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Mental Health in Fiction: The Shock of the Fall by Nathan Filer

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In one of the three winning entries from our Mental Health Awareness Week competition with Mind Your Head Society, Sam Davies takes a look at the portrayal of mental deterioration in recent award winning novel The Shock of the Fall.

Can we ever really understand what someone else is going through?

The Shock of the Fall, the debut novel from Nathan Filer, is a touching, emotional, and at times difficult, read. Recently awarded the 2013 Costa Book of the Year Award, it tells a story of grief, depression and madness. It deals with mental health with a frankness that is all too often lacking in real world discussions on the issue.

The story is told from the perspective of Matthew Homes, whose mental disintegration after the tragic death of his older brother Simon, who has Down’s Syndrome, on a family holiday when they were both children, is laid bare before us. We do not find out the full details of Simon’s death until towards the end of the book, and this tension is the underlying thread on top of which the novel evolves. Matt is a witty, blunt and admirably brave narrator, which makes his story all the more stark.

Image Credit: The Telegraph
Image Credit: The Telegraph

The book itself is quite magnificently presented. It is pieced together from Matt’s self-imposed ‘writing therapy’ – where he bashes away on an old typewriter and then computer –  along with letters and doctors’ notes,interspersed with Matt’s own sketches. Different typefaces and formatting add to the reader’s immersion in Matt’s increasingly erratic behaviour as his state of mind deteriorates.

Matt moves away from home at seventeen and into a dirty flat with his friend Jacob where they sit and smoke weed in the early hours, both of them working night shifts. His desperation at his brother’s death leads him into insularity, “Mental illness turns people inwards. That’s what I reckon. It keeps us forever trapped by the pain of our own minds” Matt recounts.

As Matt is drawn deeper into himself, we go with him, until he eventually begins to have visions of his dead brother in everything, forever seeing things in the “small print”, culminating in a particularly harrowing scene where Simon appears under his bed: “I want you to play with me forever”, Simon says. Matt’s deterioration is heart-breaking, but it is made all the more so by the fact that his schizophrenia allows him to have what he really wants – to be with his brother again.

This is a brilliant piece of fiction and a fantastic read. It is, however, only a piece of fiction. Whilst Filer, who worked as a mental health nurse in Bristol for a decade and continues with some shifts, has spoken about his desire not to propagate myths about mental illness, he can still give us only a limited insight into what life is like living with a mental health condition.

The Shock of the Fall was never intended as a description of schizophrenia, nor, in reality, could it be. Everyone’s mind is different, and as such every disorder manifests itself differently for every individual. Trying to understand the state of mind of another is a very difficult thing indeed. But what we can do is offer them support, and make sure they receive the best possible help. Whilst Filer’s experience in the mental health field is no doubt an important part of why The Shock of the Fall feels so real, outside of the world of fiction we often cannot hope to fully understand the feelings others experience.

Filer does, however, provide something of a commentary on the state of mental health care in the UK. “There is literally nothing to do”, Matt states over and over on his time in a mental health ward, “I live a Cut & Paste kind of life”. Terribly tedious routines of chats with staff who never seem to understand, smoking with other patients, listening to the “maniacs” on the ward, and being given drugs that produce grim side-effects, are all elements outlined by Filer which give us an insight into what life in this system is like.

In multiple interviews, Filer has despaired, as many do, at the state of the NHS’s mental health services. He sees cognitive therapies increasingly being side-lined in favour of cheaper and more readily available drugs. In the face of cutbacks, this trend is unlikely to halt: from 2000 to 2011 the number of people in the UK taking anti-depressants doubled.

Whilst Filer’s novel is only a piece of fiction, it highlights the difficulties that staff in mental health services have to deal with, and the need for proper interaction instead of just administering a set of pills.

Bed closures are continuing at a pace, and cut-backs mean that those with mental health problems have to be faring worse to be admitted to wards, and are released from them earlier, before a meaningful recovery. These are some of the most vulnerable people in our society, and if these trends continue, we will be failing them.

Fiction which uses mental health as a theme can at least provide a reference point from which all can better appreciate the strain of mental illness on both sufferers, and on those in the NHS who try to help cure people of such disorders.

With this being the University’s Mental Health Week, it seems there is no better time to raise awareness about these issues and start encouraging everyone to think more about what we can all do to help those suffering from mental health problems.

Sam Davies

You can like Mind Your Head Society on Facebook to keep up with their Mental Health Awareness Week events and take a look at our highlights here.

Also, don’t forget to like Exeposé Books for more reviews and features from the literary world. 

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