Sticks and Stones: Mental Health Stigma and Crime Fiction


Crime fiction is entertainment. Writers’ primary goal is to entertain. But what is the impact of the written word on the most vulnerable people in society? Does crime fiction contribute to mental health stigma?

What is stigma?
The term stigma refers to the negative stereotypes, prejudice and discrimination directed towards a group – in this case, people with mental health problems. For example, the stereotype “schizophrenics are psycho killers” may lead to attitudes like “all mental patients should be locked up” and “I don’t want a nutter around my children” and actions like avoiding people with mental health problems, opposing mental health facilities in their neighbourhoods, and beating a man to death.

Stigma is not just about public attitudes to mental health. People with mental health problems can direct these negative attitudes towards themselves – self-stigma: “It’s my fault I’m depressed – I’m not strong enough to cope.” There is also institutional or structural stigma, where organisations discriminate against individuals, such as quietly cutting 1,711 psychiatric beds.

Stigma and Crime Fiction
People with mental health problems have a long history of portrayal in fiction. In Sophocles’ Greek tragedy Ajax, the titular character is tricked by Athena into believing animals are the Greek leaders. He is deeply ashamed that he was fooled by the goddess, convinced the Greeks are laughing at him, and literally falls on his sword. Here we have a classic example of self-stigma ending in violent death.

The Samaritans have issued guidance to all individuals involved in the media about portrayals of suicide, due to the evidence that suicide reporting influences suicidal people. Over 60% of broadcast media portrayals of people with mental health problems are “pejorative, flippant or unsympathetic”.

I hate reaching the end of a crime novel and, when the detective reveals the killer, the only explanation for his crimes is “oh, he’s mad”. Not only this lazy and deeply unsatisfying for the reader, it also contributes to the wealth of mental health stigma contributing to the lie that “killers are crazy, so crazies are killers”.

The stigmatising doesn’t end with the perpetrators of crime. Detectives and crime solvers are also suffering from poor mental health, although their issues may be treated more as quirks or “character flaws” rather than serious health problems. The functional alcoholic detective has existed for decades, belying the serious consequences of alcohol dependence. While Adrian Monk’s OCD may be well-realised at times, his colleagues reference to him being “very persnickety” falls short of describing this debilitating condition. And the rise of Autistic Spectrum Disorders, particularly Aspergers, in detectives such as Sarah Lund, Saga Norén and the BBC’s Sherlock fails to take in the breath of ASD while shamelessly enjoying a character who “speaks their mind” as if this is the only hallmark of the disorders.

Stigma and Crime Writers
Writers have long understood the significance of words. Edward Bulwer-Lytton cemented a sentiment over two thousand years old when he wrote “The pen is mightier than the sword.”

When I asked panellists at CrimeFest 2014 about the impact of crime fiction on mental health stigma, answers ranged from striving for accuracy to be respectful to not doing research because entertainment is the most important thing.

The words at the top of this page were all used by crime writers at Theakstons Crime Writing Festival last weekend. These are individuals whose work I enjoy and opinions I generally respect.

However, even as influencers of culture, they are also products of it – their language is the language of their community. As George Orwell wrote in 1984 “if thought corrupts language, language can also corrupt thought.”

Words can kill can kill with far great efficiency than sticks and stones. Perhaps some crime writers need to reconsider how they use theirs.

Are My Book Sales Good? Data for Novelists


Every debut novelist asks “what are good sales figures?” and every seasoned novelist/agent/publisher replies with “it depends”.

While this is undoubtedly true, it’s not very useful to the novelist trying to work out where they fit in the world of books. We know who’s at the top – bestsellers are determined by The Sunday Times, The New York Times, USA Today and more recently Amazon. These folks are selling 2000+ copies per day, depending on the season.

Newsflash: most novelists do not sell thousands of books per day.

Reports on author earnings can be useful, but they are difficult to apply on an individual level. Also, earnings =/= sales.

Traditional publishers pay in two main ways – advances, where you get money before you sell anything, and royalties. Some publishers, like my publisher Carina Press, don’t give advances but give higher royalty rates. However, royalties are only paid once you’ve “earned out” your advance (i.e. accumulated royalties are more than what was paid upfront) and they’re paid on a schedule, when the publisher receives money for sales.

For example, Carina Press pays royalties four times per year. The next royalties are due in September, but the accounting period for those ended May 2014. As my debut novel Binary Witness was released 5th May 2014, I will be paid for the first month of sales in September. Except Amazon usually operates around a three month delay, so I probably won’t see those payments until December. Confused yet?

My second book Code Runner is released in September. Therefore, finding out how well Binary Witness sold in December is a little late to know if my various marketing strategies worked. I’m fortunate in that Harlequin, the publisher that the Carina Press imprint sits under, gives me sales data on a weekly basis – however, this only represents 80% of North American sales. As I’m a UK-based author, this is again of limited use.

Which returns us to the original question: how do I find out my sales and how do I know if they’re any good?

Enter NovelRank.


NovelRank uses Amazon Sales Rank to calculate book sales. It’s main limitations are that it only accounts for Amazon and it is by its very nature not particularly accurate, but for our purposes it is good enough. Theresa Rangan has helpfully made a chart that allows folk to estimate actual sales from Amazon’s rank, if you don’t want to add your book to NovelRank.

Not only does NovelRank help you estimate your own sales, it allows you to look at other people’s. For me, this is the most useful part of the exercise and helps to answer the second part of the question. Because when we ask “are my book sales good?”, what we’re really asking is “how do they compare to other novelists’?”.

Comparing yourself to every other novelist is pointless. I am not going to sell like Stephen King, because a) he writes in a different genre and b) he has a few more decades of writing and motion picture deals on me. I’m also not going to sell like top self-publishers, because certain marketing options are limited by my publisher – e.g offering free/cut-price books to encourage growth of my fanbase.

Therefore, the best comparison is other novelists in my genre and with my publisher. Luckily for me, several Carina Press mystery authors are also signed up for NovelRank, so I can peruse their sales figures for the past few years.

