RABBIT HOLE takes place almost entirely inside a psychiatric hospital, which is remarkable in and of itself. Aside from two successful books made into classic movies --- ONE FLEW OVER THE CUCKOO’S NEST and SILENCE OF THE LAMBS --- psychiatric hospitals don’t play much of a role in the popular mindset. And that’s very odd when you think about it. Mental health is something of a cultural preoccupation, but the treatment of mental illness, at least in the congregate setting, causes us as a society to look away.

This is partly because psychiatric hospitals are just unsettling. The first time I walked into a locked psychiatric ward --- I am an attorney and was there to investigate a complaint --- I was wandering through the dayroom, trying to look inconspicuous. I fell into a conversation with a patient, and as I was talking to him, a nurse drifted behind me. “He’s unpredictable,” she whispered to me.

But that’s only part of the story. The truth is, these are public institutions --- we as taxpayers built them, staff them and keep them running --- and they have the potential to be dangerous places. We are aware of this even if we don’t want to acknowledge it.

"...an uncommonly well-done book that lifts the lid off a dark corner of the world that we don’t like to think about."

RABBIT HOLE is primarily a murder mystery, and despite the "Alice in Wonderland" motif in the title and the name of the main character, it’s very much in the English murder mystery tradition. The heroine, Alice, gets called “Miss Marple” at one point, and the locked psychiatric ward in London where she resides has some of the characteristics of the sort of English village that Miss Marple fancied --- with rather more in the way of psychosis and drugs.

Alice is in the psychiatric hospital due to post-traumatic stress disorder, which, combined with self-medication through alcohol and drugs, has led to severe delusions. (While we’re on the subject of Agatha Christie here, remember that she was one of the pioneers in using an unreliable narrator.) Alice had worked for the “Met” --- the London metropolitan police --- and when one of her fellow patients is murdered, she takes up the case.

Mental illness and addiction presents itself in many different ways. Alice is portrayed as being charming, articulate and likable, which makes her engaging as a character (and would make her very difficult to treat in real life). But Alice is not just a detective; she is our guide through a complicated world, introducing us to the various individuals who inhabit the ward --- both patients and staff.

Author Mark Billingham gets almost everything right here --- the character of Alice, who is by turns fascinating, pitiful and manipulative; the atmosphere of the ward and its grimness; the unctuous posturing of the staff; and the effects of the various drugs. Overall, the book is an effective hybrid --- an absorbing character study doubling as a travelogue through a place that many of us find intimidating.

Ultimately, though, this is a mystery novel, and unfortunately that is the weakest part of the construct. You can’t fairly blame this on Alice. Setting aside her own unfortunate personal problems and delusions, she’s not able to effectively conduct a modern, professional police investigation --- and she has to come to grips with this. You might think that her unique point of view could lead to an unconventional insight that would solve the case. I certainly did and was somewhat disappointed.

I am not here to tell you that RABBIT HOLE is in the same class as ONE FLEW OVER THE CUCKOO’S NEST and SILENCE OF THE LAMBS; that would be asking too much of it. But it is an uncommonly well-done book that lifts the lid off a dark corner of the world that we don’t like to think about. It also introduces us to a character who, despite all her inner turmoil and delusional behavior, we end up rooting for.