It would be difficult to produce a dull book on severe mental illness. It has always been a subject of fascination: in the eighteenth century Bedlam, Britain’s oldest psychiatric hospital, would open its doors to allow the paying public to gawk at the ‘lunatics’ held there. With this book, and with more enlightened aims, Dennis O’Donnell opens the doors on a modern-day Bedlam: the Psychiatric Intensive Care Unit (PICU), which houses those patients considered too disturbed and too risky for other inpatient mental-health wards. O’Donnell worked for seven years as a nursing assistant on a Scottish PICU, and this is a memoir of those years. It was written, he says, by way of tribute to the patients: ‘Their bravery and resourcefulness were simply staggering … What’s not to admire?’

The story is structured around the most memorable patients and events on the ward, with discussion along the way about the main diagnoses found there (schizophrenia, bipolar disorder, depression, personality disorder) and the treatments and care provided. Within a few chapters we have met Grace, who is intensely paranoid; Bill,