This was a very interesting exercise. I looked at authors who wrote series and I went back to their debut novel sales. I then looked at the sales of subsequent books in the series, and how the sales of that book increased relative to the first book AND how the previous books also experienced a bump. Which makes sense, as marketing for Book Two will probably make new readers look for Book One.

What I found was very encouraging. Authors starting with tens of sales per month have now reached hundreds of sales per month, including an increase in pre-orders and backlist sales. I also found my debut novel sales to be comparable to my peers. This gave me increased confidence when approaching acquisitions, knowing I wasn’t starting at a significant disadvantage.

Do you track your book sales? Do you compare yourself to other authors or do you set personal targets? What tools do you use?

Freudian Script: Inside a Psychiatric Ward

The madhouse. Loony bin. Asylum. Psychiatric wards are called many things, but what is it really like inside one?

Freudian Script continues to give writers an up-close-and-personal view of mental health services in the UK and this week’s post concentrates on the inside of mental health unit.

History of the psychiatric ward
The first “psychiatric wards” were the asylums of the 18th century. These were private houses where your relatives could send you because…well, because they felt like it, really. There was no regulation and the owners didn’t ask many questions, provided you could pay. The first mental health legislation in the UK – The Madhouses Act 1774, for the legal nerds – was to regulate these houses, license and inspect them. In many ways, mental health services have moved on from this point – and in some ways they haven’t.

Who is admitted to a psychiatric ward?
So, why do people come to a psychiatric ward? In the old days of asylums and institutionalisation, you came to a psychiatric ward when you displayed any sign of mental health problems. The default treatment was containment. As treatments for mental health problems got better and people realised locking folks up for an indefinite period was bad for them (which took a shockingly long time), more emphasis was placed on care in the community.

Which is a long-winded way of saying that the threshold is quite high for hospital admission. It mostly comes down to risk. Psychiatrists and mental health professionals are in the business of risk – apparently, doctors make good stock brokers because of our risk assessment skills. Admission to a psychiatric ward happens when it is the only safe place for that person at that time, usually because they are a danger to themselves (e.g. feeling suicidal), to others (e.g. experiencing delusions that their family are trying to kill them) or at risk from the illness (e.g. too depressed to wash or feed themselves).

Some people only stay one night – referred to as a “crisis admission”. Some people stay for weeks and months. Some hospitals have specific assessment units, where people only stay a few days and, if they need further treatment, they are moved on to longer-stay wards.

What if you don’t want to come in?
If you are a danger to yourself or others and those risks can’t be addressed safely in the community, that’s where the Mental Health Act comes in. I won’t go over the law again here but, suffice it to say, you can be admitted to hospital against your will if specific criteria are met.

What does a psychiatric ward look like?
First, a caveat – all psychiatric wards are different. Obviously, things like building age, local variations, etc. play a part. I have worked in a handful of them, so this is from my experience. Also, I’m not commenting on the private sector – I’m sure you can take a tour of The Priory, if you wish.

The dining room of a psychiatric ward in North Wales

These are not your ordinary hospital wards. Forget your six-bed rooms, your nurses’ uniforms, gaggles of doctors doing daily ward rounds. Most psychiatric wards have individual rooms, though there are a few dormitories remaining, and these are often en suite – think university halls. These can be locked – sometimes patients have their own keys, sometimes not. They are typically divided into male and female corridors. There are communal areas, like a dining room, lounge/TV room and an occupational therapy room/games room. And there’s an outside space, which is also where people smoke, though more and more hospitals are going smoke-free.

Typical day on a psychiatric ward
For the staff, the day begins with a handover of information. For patients, it begins with breakfast – and, sadly, psychiatric wards are not exempt from the “hospital food is crap” stereotype. During the day, the consultant (i.e. head doctor) will see some of the patients for a review.

People are typically reviewed once a week, sometimes more in ward with high turnovers. Unlike general hospital ward rounds, the psychiatrist sits in a room and the patient comes to her. Other people in the room might include a junior doctor, a nurse and a pharmacist from the staff side. If the person is already under mental health services, they might have a designated person who is responsible for them – called a key worker or care coordinator, who also attends – especially when planning discharge. Members of the patient’s family and independent advocates may also attend. Some people bring their lawyers.

The rest of the day is taken up with meals, a few scheduled activities (typically in the afternoon), and visits from family, advocates or the chaplain. I’ll be frank – psychiatric wards are not renowned for being a stimulating environment, and people frequently take up smoking out of boredom and to socialise. Smoking rates are obscenely high in people with mental health problems. Aside from the scheduled reviews, the patient might see a doctor for physical health problems as they would usually see their GP.

Psychiatric Intensive Care
Like a general hospital, intensive care is for most unwell patients. However, psychiatric intensive care units (aka PICU, pronounced pick-you or pee-cue) don’t involved tubes and machines. It’s a very low stimulus environment, to reduce agitation levels, and there’s a high staff: patient ratio.

One thing to note here: no padded cells, no strait jackets. Some rooms are stripped down with weighted furniture, but an actual padded cell is very rare. PICU can be very calm and controlled – until it’s not.

Psychiatric emergencies
This is not like a crash call on Holby City (though, of course, psychiatric wards have medical emergencies too – they just mostly involved dialling 999 and waiting for the ambulance).


Imagine, for a moment, that you woke up this morning and thought the NSA were spying on you – not a difficult leap. Your phone has been bugged, your laptop monitored, and the car parked across the street has two of their spies. You confide in your best friend, but instead of helping you escape, he takes you to a hospital. Where they lock you up, suggest you take medication and call you crazy. Meanwhile, anyone could be a spy for the NSA in here and they ask so many intrusive questions. You’ve had enough – you’re getting out of there.

You try the door, but you’re locked in. So you try to kick it down. When that fails, you grab a mug and smash it against the sink, so you at least have a weapon when they come for you. Suddenly, they’re all surrounding you, trying to get you to take more pills. You have to GET OUT!

This is a psychiatric emergency. First this is de-escalation – basically, talking someone down. If that doesn’t work, a thing called Rapid Tranquillisation comes into play. It’s medication to sedate someone, plain and simple, and it’s a last resort when something is an acute danger to themselves or others – i.e. an emergency. Tablets are always offered first, but if they are refused – or often thrown – the next step is injectable medication, into the muscle under restraint.

