Within the Ward

Publication Date: 15 Oct. 2021
Format: Paperback / softback

ISBN 9781761110221

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    Paige Newell can't stop feeling--and hurting. The 17-year-old has never fit in, since her turbulent emotions and rebellious streak place her at odds with Raydale's clinical rationality. When her best friend dies, Paige is ready to end it all. But, before she can make a final exit, she's admitted to Raydale State Hospital. There, she is immersed in a dream reality, called "the Journey'. If patients finish the Journey, then they can go home.

    The Journey is meant to be the cure, but Paige soon discovers dark forces within the hospital, and that the dream reality is the stuff of nightmares. Paige wants to escape her pain, but is drawn into the lives of other patients. When they need her help, she must act. Paige can't get the past back, but maybe the future is within reach. Can the patients escape the ward? And can Paige find reasons to live?

    The Pause meets Divergent in this compelling YA novel that explores mental health in a dystopian tomorrow.


    Book Type: Senior High
    Age Group: 16 years +
    Traffic Lights: Amber/Red
    Class Novel: Yes
    Good Reads Rating: 4/5
    Literary Rating: 4.5/5


    In a world where demonstrations of emotion are outlawed, Paige's best friend has committed suicide. Struggling to cope, Paige also attempts suicide. When she survives, she's labelled as one of the community's "depressives' and sent to a treatment centre.

    There she meets a number of other patients, including Thomas--who claims not to be depressed, pretending to be happy all the time--and Nate--a former athlete who's been injured. Outside of the ward her best friend's brother, Michael, worries about her and tries his best to support her throughout her treatment.

    As part of her treatment, Paige must complete The Journey, a VR simulation based on The Pilgrim's Progress. Each course symbolises an aspect of recovery. If she's able to complete the courses, she will no longer be classed as a depressive. She doesn't care enough to try at first--distressed at the loss of her friend, it doesn't matter to her if she gets out or succeeds in this recovery. She makes no effort with Dr Shephard and ignores the nurse Lucy. But as she makes stronger friendships in the ward, and slowly goes through the levels of The Journey, she finds the will to survive.

    What she doesn't initially realise is that, if she doesn't complete The Journey, there will be no life left to live. The head nurse, Matron, is killing those that don't recover, and Paige decides that neither she nor her friends will be amongst them. However the Journey is getting more dangerous--they're not just facing the perilous courses, but the strange wolf made of smoke that keeps appearing in them. The wolf, which symbolises depression, attacks the people who are feeling the worst--making it even harder to complete the course.

    When Thomas--finding his depression overwhelming--takes the opportunity of an open window to commit suicide, Paige decides to take a stand; she can't lose any more friends. Paige makes a commitment to getting through the Journey with Nate and leaving the ward. With the help of Michael, Dr Shephard and Lucy they fight off Matron and make it out.

    This book deals with heavy themes with nuance and intelligence. Set in a dystopian future world and with elements of science fiction and action, the pace never relents--yet the struggles, losses, and victories of the characters feel grounded and believable. The author takes a responsible and informed look at the ways mental health issues are currently treated, and imagines where those current attitudes and treatments could lead, in a dystopian future.

    Paige's grief, healing, and growth from the beginning to the end of the novel are compelling, and the comments about euthanasia and society's treatment of mental illness add further depth. Overall, a hugely engrossing and thought-provoking read for young adults. The opportunity to discuss the themes would be beneficial, and it would make a very good class novel for older students.


    science fiction, dystopia, virtual reality, resilience, mental illness, depression, suicide, euthanasia, institutions

    Content Notes

    1. Language: shit x 10, bastard x 3, bitch x 4, f**k (p. 151, 153, 185, 234, 235), Christ (p. 189, 239). The Technician calls Nate a cripple (p. 264). 2. Thomas flirts with Lucy, the nurse (p. 26). He later tries to kiss Paige (p. 219), but she turns her head away. Lucy kisses Nate (p. 276). Paige and Michael have a strong connection, but this is not confirmed to be either romantic or platonic. 3. Avery takes a handful of pills from the medicine cabinet (p. 50). Paige remembers drinking with Beth (p. 157). Denna tells Paige that she got drunk at a party trying to impress a girl, because she hadn't had a girlfriend in ages (p. 206). 4. At 13, everyone is required to be Tagged, a procedure similar to a piercing. Paige's Tag is in her nose (p. 84). 5. Dr James Shephard admits to having euthanised patients in the past (p. 108). This is why he was hired for his current position; however, he doesn't agree that euthanasia is an appropriate response to mental illness. 6. The novel deals extensively with themes of mental illness and suicide. Throughout, the characters discuss their struggles with depression, their suicidal ideation and reasons for attempting. There is rhetoric from the Matron and some technicians about people with mental illnesses being a danger to society and irredeemable. This is countered by the discussions with Dr Shephard and Lucy, who genuinely believe their patients can recover and do everything they can to help. Throughout the book, the characters are forced to undergo The Journey, a VR simulation in which they die (p. 5, 53, 75, 184, 237, 255, 270). This was intended to build resilience by placing them in situations where they would have to fight for their lives, but with limited access to other forms of support they struggle to complete the courses. Anyone who doesn't make enough progress is a target for the Matron. Thomas tries to jump out of a window, but he insists this was not a suicide attempt (p. 19). Paige punches a technician (p. 134). The Matron uses an injection of potassium chloride to kill Avery (p. 159). She attempts to kill Nate the same way, but the others stop her (p. 238). She kills Dr. Shephard by clubbing him in the head (p. 256). She attempts to kill Denna with the syringe, but Denna takes it and kills her (p. 272). Denna tells Paige that she drove while intoxicated and hit two pedestrians (p. 207). Thomas commits suicide (p. 223).

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