Poisoned Ground by Barbara Nadel

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To get straight to the point, I’ve got a new Hakim and Arnold novel out (4th September) called ‘Poisoned Ground’. Of course I want you to buy/read it but not just, this time, because my ego needs some massaging and I would like to pay the gas bill.

‘Poisoned Ground’ is special to me. Based largely in a psychiatric institution, it reflects much of my own experience as a patient advocate in a hospital just outside London. I worked on all types of wards including our forensic unit for mentally disordered offenders. Later I worked out in the community. So when Mumtaz Hakim goes undercover into the fictional hospital I have created,  what she experiences is based on how it was for me.

It wasn’t easy. The job of a patient advocate is to reflect the views of the residents and inform them of their rights under the Mental Health Act. It is also a forum for complaints and complaints made by people who are usually ignored and dismissed as ‘insane’ is a hard gig. ‘Don’t listen to her, she thinks she’s the Virgin Mary’, is just one of the things that was said to me during the course of my time as an advocate. But I have always worked from the starting point that however ‘mad’ a person might be, he or she knows when he or she has been kicked. And he or she is also aware of the fact they are detained and therefore effectively powerless. At the same time however, one has also to bear in mind that patients can, just like anyone else, have issues with other patients and members of staff. There are brilliant people working in psychiatric hospitals, but one has to always remember that these places are total institutions and so they are by their very nature prone to all the ills that afflict such places. Things like stress, bullying, abuse and violence. The whole reason that advocacy was developed was to try and limit such things. Sometimes it worked, in my experience. Mumtaz has much the same experience. She also comes across something so serious and frightening that it eventually threatens her life. And that threat has nothing to do with a delusional patient.

At this point, I have to declare an interest inasmuch as I have had family members who have been patients in hospitals like this. I know the world from both sides. I know how hard it is for everyone. I also know what the temptations inherent in such organisations are. And whether patients are in hospital or in the community, they are always vulnerable. They are also subject to the false beliefs of others and stigma that has been with the human race since the beginning of time. There is evidence that even in the Stone Age, people deemed mentally ‘other’ were trepanned (had holes cut in their skulls to let the ‘demons’ out).

Over the centuries, mentally ill people have been excluded, laughed at, burnt, beaten, sexually abused… I could go on. And in modern times probably the greatest threat has been the belief that they kill. The reality is that mental distress, when it does result in violence, is usually self harm or suicide. Mentally ill people actually kill others a lot less frequently than the ‘sane’ (whoever they are). It’s just that every time this does happen it hits the headlines. Because ‘madman who believed he was  threatened by ghosts kills’ makes a far better story than ‘sane bloke murders his wife to get her money’ which is mundane, and much more common. People need to get this into their heads and I hope that ‘Poisoned Ground’, in a small way, helps to get that message out.

If people with mental health problems are going to be able to live in the community successfully, society HAS to learn to treat mental illness like physical illness. There has to be sympathy, understanding and a desire for real integration. Years ago I met a man with a diagnosis of schizophrenia who held down a very high powered job. Via medication and survival methods he had developed himself, he kept his voices in check and was, as I say, very successful. Sadly however his employers could and would never know just how brilliant he was because they didn’t know. How could they? Had he told them, even if they had been sympathetic, at some point his condition would have been cited as a reason why he didn’t perform quite so well one day, and he would have been, metaphorically, crucified.

So do enjoy ‘Poisoned Ground’ and don’t think that it’s a ‘preachy’ book because it isn’t. It’s exciting and features some spectacular scenes in the older, creepier, derelict parts of the Royal London Docks. But also spare a thought, if you know what I mean.

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