These situations are terrifying – for the person at the centre and for staff in fear of their safety. Sometimes, sadly, there are no good solutions – only the lesser of many evils at that time.

Do you have experience of a psychiatric ward? What notable books/TV/films get it right – or very wrong? How can you use an accurate depiction of a psychiatric ward in your project?

Writing Battles: Making Death Personal

What do war films, comic books, high fantasy and epic poetry have in common? Their writers must hold our interest through long battle scenes.

I love a good explosion, mech fight or horde of screaming orcs as much as the next geek. But I struggle with large-scale senseless violence if it doesn’t make a point. Do I care about the giant who just swept aside fifty nameless, faceless barbarians? Of course not. It looks cool for five seconds, makes a nice trailer shot, but leaves no impact on me.

SPOILER WARNING: This post uses examples from Edge of Tomorrow, Game of Thrones Season 4, Blood of Tyrants (Temeraire series), Avengers Assemble, Man of Steel, Harry Potter and the Deathly Hallows, Lord of the Rings: Return of the King, Buffy the Vampire Slayer, and The Iliad. These spoilers include major character death. You have been warned!

So, how do you write an exciting, enthralling battle sequence, while marking the tragedy of death and ensuring our heroes die well? And what pitfalls do you need to avoid?

Heroes kill heroes
If a major character dies, they probably die at the hands of another major character – or, at least, someone with a name and a face recognised by the audience.

Let’s take the penultimate episode of Game of Thrones Season 4. Mance has finally arrived at the wall and the Night’s Watch make their Last Stand. Unsurprisingly, lots of people die. Thankfully, George R.R. Martin has a large cast of characters marked for death, but let’s examine the individual passings of our brave warriors:

> Pyp – shot by Ygritte
> Alliser Thorne – stabbed by Tormund Giantsbane
> Styr – hammered by Jon Snow
> Ygritte – shot by Olly

Two of those were death by “random arrow” – shot by people we’ve met and known – and two of them followed lengthy battles between evenly-matched characters. One death I’ve omitted is Grenn, who doesn’t die at the hand of a main character but does get a rallying pre-death speech before he meet his end off-screen at the hands of a massive fuck-off giant.

Pyp and Ygritte get cradling and last words. We see the impact of their deaths directly on Sam and Jon respectively. Grenn’s death is briefly acknowledged by Sam and Jon, over his body. Alliser Thorne and Styr’s deaths are made “heroic” because we’re invested in them – they’ve antagonised Jon for this season and beyond, and we want closure.

Ser Whosit of Whocares

However, if you have too many heroes dying bravely on the battlefield, what you end up with is a huge glut of names and my shrivelled black heart has a limited supply of tears for them.

Let’s look at The Iliad, that exceptional epic poem by Homer. If your only knowledge of The Iliad is Brad Pitt in Troy, you are fortunate indeed. Troy takes all the best bits of The Iliad (minus the Achilles/Patroklus insinuations) and condenses it into a feature film.

Homer, however, had an agenda. When he wrote this poem, he wanted to name-check all the supposed ancestors of his audience to make sure they felt special and included in his tale. There is a long and tedious section in Book 2 called The Catalogue of Ships, which is basically a list of all the people who went to war and is a massive snorefest.

The majority of the battle sequences aren’t much better:

“Then Priam’s son, Antiphus of the glittering cuirass, replied with a spear-throw from the ranks. He missed Ajax, but struck Odysseus’s loyal comrade Leucus in the groin as he was hauling Simoeisius away.”

Homer’s original audience knew these heroes well, and every one of them had to die well – and named. The modern reader really couldn’t care less and some fantasy works do fall into this trap.

The Off-Screen Exit
However, in some cases, your audience will feel robbed if your hero’s demise is not laid out in all its heart-breaking glory. One example that particularly strikes me is Anya in the series finale of Buffy. Her dead body was a casual postscript, not important enough to dwell on for more than a few seconds. She deserved better.

In Harry Potter 7, a number of characters die off-page. At least, Remus Lupin (my personal favourite) gets a goodbye after the fact, but the majority get their name entered into the Butcher’s Bill without ceremony. The difficulty of bringing a rich tapestry of characters to one final battle, within the POV of a single protagonist, is highlighted here – there was no way to do justice to all those deaths. JKR had to be selective in what could be shown, so that we didn’t end up in the middle of The Iliad.

Know Your Comrades In Arms
If you are writing a single/dual protagonist piece as opposed to an ensemble, your hero probably needs to survive to the end but realistically someone has to die in these battles. Who better to do that than his friends and comrades?

In Edge of Tomorrow – which is awesome, by the way – everyone has to die in the first go-round. So, we meet them, give them names, have some banter, and then watch them all die. And, because this is a time-loop film, we get to watch both our protagonists die too.

By the time we get to the loop that can’t be reset, we really don’t want them to die this time and we feel the loss of these characters we know, even though they are only peripheral.

Absent Friends
But what happens when you’re venturing out alone, and all your friends are fighting some other battle?

In the Temeraire series, the Napoleonic Wars are retold with the added awesome of dragons. I love these books, but the latest – Blood of Tyrants – was lacking something for me.

In the last third of the book, Temeraire and Lawrence go to Russia to kick arse. Meanwhile, all their friends go off to fight on another front. In the ensuing battle, Temeraire isn’t allowed to join in much of the actual fighting and the result is that the battles are a series of troop movements, tactics and the occasional bit of politics.

In previous books, we’ve had multiple characters to track through the fight, to get injured, to be heroic, to rescue. Without the supporting cast, without an active protagonist, the Russian battles fall flat.

One Man’s Fall
When you do have a lone hero in a battle of hundreds, thousands, or multiple heroes involved in separate fights, how do you keep interest and tie it all to the wider story?

Avengers Assemble has one of my favourite action sequences of recent years. As the Avengers fight among the skyscrapers, the seamless leaps from hero to hero keep continuity in a chaotic and spectacular fight. If I had one criticism, however, it would be that this violence is superficial. We don’t see much of casualties, consequences. Except for Tony’s spectacular fall from the sky, a personalised tragedy for our heroes. The threat of death on one of our heroes.

