The rise of the mental health memoir is a symptom of our increasing interest not only in mental ill-health but in first person experiences of it. The spread of standpoint theory — i.e. the idea that we can only analyse issues from our individual perspective — lends credence to the false notion that we are inextricably connected to social mores and identities. 

Taking this into account when I picked up Committed, I was somewhat sceptical. There have been far too many self-indulgent memoirs conflating a serious reflection on a difficult life with salacious gossip about a turbulent period in one’s twenties. 

But Suzanne Scanlon moves beyond such parochial categories. Committed intelligently details not only her experiences of being an in-patient for a number of years in New York but the poetry, philosophy and identities which guided her journey and illuminate important aspects of our fraught relationship with this most sensitive of subjects. 

Refusing to maintain a linear description of illness, hospitalisation and eventual recovery, Committed skips between episodes where Scanlon is in and out the hospital, and details her emerging relationship with literature and writing. There is barely a page where you do not stop and wonder about what is happening and what this means. The tone is constantly searching — probing around the edges not simply of Scanlon’s illness but the social, cultural, and intellectual constructions underlying her experiences. 

Scanlon recognises that people are not merely ill and refuses to narrow her categorisation towards the stereotypical notion of the broken leg. Casting doubt on the medicalisation of ill-health, she argues that such a model encourages people to “act out” the illness as a way of finding a “cure”. Indeed, the picture of Dr Freud on a wall of Scanlon’s hospital, and the taking of pills to climb the mountain of ill-health to wellness, is a vision which Scanlon emphatically rejects.

But we must remember Scanlon’s experiences are not the same as ours are today. Arriving in Hospital in 1992 and staying there for almost four years, her encounter with the mental health unit is a far cry from the short stay roundabouts that patients experience today. Today, both the US and the UK emphasise treatment in the community rather than hospitalising people long-term. Yet, despite these differences, Scanlon’s experiences resonate with those who have been inside the mental health maze. 

As Ken Clarke recollected in his memoir A Different Kind of Blue, the transition from inpatient facilities to care in the community left many formerly institutionalised patients incredibly vulnerable not only for re-admission but homelessness, drug abuse, and other pitfalls that come associated with life. The rolling up of the American institutes had a similar effect on many of the patients who Scanlon had come to know. They were simply unable to cope with the outside world as budget cuts, an increasing reliance on pharmacology, and a curious new found certainty about what was right had emerged in the world. Caring for caring’s sake was no longer an option. 

In the final scene of the book, Scanlon focuses on a disturbing conversation with a doctor who could not comprehend why she had been kept so long. The nature of the conversation was curious not simply because of the doctor’s disbelief but also the apparently terse nature of the exchange. Scanlon’s seeming distaste for many doctors and their institutions can be seen in the final setting where the doctor remains oblivious as to what outside her professional capacity can make people well again. 

This is not to glorify long stays in mental health units. From my own experience in my early 20’s, it is not an environment we should inflict on anyone without good reason. Even those who “self-admit” do so when in a perilous state. Although units operate as an “island of safety” where everything and everyone else is shut out, it is easy to get lost and it can be difficult to find a way out. Longer stays not only commit people to the safety and identity to be found in the label of illness but deprive people of their true self, potential and exploration of what the world has to offer. 

It is this true self which Scanlon explores throughout the book via short sharp chapters. Her reading of the social, political, and moral frameworks which we find ourselves in emphasises the inherent complexity of categorising and treating the mentally ill. The argument over the barrage of chemicals we take to alleviate our ills, even when we have little understanding over the nature of their actual functioning, versus the promise of therapeutic measures merely highlights the limitations inherently present in the debate. Indeed, even the classification of mental illness remains disputed.

Scanlon sees the classification of mental illness as part of the problem itself. For some, the label appeals, creating a need for safety and security, while for some it is toxic, engendering illness and repeated stays in facilities doing the patient nor the physicians any good. Scanlon paints a picture where the label “mental health” becomes a shackle which can be difficult for us to release ourselves from. 

There can be a certain comfort in being unwell and this is something I recognised not merely in others but also myself. If we are recognised as unwell, nothing can or should be expected of us — it is a comfortable refuge which some return to time and again regardless of their genuine mental state. 

Therapy as a method, meanwhile, can create perverse incentives of reward for disclosure even if it turns out to be untrue. Sometimes, patients begin to conform to the doctor’s diagnoses and efforts to make them “well”. 

Just as Committed is not linear in narrative, it expresses scepticism towards linear transitions from ill host to healthy person. Considering the drastic increase in modern times of mental health diagnoses and cries for help, this aspect of the memoir struck me as particularly poignant. Scanlon’s radical notion that we are all a mere slip away from the label of insanity might be overstated but the concept of building resilience outside of medical categories reminds me of a more sophisticated version of Jonathan Haidt’s arguments. 

Committed offers a valuable insight into the roller coaster and paradoxes of mental health with many observations still prescient to today’s struggles.