A Danger to Herself and Others(76)

In chapter thirty-nine, Dr. Lightfoot—er, Dr. Charan—says that people with Hannah’s disease are more likely to hurt themselves than others. In fact, while researching this book, I read that rates of violence against people with mental illness are much higher than for the general population, especially those with complex mental illness and psychotic illnesses, and people with mental illness are also more at risk of homicide, suicide, and self-harm. At the end of the novel, Hannah isn’t sure whether she meant to hurt Agnes. But one thing that is certain is that Hannah hurt herself and might have done a lot more damage if the orderly hadn’t gotten to her room when he did.

Dr. Charan also says that Hannah is lucky to have been diagnosed so young—lucky that she’ll benefit from treatment (and, though the doctor doesn’t mention it, lucky to have parents who can pay for treatment not covered by insurance). Some people suffering from mental illness go years without a diagnosis or are misdiagnosed and therefore mistreated for years.

This book is a work of fiction and is not meant to educate readers about mental illness or institutionalization. No doubt I granted myself some creative liberty to tell Hannah’s story: it’s unlikely that any proper doctor would keep Hannah confined to her room the way she is (or rather, believes she is) for much of the story, and Hannah might not be sent home quite so quickly following her diagnosis. Additionally, I read that antipsychotics may take effect after a few days, but following acute episodes, they can take as long as four to six weeks, so it’s hard to say how long Hannah would have been medicated before she discovered Lucy was a hallucination.





If you or someone you know is struggling

with mental illness, please reach out to:

Mind

Helpline: 0300 123 3393

Email: [email protected]

www.mind.org.uk





ACKNOWLEDGMENTS


Many thanks to my wonderful agent, Mollie Glick, and to Emily Westcott, Joy Fowkles, Jamie Stockton, and the entire team at CAA.

Thank you to my lovely editor, Annette Pollert-Morgan, and to the Sourcebooks team: Chris Bauerle, Sarah Cardillo, Sara Hartman-Seeskin, Cassie Gutman, Nicole Hower, Sarah Kasman, Kelly Lawler, Katy Lynch, Sean Murray, Beth Oleniczak, William Preston, Dominique Raccah, Jillian Rahn, Stefani Sloma, Todd Stocke, Heidi Weiland, Shane White, Christina Wilson, Christa Desir, and thanks to Jennifer Heuer for the stunning cover.

Thanks to Samantha Schutz, and many thanks to Hannah’s early readers: Rachel Feld, Caroline Gertler, Jackie Resnick, Danielle Rollins, Julie Sternberg, and Melissa Zar. Thanks also to Jocelyn Davies and Anne Heltzel.

Thank you to my sister, my parents, my friends, and my teachers. And once again, thank you JP Gravitt, for everything.

“Because of the dog’s joyfulness, our own is increased. It is no small gift.”

—Mary Oliver, “The Summer Beach”