Less is More

Contrast this to Faramir riding out to retake Osgiliath in Lord of the Rings: Return of the King, at the command of Denethor and in expectation of death. We don’t really give a damn about the men of Gondor at this point, though we do like Faramir. Instead of concentrating on Faramir’s fight, we watch him ride out as the crowd mourns in advance and Pippin sings him a lament – and only see his broken body return to the city. The best thing about this battle is that we never actually see it – we anticipate it, and we see the consequences. Witnessing the actual blows would’ve diminished it.


Disposable Cities
When destruction is completely devoid of consequences, it becomes hollow. One criticism of Man of Steel was the mindless destruction both sides inflicted on Metropolis. Buzzfeed consulted disaster expert Charles Watson on exactly how much damage was inflicted in that final battle and estimated “129,000 known killed, over 250,000 missing (most of whom would have also died), and nearly a million injured”.

And did those deaths mean anything to the viewer? No. We weren’t aware the vast majority were even happening. It is difficult for us to conceptualise death on a large scale – as the saying goes: “One death is a tragedy – one million deaths are a statistic”

Writing Battles: The Personal Touch
So, what can we glean from these examples? For battle to be satisfying, it must focus on the personal – the hero, his friends, individuals among the enemy (if possible), and the consequences of the whole bloody mess. Without these touches, battles in fiction become meaningless slaughter – a violent titillation, perhaps, but relegating your battle to those forgotten as much as the dead men on your field.

What are your favourite battle sequences? How do they make the battle personal? How can you apply this to your own writing?

INTERVIEW: Lucy V Hay on Teen Mental Health and Jasmine’s Story

For this week’s Freudian Script, Lucy V Hay (aka the infamous script guru Bang2write) talks frankly about her struggles with her mental health as a teenager and how that contributed to the latest book in her THE DECISION series, JASMINE’S STORY.


You drew on your personal experiences in THE DECISION: LIZZIE’S STORY to write about teen pregnancy. How did your experiences shape JASMINE’S STORY?

Being popular is a huge part of growing up, especially for girls. I was not popular and I felt it every day, but I was not hugely unpopular either, so I got through school relatively unscathed… I got the usual taunts about being ugly or fat or whatever, but probably no worse than anyone else. I was very much The Outsider at school and felt very “detached” from it all, as if I was watching myself and others there. This was underlined by the fact I attended a school out of catchment where I lived; there was no real opportunity to socialise after school, everything had to be planned in advance. Teens don’t plan that well, so often I’d get left out.

I wanted to encapsulate that experience in Jasmine herself: this feeling of isolation, confusion, uncertainty. Is it her? Is it everyone else? A combination of the two? Where I lived, people literally didn’t know me, as we’d moved into the area when I was about twelve and missed out on going to the local primary school like the rest of my siblings. I recall one moment so clearly, when I was about fifteen, walking into the living room and a friend of my mother’s saying to her, surprised, “Oh is she one of yours as well?” Of course, she just meant she hadn’t seen me before, but for me, at that time, I felt like I was this invisible creature, of no consequence.

Though her actual experiences are not the same as mine were, Jasmine feels like that: I wanted to evoke that same feeling of being that Outsider. In comparison, Jasmine’s best friend Olivia is her polar opposite: an outgoing party girl who everyone knows. I always wanted to be that girl as a young teenager, but as I grew older I realised they had their own problems and that’s what I wanted to draw on in the story – this sense of contrast, yin/yang if you like.

How did your mental health affect your life as a teenager?

I was the eldest of five kids and a teenager during a very tumultuous time in my family; we moved area up and down the country several times in a very short space of time. We also went from being quite well off to dirt poor practically overnight when the recession of the 90s hit.

I was prone to anxiety attacks and frequently felt animals were following me, especially dogs. I fixated on the idea of our parents dying and what would happen to us all if we had to go into care, because I knew we had no relatives who would be prepared to take us all five of us in. I would plan obsessively in case of emergencies, such as fires: who could I save? What could I save? I was terrified of being abandoned, or of someone kidnapping my younger sisters in the night, even though we lived miles from anywhere.

And possibly most noticeably I would starve myself. I enjoyed feeling light-headed, but most of all I liked the attention it got me: from my parents who would try and cajole me into eating; from my friends who would say how they wanted to be as thin as me; and yes, from boys, because despite being thin I had a large bust! But that’s how everyone knew me on the surface; I was completely different to the scared, paranoid, invisible lost girl I felt.

I seemed like I was confident, opinionated, even jolly; but I felt I had split in half. I became convinced for a long time I was a liar, essentially; I was playing two different roles, and that people would “find me out”, which gave me even more anxiety!

What support did you have? Was there anything missing that you feel could’ve helped?

My mother and I are pretty close and it was good to have the release of talking to her, but I always felt I couldn’t tell her the whole truth because she had problems of her own. I tried going to teachers and doctors, but no one recognized what I was “really” asking, which was to help me understand what was going on.

Looking back now, I recognize a couple of moments where an adult did make an attempt to reach out, but because I was also quite paranoid, I suspected they had ulterior motives. I was so sure the problem was with me and that I was some kind of evil person deceiving everyone, I wish I could have just had Facebook or Twitter and seen other people have the same thoughts!

There’s a lot of stigma around self-harm and mental health problems among teenagers. What do you think are the best ways to combat it?

I suspect that if I was a teen today, I might be one of those “Emos” or “Pale Girls” and have one of those Tumblr blogs filled with so-called “depression quotes”. I understand that some people worry about these blogs, especially those that show graphic images of cutting or videoblogs, but I don’t think the answer is to take them away; it doesn’t make the thought processes magically go away! I’m not sure what the answer is, but teenagers with mental health problems pre-date the internet.

Arguably, depression quotes can have a very useful function for many teenagers as it helps them realise they’re not the first to feel that way. Feeling isolated and alone was a major issue for me and for many young people. But many teenagers hate these quotes and say those who like them are simply attention seeking. I believe this attitude is fuelled by many adults’ patronising stance on mental health issues, telling teenagers they “haven’t really” got any problems, or that depression is “romanticised”.

