A review by novel_feelings
The Glass House by Anne Buist, Graeme Simsion

4.5

The Glass House delves into the intricate world of acute psychiatry through the eyes of Hannah, her fellow registrars, and the wider team at Menzies. With humour and heart, we see the very real difference that timely psychiatric support can make in patients’ lives. Their work is life-saving, literally.

Throughout the novel, we meet many patients and families in crisis. Topics such as suicide, risk of violence to others, and mental illnesses that may be ‘terminal’, are handled sensitively. The curtain is drawn back regarding the tricky (and imperfect) decisions mental health professionals must make around boundary-setting, confrontation, family involvement, and clinical risk management. We also see the resulting anxiety experienced by clinicians around such choices.

Like many episodic hospital dramas, the story has elements of mystery-solving. Readers are likely to play armchair mental health professionals in the fast-paced, complex, and sadly under-resourced setting. As a psychologist, albeit one who has not worked in an acute role, I was immediately drawn to the patient stories, trying to figure out how I would approach treatment and support if I were in Hannah’s shoes.

Yet, the novel also candidly explores cultural issues within psychiatry, including power trips, bullying, and often narrow focus on the medical model – resulting in some characters’ dismissiveness towards the consumer movement and allied health. As the book highlights both the strengths and shortfalls of psychiatry, I was almost painfully aware that many of the characters would dismiss my professional opinions (I did not always agree with the characters’ formulations and treatment plans). Despite one particular character’s misgivings, I want to make it abundantly clear to any readers that psychotherapy is backed by evidence – in many cases, meta-analyses of randomised controlled trials – though, of course, it relies on the skill of the therapist and does not work for everyone. We see the lack of exposure that psychiatrists get to training in psychotherapy, and the novel underscores the importance of holistic approaches to mental health care that are not always feasible in an acute setting.

Like the mental health system itself – there is a lot going on. The episodic nature is engaging, though it can be difficult to track of, or connect with, the multitude of patients and hospital staff. I didn’t find the romance subplot all that satisfying, mainly because we didn’t get enough time with the main love interest, Alex, to get a good sense of his personality outside of work. Perhaps this was intentional – work is their lives. To contrast, Carey was a personal favourite character; as a nonbinary autistic character working in a somewhat conservative setting, they offered a unique perspective on patient experiences and the strength of neurodiversity.

In the acknowledgments, the authors pays tribute to the courage of patients and the dedication of mental health workers, acknowledging the complexity and challenges inherent to their roles. It’s this dedication to authenticity that make it The Glass House a must-read for anyone interested in the human stories behind clinical care.

Thank you to Hachette Australia for providing us a copy of the book in exchange for a review.

Review by Elise from novelfeelings.com - where two psychologists take a deep dive into your favourite books