Eleanor Oliphant is Completely Fine…but Gail Honeyman’s Perceptions of Mental Health Services Are Not. A Review.

After winning the Best First Novel category in the Costa Book Awards 2018, everyone’s attention has firmly focused on Eleanor Oliphant is Completely Fine, and I must admit for all its flaws, I am a fan. In a thoroughly readable and impossible-to-put-down tale of a young woman’s struggle with mental health, loneliness, and bullying, Honeyman opens up a variety of much needed discussions on today’s society.

The title serves as a reminded to the reader that someone who says they’re fine probably isn’t fine. For instance, Eleanor admits that she doesn’t speak to anyone from Friday evening until Monday morning, and though she brushes this off with nonchalance, claiming repeatedly that she is fine, we discover this is not the case when she goes on to explain that she spends her weekends drinking two whole bottles of vodka. The experience of loneliness and its effects on young people are often overlooked, but this does not mean it does not exist, and Honeyman’s decision to highlight this is one which hopefully will contribute to more open discussions of loneliness and ensure people who suffer from this are supported.

Honeyman quickly introduces the topic of workplace bullying. Eleanor is described as strange in the way she looks and how she acts. Her co-workers make fun of her, and although Eleanor assures the reader, and herself, she is fine with this, she clearly isn’t. It forces the reader to question how they would behave towards Eleanor; would they conform to the expectations of others and their joke making, or would they stand up for her?

The bullying also permits Honeyman to make a saddening critique of our society and the prominence placed on aesthetics. Eleanor is only accepted by her co-workers after she alters her appearance, gets her hair done, applies makeup and changes the way she dresses to appear ‘normal’. With beauty and body image very topical issues at the moment, Honeyman introduces this into her novel in a subtle and ingenious way. She suggests that a woman’s worth in society, as acknowledged by her peers, almost entirely depends on the way she looks. This depiction of the importance modern beauty standards has over the lives of individuals is something I think Honeyman should be commended on.

However, these positives come hand in hand with some negative aspects of the novel which I do struggle with, most concerning being the presentation of mental health services. Eleanor attempts suicide and after her friend Raymond discovers her, encourages her to seek medical help. As a result she has an unspecified amount of time off work to recover, during which time she sees a psychologist. We are led to believe her time off work isn’t very substantial, perhaps a few months at most. Now, excuse me for seeming cynical, but having had experiences with the UK mental health services, with myself and with others close to me, I know it takes far longer than this to be seen after a doctor’s referral. In fact, Andrew Matthews-King, writing for The Independent in February 2018, highlighted the BMA’s (British Medical Association) investigation into mental health services. This investigation uncovered thousands of NHS patients with severe mental health problems waiting more than six months, with some waiting two years before access to psychological therapy. If these are severe mental health issues, then it seems unrealistic for Eleanor to be referred so quickly after not revealing her suicide attempt to the doctor, thereby classifying her as not severe. Furthermore, telling a doctor you are depressed does not lead to an automatic referral, because doctors are very aware of the massive strain mental health services are under. It could take several appointments, and several lots of various antidepressants before they choose to refer someone to a specialist, and even then, there is a waiting list (which if the BMA study is to be believed, could be anywhere between 6 months to 2 years). This is in no way an attack on the NHS – the mental health services in the UK are vastly overworked – but the reality is it can take ages to see a professional through the NHS. In short; there is no way Eleanor would have been referred, had counseling, AND have returned to work in a matter of what appears to be 3-6 months.

But, maybe I am overthinking this. Maybe I’m picking holes in what is, essentially, fiction? Maybe I’m making this more of a big deal than it should be? But the fact is, mental health is serious, and its representation in the media must be carefully considered. Whilst Honeyman does not go as far as 13 Reasons Why (a whole other ball game) in its dangerously graphic details of mental health struggles, her failure to acknowledge the difficulty in accessing mental health services, and furthermore, what I believe is a trivialization of the difficulty of ‘getting better’, is something I struggle with.

A book which did get mental health right is A Little Life by Hanya Yanagihara. Though set in America, not the UK, the main character Jude bares striking similarities to Eleanor. Both experienced traumatic events as children, both have suicidal thoughts, and both make attempts at suicide. Yanagihara portrays the painful journey Jude takes through depression; the struggle he has to get better, even after counseling and medication. Years go by and Jude continues to struggle - which is a far more realistic perspective on the difficulty people with depression have. I realize that A Little Life takes place over a longer time frame, following Jude from being a young adult to a middle aged man (and is about 400 pages longer than Eleanor Oliphant), but I do feel Honeyman could have done more to suggest Eleanor did not ‘get better’ so rapidly. However, an argument which could be raised about this comparison between these two books is that it is an unfair one; their overall outlook and conclusion is drastically different. Eleanor Oliphant ends happily, with a positive outcome to her journey through depression, whereas A Little Life ultimately finishes with Jude’s suicide, a far bleaker ending. It could be suggested that therefore Honeyman presented her material more positively to lead to this happy ending, and to make the book more uplifting than tragic, which is important, because sometimes there are happy endings, but I think she should have emphasized more strongly that Eleanor’s journey to get to that happy ending was difficult, not a hop-skip-and-jump to recovery a few months after her suicide attempt.

In saying all this I am aware I could be perceived as negative, when in reality, Honeyman’s decision to write on mental health in the first place was a brave and valuable undertaking. I don’t wish to discourage other writers because I do think mental health should feature in media, continuing to generate important discussions. Nevertheless, whilst Eleanor Oliphant is, in many ways, a brilliant example of writing on this topic, I do think it falls short in its representation of mental health services and recovery.

On a final note to all creatives out there; please do write, discuss, create and film stories of mental health. But please also do your research and try your best to ensure you are accurately and sensitively portraying all aspects of mental health to ensure people understand it’s reality, not the romanticist distortion of it.

by: Alicia Pountney

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