Let’s be clear: depression quotes are barely even the tip of the iceberg. We, as adults, need to stop invalidating teenagers as standard; just because they are young does not mean they deserve to be dismissed. We should also be encouraging teenagers to be kinder to one another and gently pointing out that everyone has problems adjusting to the various issues of being a teen. We also need to be framing conversations about mental health with teens in a variety of settings, but especially at school.

At one school I worked at, a young teenager tried to kill herself. When she attempted to come back, she was not met with sympathy; she was completely ostracised and eventually had to change schools. I know so many teens who champion gay rights, gender or race issues, yet would STILL not see the problem telling someone on Tumblr she is an “attention seeking Emo” and how pathetic she is. That’s not good. It’s not that the conversation hasn’t moved on, it’s barely begun from what I can see.

As a writer, would you recommend any particular films/TV shows/novels that do a good job of portraying teen mental health problems that other writers could use as inspiration?

I think WINTER GIRLS, a YA novel by Laurie Halse Anderson is an absolute masterclass in tearing back the secretive world of eating disorders and the competitive element between young girls over who can be thinner. I remember that feeling so well, it was how I validated myself. Of my group of friends, someone else can be the cleverest, the most beautiful, the “sluttiest”… Me? I would be the thinnest. I remember making that decision quite consciously. It’s an obsession; nothing else matters. Others say people with eating disorders are selfish, but they don’t understand; it’s not about vanity, it’s about control. Anderson totally gets this.

He’s no longer a teen, but Gary’s panic attacks in CORONATION STREET are well represented. He becomes agitated, pacing, rubbing his face, unable to speak properly. This is how I experience them. For years, I didn’t realise I had panic attacks because all the ones I’d seen on television usually portrayed them as mainly hugely exaggerated breathing. Sometimes panic attacks would be played for comedic value, yet I’ve never felt they were funny in the slightest!

What would you like to see more of in terms of young characters with mental health problems?

I would like to see more portrayals of self harm as being something other than cutting. Not because cutting is not important, but because it’s been covered very extensively in fiction (especially soap opera), so it’s now the first thing anyone thinks of. Yet self harm covers myriad things people to do themselves: anything that someone does to themselves on purpose that is bad for them and endangers them physically or mentally is a form of self harm.

I was very keen to avoid cutting in JASMINE’S STORY on this basis. Olivia, who is a self harmer, binge drinks, has one night stands, even uses social media against herself. Obviously all of those things are fine for many people, but for Olivia they’re not, her life is getting out of control and that’s the point I’m trying to get across.

What one piece of advice would you give a young person struggling with their mental health?

Know that you’re not the only one who feels like this; you feel alone, but you’re not alone.

And what advice would you give to writers looking to portray that struggle accurately and sensitively?

Do your research. Know that some people live difficult realities for complicated reasons you know very little about. Ask people their experiences, how it made them feel, but don’t jump in with theories, or be intrusive. Be sensitive. Just listen.

Lucy V. Hay is a novelist, script editor and blogger who helps writers via her Bang2write consultancy at Lucy is the author of The Decision Book Series of YA novels and WRITING AND SELLING THRILLER SCREENPLAYS for Kamera Books’ “Creative Essentials” range.

If you’re a young person struggling with your mental health, there is help available:
MindFull – online support, information and advice for 11-17 year olds
Young Minds – leading UK charity for young people’s mental health
WellHappy – app for London-based 12-25 year olds to access local support services including mental health, sexual health and substance misuse.
Samaritans – 24-hour support for anyone struggling with mental health, by phone, email or drop-in.

Crime Cymraeg: A Tour of Welsh Crime Fiction

Forget Nordic and Tartan Noir. From drug dealers in Cardiff to PIs in Aberystwyth, Crime Cymraeg is a broad church with something for everyone.

Wales is curious mix of busy port cities, kooky university towns, coastal tourist traps and rural isolation. It has a thriving capital city next to some of the most deprived areas in the UK, the post-mining legacy of the Valleys. It has a glorious national park, with mountains and lakes, award-winning beaches, and a heavy reliance on state jobs, manual labour and hill farming. It has a rich cultural history, from bardic poetry to male voice choirs to the Welsh language revival during the latter half of the twentieth century. It is the birthplace of Tom Jones, Shirley Bassey and the peerless Aneurin Bevan, founder of the National Health Service.

No wonder this varied nation has produced such a diverse range of crime fiction. I’ve been reading a lot of Welsh crime fiction while researching The Amy Lane Mysteries – here are some of the highlights of the genre.


Good People by Ewart Hutton features Detective Sergeant Glyn Capaldi, exiled from Cardiff to the Middle of Nowhere, West Wales. Told in the first person, Glyn navigates small town life and the incestuous, self-protecting community while first trying to establish if a crime has even been committed, and then fighting to uncover the truth. Uncomfortable at times, this book makes you suffer alongside Glyn and agonise with him over his decisions.

For lovers of rural policing, ambiguous moral choices and towns full of liars.

Buy on Amazon | Add to Goodreads


Barry Island Murders by Andrew Peters comprises a series of short stories recounted by retired Chief Superintendent Williams of his early days policing Barry Island – a seaside resort near Cardiff, home of British sitcom Gavin and Stacey. An old school copper in a small town where everyone knows everyone, this is a highly-amusing foray into 1960s Barry life.

For lovers of alcohol-soaked retired detectives, nostalgia hunters and the truths of a seaside town.

Buy on Amazon | Add to Goodreads


Five Pubs, Two Bars and a Nightclub by John Williams is a collection of interweaving tales about low-level gangsters operating in Cardiff. From the nightclub owner who wants to open a mosque to wannabe terrorists planting a bomb during a funeral procession, these are truly crime stories rather than mysteries or whodunnits. Featuring ordinary people eking out a living in a less than legal fashion, Cardiff’s underworld is a community where everyone’s somehow connected.

