Using creative freedoms responsibly

A recent report into the deaths of mental health patients (Yvonne Roberts, The Guardian, 26/5/12) suggests that in 2010 there were 3,626 deaths in mental health detention in the UK, of which 501 were self-inflicted and that the proportion of deaths recorded from “natural causes” is exceptionally high. Roberts report draws attention to the fact that investigations into such deaths are investigated “in house” by the Health Services involved and unlike deaths in custody investigations do not have to be independent or findings made public.  Doubts are raised in terms of the quality of such investigations and, whether accountability is properly explored.

I share these concerns.  However, for a writer the relative lack of transparent structure is a window of opportunity - freedom.

In my current novel _Shadow of the Wing, _one of my characters is playing deadly havoc in the top security special hospital where she is an in-patient.  The environment of a top security hospital has of course a different daily reality than most of us will experience, and “the unusual” can be the norm in such hospitals, but the fact of less than robust and in-house investigation presents an opportunity for “getting away with things” and “cover up” that could never happen in the world outside.

Police procedurals evidence the thoroughness of police investigation and the knowledgeable crime reader will quickly lose patience with crime case management which stretches the bounds of credibility.  In _Shadow, _as an author, I benefit from the fact that the lack of transparency – and indeed amateurism - of investigation procedures for deaths in in-patient psychiatric care gives both my book and its characters freedoms they could not have in a crime story set outside the secret confines of the top psychiatric hospital.

However, having witnessed deeply concerning lack of proper attention to accountability and the failure to be transparent in our top security hospitals, I hope the creativity it gives me is repaid.  Whist the structures of investigation may be hidden in the system, I have a responsibility to ensure that the outcomes in my novel reflect the outcomes still impacting on the UKpsychiatric population._ Shadow _is not intended to be a campaigning book for the rights of patients but if, alongside a gripping story, it helps people to question what actually goes on behind the closed doors of secure psychiatric care it will have done the job I set out to achieve.