Black Dog’s Gordon Parker writes stark psychological thriller In Two Minds

Black Dog founder Gordon Parker, who has devoted his life to mental health, has written a psychological thriller.

Detail from the cover of In Two Minds by Gordon Parker.

People who suffer from mental illness still struggle to throw off the stigma cast by residual Victorian attitudes and present-day disdain or fear. We have been reluctant to recognise that mental health needs full community acknow­ledgment as a vital branch of healthcare. Fortunately, this is changing.

In his role as scientia professor of psychiatry at the University of NSW, Gordon Parker has devoted much of his professional life to acquainting the public with the need to confront psychiatric illness as a worthy, and equal, associate of other branches of medicine, one that deserves our unguarded attention.

His establishment of the Black Dog Institute and its focus on the treatment of mood disorders has gone far in achieving this goal. His unrelenting advocacy of rational diagnosis and evidence-based treatment, highlighted in his 2013 autobiography A Piece of My Mind, has generated much interest but also a little criticism from within the psychiatric community.

Now he has written a novel, In Two Minds, in which he aims to bring that important therapeutic duo forcefully before the non-professional public. And he does so in the form of a stark psychological thriller.

Bella Donna — the name known in pharmacy as an extract of deadly nightshade (Atropa belladonna) — is a wily, headstrong and fatally attractive sociopath. Her victim — or one of several victims (we meet others) — is Martin Homer, an intense, structured, suburban general practitioner with a history that has left him flawed and psychologically vulnerable. He finds himself caught in Bella’s trap while on an odyssey through his developing mental illness. Their week of extreme passion, while Martin’s wife Sarah is overseas at a conference, feeds Bella’s need for control while enhancing the development of the manic phase of Martin’s flowering bipolar condition.

The apogee of Martin’s mental instability occurs when he is caught driving fast and recklessly over the Sydney Harbour Bridge to meet his wife’s plane. The police recognise his disordered mental state and he is admitted to a psychiatric ward, out of harm’s way.

Diagnosed with bipolar disorder but unwilling to accept the diagnosis or the revised treatment (he had started himself on an excessive dosage of antidepressants), Martin impatiently awaits his discharge. The treating psychiatrists stabilise his mood imbalance. Now they must meet the legislated requirement to obtain a second opinion to satisfy the Medical Board of Martin’s fitness to practise, an opinion that turns out to be contrarian.

Here lies one of Parker’s concerns about how mental illness is managed. His mantra — “Get the diagnosis right and make the treatment appropriate, safe and steadfastly overseen” — recognises and emphasises continuity of care as a fundamental plank of successful treatment.

Martin’s self-prescribing has been corrected and he has been reintroduced into a balanced therapeutic atmosphere. He now has the opportunity to choose his preferred ongoing care provider: the psychiatrist who first treated him or the authoritarian academic who provided the second opinion. His decision has significant consequences. His goal is to find Bella, the diabolical one, to help her with her “problem”. The consequences of this we are left to imagine.

Parker knows his therapeutic approach doesn’t suit everyone. But he is unapologetic about his firm stance on rational diagnosis and carefully monitored and balanced treatment. Martin Homer and his odyssey stand as a stark example of how it can all go terribly wrong.

In Two Minds

By Gordon Parker

Ventura Press, 304pp $24.99

Ian Stewart is a doctor and writer.