For lovers of broken-hearted gang runners, disillusioned activists and conniving journalists taking a walk on the wild side

Buy on Amazon | Add to Goodreads


Aberystwyth Mon Amour by Malcolm Pryce is the first in a noir series set in an alternate Wales, where the Druids run the mobs and no one ever got over the war in Patagonia. This black comedy has a quirky tone reminiscent of Jasper Fforde (who recommended this book to me) and pokes fun at Welsh life with an affectionate pat on the head. Once you’re immersed in the strange reality, the world comes together to shed light on contemporary Wales through a humorous eye.

For lovers of down-on-their-luck private investigators, Druidic conspiracies and precocious teens with a plan.

Buy on Amazon | Add to Goodreads

You can find more Welsh crime fiction on my Goodreads list – please add and vote for your favourites, or share in the comments.

Freudian Script: Police and Crime


Police officers – not the most likely custodians of society’s mental health. However, they are frequently called out to mental health emergencies and they play an uneasy role alongside the mental health profession in enforcing mental health law.

In commemoration of National Crime Reading Month, I’m going to explore the often-complex relationship between the police, mental health professionals and people suffering from mental health problems.

Please note, I am neither a lawyer nor a police officer. These examples are mostly drawn from my own experience and attempt to offer insight for writers who wish to write about these topics.

Why involve the police?
Several situations may require a police presence in the context of a mental health problem. A few examples include:
> A disturbed man in the street, running into traffic.
> A desperate woman on a bridge, threatening to jump
> A 999 call from a concerned mother whose son with schizophrenia has gone missing
> A woman accused of assault says the demons made her do it
> A Mental Health Act Assessment at the home of man experiencing severe depression

In short, police officers attend emergencies. Therefore, they are often the first people on the scene when someone is experiencing a deterioration in their mental health.

However, although they receive training, they are not mental health professionals. Their ability to accurately determine whether someone has a mental health problem is limited. In the UK, they act under suspicion of a mental health problem to remove someone to place of safety for further assessment – Section 136 of The Mental Health Act.

To address this problem, some police forces are employing mental health nurses to work alongside police in identifying people in need of treatment.

Black and ethnic minority groups are over-represented in police sections, as they are in all Mental Health Act sections. The reasons for this remain unclear, as Section 136 data is difficult to gather centrally, but it’s an important area of research if the inequality is to be addressed.

Section 136: what happens
If a person is behaving in a way that makes police suspect a mental health health problem in a public place, they can be placed on Section 136. This allows police to remove them to a place of safety.

This could be in a hospital A&E, a police station and a specially-designed Section 136 suite. The example I am going to discuss in detail is what happens in a Section 136 suite attached to a mental health unit.

The suite is ideally located next to the Psychiatric Intensive Care Unit (PICU), where the most distressed and unwell patients are treated. This is because patients who come in on Section 136 who need to be admitted may need urgent transfer to this ward.

The person is brought through a dedicated door directly into the suite. Their personal belongings are removed, usually including their shoes and belts (anything that could be used to harm themselves or others). Inside the room, there is a mattress and chair, with an adjoining bathroom. Everything is securely bolted to the floor – again, to prevent throwing/damage.

At this point, the police sign over the person to the care of mental health services. They also hand over any information they have about how the person was find and if their demographic details are known.

The person is offered something to eat and drink – sandwiches and tea, with plastic plates and cups. Their basic vital signs are taken by the nurses, if it is safe to do so, and a doctor is called for a physical examination. The first examination is to determine if the person is fit to have a full assessment. Reasons for not assessing immediately are usually related to intoxication – an assessment while drunk can go very differently to one when sober.

It’s also to check out if there are any overriding physical health problems that need attention. Because police are not trained doctors or nurses, they may mistake a delirium, an epileptic fit or diseases such as diabetes or liver failure for a primary mental health problem like psychosis.

When the person is fit for assessment, a Mental Health Act assessment is arranged – as detailed in my post on The Mental Health Act.

Crime and Mental Health
With Hollywood’s love affair with psychopaths and high-profile cases such as Oscar Pistorius, the subject of mental health and criminality is beloved of the media.

Here are the facts:
> There is a slight increase in risk of violence in psychosis, but this is often in the context of delusions. Because if you thought people were going to experiment on you, you’d probably fight back too.
> People with severe mental health problems are three times more likely to be victims of crime than the general population.
> When reporting crime, a mental health problem can often lead to testimony being dismissed or disbelieved.

When a person with a mental health problem is deemed to be a vulnerable adult, he cannot be interviewed without an appropriate adult present. This is a legal provision to ensure that the person’s rights are safeguarded during interviews, intimate searches, etc.

Forensic psychiatrists are those concerned with mental health in the criminal justice systems – mainly prisons, police cells and court rooms. They also have their own forensic units, where they treat convicted criminals with mental health problems. The most famous example is Broadmoor Hospital in London.

Writing about mental health and crime
At CrimeFest this year, I asked the psychology and psychiatry panel about mental health and stigma related to crime fiction. We are pedlars of fiction, but if we drown the market in psychotic serial killers, do we contribute to stigma? We are fascinated by the psychology behind murder, but at the risk of perpetuating negative and damaging stereotypes.

I would like to see more recognition of how people with mental health problems are often victims of crime, particularly in crime fiction. There are fascinating avenues to explore in reflecting the real world in our inventions, and doing justice to the reality of living with a mental health problem.

If you have any questions about mental health or would like help with research, please feel free to contact me – I’m always happy to help!

COVER REVEAL: Code Runner by Rosie Claverton

I am very excited to reveal the cover for CODE RUNNER, the second book in The Amy Lane Mysteries.


Ex-con Jason Carr has faced down the toughest thugs in Cardiff, but being assistant to a brilliant, eccentric hacker who hasn’t been outdoors in ten years has its own challenges. Still, he and Amy Lane can solve cases even the cops can’t crack. And when a corpse washes up on a beach, Jason can’t resist chasing the clues—or defying Amy by infiltrating the very gangs he once escaped.

Amy is distraught when Jason’s pursuit gets him framed for murder. He’s thrown back in prison where he’s vulnerable to people who want him dead. He needs Amy to prove his innocence. Fast.

