy-feely but ultimately useless Tzars, while discharging patients before they are ready in order to save resources is a well-established necessity in our cash-strapped NHS. Although the days of chaining up people with psychiatric problems are long gone, psychiatric care is far from the soothing and therapeutic panacea it should be.
Full of dry humour and shockingly astute observations , Allan's debut is a stonkingly good read. My initial slight enniue at a text written entirely in slang dialect (a trick that has become commonplace since its devastatingly effective first few uses by the likes of Irvine Welsh and James Kelman) soon evaporated and I thoroughly enjoyed this clever and well-written novel.