On a Scale of One to Ten – Ceylan Scott

Some words of warning before I tell you anything else: I expect some people whose experiences resemble its themes will find understanding and a sense that they’re not alone if they read this book. Others may be triggered by its contents so please, please do not read this book if you’re not in a good place psychologically.

I know that Iris is dead. I know that it was sudden and so shocking that the waves of horror shimmered in the distance for months afterward. I also know that it is my fault, that one second she was there and her heart pumped crimson blood through her veins, and the next she was gone, blood frozen solid, and I could have prevented it, but I did not.

Tamar has been admitted to a psychiatric hospital as a result of a recent suicide attempt and history of self harm. She feels overwhelming guilt over the death of her friend, Iris, a death she is certain she is responsible for. During her time at Lime Grove she meets other adolescents who are similarly dealing with mental health issues, ranging from eating disorders to bipolar and psychosis.

Tamar’s internal turmoil feels authentic, likely because, although the story is fiction, its author shares her main character’s diagnosis of borderline personality disorder. Although this character’s behaviour does seem to tick many of the borderline personality disorder boxes, it isn’t until near the end that this is even mentioned and it’s never actually explained to Tamar on page. Hats off to the author for tackling subject matter so close to home at such a young age though.

I don’t know if this story is reflective of what psychiatric hospitals in England are like in general, or anywhere for that matter, although in the Author’s Note she does mention an admission when she was a teen but I was appalled by the lack of security measures. The patients could easily escape and bring prohibited items into the hospital.

The staff appeared to be a blend of people simply waiting for their next pay check and those who sincerely wanted to make a positive difference in the lives of their patients. The psychiatrist’s seemingly narrow view of what constitutes self harm allowed Tamar’s behaviour during an overnight home visit to be glossed over rather than addressed. There’s a huge difference between empathy and applauding obvious self harm behaviour simply because someone used a different method than they normally would. This psychiatrist didn’t even recognise what she did as self harm on that occasion.

Although I would have loved knowing what eventually became of invincible Elle and some of the others Tamar met at Lime Grove it felt more authentic to not have that resolution. In that kind of setting I expect it would be more unusual to have the blanks filled in.

While Elle and Jasper became real to me most of the other characters felt two dimensional, even Iris. The teens at Lime Grove felt like the usual suspects in a psychiatric patient setting, with little to differentiate them from their diagnoses. Given how young the author is I expect their background characters will become more memorable and fleshed out in future books.

I admit that I initially picked up this book because I (wrongly) assumed the title foretold a story about chronic pain/illness, something I’m unfortunately very familiar with. I detest the “rate your ‘whatever’ on a scale of 1 to 10” question for its subjectivity and lack of real meaning. Seriously, what’s a 7 for me may be a 2 or 10 for you and if you asked me the same question tomorrow I may have just received great news; my symptoms that I reported as a 7 yesterday may generate a response of 4 today. Because of my interest in mental health I decided to read this book anyway and am glad I did but it has resulted in my ‘1 to 10 scale’ disdain growing to encompass mental health as well as physical.

I couldn’t help making comparisons between this story and Girl Interrupted – the movie because I haven’t read it yet. (I know! The book will be better!) The escape and subsequent hitchhiking, the main characters with the same diagnosis and the parallels between Elle in this book and Lisa in Girl felt eerily similar.

I’d be hesitant to recommend this book to anyone, mostly because I wouldn’t know what thoughts or feelings it may trigger in the reader. There are scenes in this book that could easily be viewed as lessons in how to self destruct more efficiently and for people who are already vulnerable in those areas it could be dangerous.

Content warnings include death by suicide, mention of death by overdose, graphic self harm, bullying, eating disorders, mental health, suicidal ideation and attempts.

If you are struggling with depression, addiction, self harm or suicide To Write Love on Her Arms is a great resource for information – https://twloha.com. There’s also a Help page where you can search for contact details of resources in your country.

Rating: 3 out of 5.

Once Upon a Blurb

Tamar is admitted to Lime Grove, a psychiatric hospital for teenagers. 

Lime Grove is home to a number of teenagers with a variety of problems: anorexia, bipolar disorder, behaviour issues. Tamar will come to know them all very well. But there’s one question she can’t … won’t answer: What happened to her friend Iris? As Tamar’s emotional angst becomes more and more clear to her, she’ll have to figure out a path to forgiveness. A shocking, moving, and darkly funny depiction of life in a psychiatric world. 

A stunning journey of one girl’s mental illness and the redemptive power of truth and healing.

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