But Amy hasn’t been honest with him—her panic attacks aren’t getting better. And now, with everything that makes her feel safe ripped away, she must stand alone, using her technological skills to expose a baffling conspiracy and a new kind of online crime. Can she clear Jason’s name before danger closes in?

When developing this cover with Carina Press, I put together a Pinterest board of images that I felt evoked the mood of the book, capturing the energy and urgency of my ex-con on the run.

Are you looking forward to the second book in the series? Add to your Goodreads TBR or order on Amazon.

Code Runner will release on 29th September 2014!

Yet to read BINARY WITNESS? You can buy it at the following online retailers:

Carina Press | Amazon | Barnes & Noble | iBooks | Google Play

Add to Goodreads | Read an Excerpt

Would I Follow Me? Twitter Tips for Writers

Twitter: the networking, promotional and procrastination hub for writers everywhere.

But how do you make it work for you? How do you persuade your fellow writers, industry professionals and consumers that you are someone they want to follow?

I tend to look at my new Twitter followers in one big batch, so I’ve noticed a few trends in what turns me on or off a potential new Twitter friend.

I don’t get it right a lot of the time. Which is why the examples of Twitter faux-pas showcased here are all from my own timeline over the past month. Learn from my mistakes, friends!

Here are my five biggest Twitter mistakes:

Retweet Central


When I’m short on time, I tend to check Twitter, flick through the latest updates and retweet one or two things that interest me. I become a consumer, not a creator.

There are accounts that very skilfully curate content from throughout the Twittersphere and are sources for the best articles out there. If that’s the point of your account, then you can be a Retweet Master.

But if you want to engage people and show the person behind the writer, you need to show you have a life and opinions beyond agreeing with someone else’s advice or sharing cute dogs.



Hopefully, most people will forgive a debut author shrieking about her book’s birthday from the hilltops, but if your whole timeline is book links, RTing praise and, worst of all, spammy @replies to folks telling them how amazing your books are? Who wants to read that?

Research by Goodreads indicates that “Twitter and Facebook do not score highly for book discovery, but they score well for book discussion”.

Twitter is a social network, not a broadcast service. Engaging in discussion with individuals interested in your book’s genre or topics may be more effective than constantly hammering them with a sales pitch.

Scheduled Tweet Syndrome


Another pointer for the time-poor writer: some scheduled tweets are bloody obvious and others may be less so. The above section of my timeline shows a day of scheduled tweets. Can you tell at first glance?

However, these tweets are all about promotion – not joining in a conversation, or sparking a discussion. Now that Twitter has separated out @replies, it can be hard for people to tell if you’re a social Twitter user. One spontaneous tweet in the midst of scheduled things – even if it’s actually scheduled – can remind people you’re human.

Inspiration Aspiration


I’m cool with having a few more sharks in my life. But if your entire Twitter feed is quote after quote from A Famous Writer, or constant links to Ten Inspirational Writing Journeys, you move from inspiration to tedium.

Being an aggregator of quotations, breathtaking photographs or unusual facts is fine if that is THE POINT of your account – i.e. SciencePorn. If the point of your account is to be a writer on Twitter, maybe to make friends or encourage people to check out your content, this approach is probably not the way forward.

Audience Alienation


We live in a global society. Which means that, while everyone in your part of the world may be watching something extraordinary on TV, there are probably a sizeable portion of your followers who are not. And have no earthly clue what is happening.

You may decide, on balance, that any screenwriter not live-tweeting the Oscars is not worth knowing. However, if you’re veering off topic into reality television or HIDEOUS SPOILERS, your words will not always be appreciated.

Doing It Right
After that burst of negativity, here are two periods where I got it right:



A series of tweets where I hopefully prove my human credentials: excitement for CrimeFest, retweet about a famous writer and tech with comment (to show I’m not just hitting the RT button like a robot), retweet of some praise for my book, and a random tech-related comment. While sometimes my tweets are completely random, these are vaguely related to my book, in that my protagonist is a hacker and these are tech-focussed issues.

On Topic


I think to think my specialist subjects are writing and mental health. In this section, I take a current news story – the Isla Vista shooting – and contribute relevant content to the discussion.

While the above examples make it seem like my entire Twitter life is a contrived social media-savvy campaign or a series of slapstick errors, the point is this: you are a writer and you are a human being. Showing both of these things, including what drives you, inspires you and enrages you, lets people know whether they want to get to know you and your work.

So, look at your Twitter timeline and ask yourself: would I follow me?

Freudian Script: The Mental Health Act


So, you want to write about mental health.

By checking out the previous series of Freudian Script, which concentrated on specific conditions – like depression, psychopathy and autistic spectrum disorders – the writer can get to grips with a sensitive and accurate portrayal of a mental health problem.

But what about the experience of living with a mental health problem in the UK? How do mental health services function? What happens when you have an urgent problem one morning? How about at midnight? What goes on inside a mental health hospital? Who comes to see you if you can’t leave the house?

And what about the professionals who work in mental health? Who are they and what do they do? How do they interact with other areas of medicine, social workers, and emergency services?

The next series of Freudian Script concentrates on these aspects of mental health. Because I live and work in the UK, this will focus on the British experience of mental health but I would love to hear from people in other countries and gain additional perspectives.

To kick off, we will be looking at the the main law relating to mental health in the UK – The Mental Health Act.

DISCLAIMER: This blog post is designed for writers of fiction. If you need advice relating to mental health law, please seek out a lawyer or mental health advocate

What is the Mental Health Act?
Born in 1983 and revised in 2007, The Mental Health Act is the principle piece of legislation governing mental health problems in the United Kingdom. It specifically deals with what happens when a person who has, or is suspected to have, a mental health problem requires treatment but refuses it.

History of the Mental Health Act
The first piece of mental health law in the UK was the Madhouses Act 1774. This gave licensing powers to the Royal College of Physicians to license madhouses, which could detain “lunatics” under the authority of a doctor. There were several versions of the Madhouses Act, before it was replaced by the Lunacy Act 1845 and County Asylums Act 1845. These laws dealt with the detention of “lunatics, idiots and persons of unsound mind” and set up local Lunatic Commissions to monitor them.

“In The Madhouse” – engraving by Hogarth

A note on language: The terms “lunatic” and “idiot” are now derogatory insults, but they were the medical language of the time for mental health problems. The problem was that they were used as insults and so health professionals changed them. You can see this process continuing with “retard”, “mental” and even “special”.

Then came the Lunacy Act 1890, which involved a Justice of the Peace in detaining people. This was replaced by the first Mental Health Act (1959). It encouraged the treatment of people with mental health problems without detention but provided for it if necessary.

However, this was still inadequate, as it was unclear whether treatment could also be enforced. This question was finally answered by The Mental Health Act 1983, and further refined in the 2007 amendment.

Sections and “sectioning”
A section is a legal term referring to part of a law. All laws have them. However, in mental health, the phrases “I’ve been sectioned” and “he’s been put on a section” are common ways to refer to being detained under a Section of the Mental Health Act. The numbers refer to the part of the law that’s being used.

To detain someone under a section, there are two requirements: that the person has a “disorder of mind” – not necessarily a diagnosed mental illness – and they are a risk to themselves and/or others.

I’m not going to go through the whole law, but I’m going to touch on the most commonly used Sections and how they work.

Section 2
Section 2 is for assessment and lasts up to 28 days. While the purpose of Section 2 is assessment, patients can also be treated on it. To place someone on Section 2, you need two doctors and an Approved Mental Health Practitioner, or AMHP (rhymes with lamp) – usually a social worker. One doctor is a Section 12-approved doctor (i.e. a doctor who meets the requirements laid out in Section 12 of the Mental Health Act), and the other can also be a Section 12 doctor or a doctor who knows the patient well (e.g. GP). The AMHP represents the views of the family, which harks back to the days where your family could place you in an asylum – and get you out.

Section 3
Section 3 is for treatment and lasts up to six months. The assessment also requires two doctors and an AMHP. People can go on a Section 3 after a Section 2 if their treatment needs to continue or people can go straight on a Section 3 if they have a diagnosed mental health problem and are presenting with one of their typical relapses.

Section 5(2)
If patients come into hospital voluntarily (known as “informal” status) but deteriorate and want to leave, they can be assessed by the Duty Doctor or their consultant psychiatrist and detained for 72 hours. This is to allow a full assessment to take place. Nurses have a similar holding power under Section 5(4), but this only lasts for four hours – until a doctor can use Section 5(2).

Section 136
This is a police power. They can take the person to a “place of safety” – usually an A&E department, police cells or a specially-designed suite at a mental health hospital. From there, they can have an assessment to see whether they need to be placed on another section, admitted informally or go home with support. Sometimes, people are placed on Section 136 while intoxicated (because being high can look a lot like mental illness), and when they sober up, there’s no need for further mental health intervention.

Appeals and Nearest Relative
Anyone on Section 2 or 3 can appeal against it. A mental health lawyer is provided free of charge and a tribunal is conducted. This involves independent judges – usually doctors and lawyers – considering evidence provided by the treating team and the patient. They can order the immediate discharge of the section or ask for certain conditions to be met.

The patient’s nearest relative can apply for the person’s discharge from the section. This again harks back to original asylum law. The nearest relative is usually spouse, oldest parent or oldest child. The treating psychiatrist (also called the Responsible Clinician) can bar the discharge if there is immediate danger – often hard to prove. If the nearest relative blocks a section during the assessment stage and the treating team thinks they don’t have the patient’s best interests in mind (because of financial gain, abusive situations, etc.), they can be displaced. But that can be a difficult legal process.

If a person doesn’t have a nearest relative or an unsuitable one, they have access to an Independent Mental Health Advocate (IMHA). That person supports them on issues such as mental health law and their rights as a detained patient.

Leave and discharge
Just because someone is on a section doesn’t mean they have to stay in the building. The Responsible Clinician can use Section 17 leave (i.e. leave as described in Section 17 of the Mental Health Act) for people to leave to ward under certain conditions – usually for certain periods of time, within certain hours and possible escorted by staff or family. If people refuse to come back or run off, the police can return them to the ward.

When the person has recovered enough to go home or chooses to remain informally, the Responsible Clinician alone can discharge them from the section. It’s considered very bad practice for a section to lapse without a follow-up assessment.

Community Treatment Order
This was one of the new measures put in place by the 2007 amendment. It provides for the group of patients who never recover insight into their illness and need monitoring and medication to prevent dangerous relapses. These people are placed on a Community Treatment Order (CTO) from a Section 3 by two doctors and a social worker. It basically requires them to meet certain conditions – usually taking medication and keeping appointments. If they fail to do so, they can be recalled to hospital without a further assessment. Once in hospital, the Responsible Clinician decides whether to change it back to a Section 3. Sometimes, they just have their medication in hospital and leave again. There is also an appeals process attached to CTOs.

Patient perspective
The Mental Health Act is a frightening and confusing beast. Add this to the fact that the person is usually suffering from a severe mental health problem and it can be absolutely terrifying.

The most common fears I hear expressed are that they’ve been arrested and imprisoned – especially if police are involved – or that the hospital has no right to hold them. All patients are given their rights, but it’s difficult to take in any information while distressed.

As a writer, The Mental Health Act can be dry and convoluted and your audience is likely to have limited knowledge of it. Give them a way in through the person experiencing this traumatic experience – and it is traumatic.

In the Mind series “Your Voices”, one woman talks about her experience of psychosis and being sectioned:

While everyone was celebrating the Olympics I was sectioned and spent a week in hospital. I had started to hear voices and was living in a very strange world. Being in hospital was a terrifying experience and I couldn’t understand why I was there or what had happened to me. I thought the nurses were trying to kill me and I refused medication. Eventually I accepted the drugs and I did recover. I was released after a week and received treatment in the community.

If you have any questions about the Mental Health Act or other parts of the UK mental health experience, please feel free to contact me in the comments or via email.

If you have personal experience of the mental health system, please get in touch. Your stories help a new generation of writers portray mental health problems with less stigma and more truth.