My 99-word story for the recent flash fiction collection, a new way to office, is about as social worker’s unease about office humour. Was it derogatory? Disrespectful of the clients? Or was it an essential part of the professionals’ toolkit, a barricade against burnout for those dealing daily with distress?

I cheated when I turned in my story. I used a character and situation from my new novel, Matilda Windsor Is Coming Home. The topic drew me because, like my character, I’m currently preoccupied with the role of humour in the book itself.

Humour and delusion

Matilda Windsor Is Coming Home is about a brother and sister, separated for fifty years, and the ardent young social worker who seeks to reunite them. What has kept them apart for decades? Will they reconnect?

My novel is set in a long-stay psychiatric hospital and a seventy-year-old patient is the star. Matty perceives the world differently to those around her: Ghyllside is a country estate, the nurses are servants, her fellow patients are houseguests and the psychiatrists are journalists researching stories about a society heiress.

I didn’t intend to write a comical novel. In fact, I cringed when Matty turned out to be funny. Mental disturbance is no laughing matter. People given a psychiatric diagnosis are too often the butt of jokes. Yet I couldn’t find any other way around it if Iwanted Matty to be both good company and authentically mentally ill.

Humour and dementia

Until reminded in a recent interview (see above), I’d forgotten I had a model for Matty in Emma Healey’s beautiful debut, Elizabeth Is Missing. Eighty-one-year-old Maud is a decade older than Matty, and is diagnosed with dementia rather than schizophrenia, but both characters contain a similar blend of poignancy, humour and tragedy.

Dementia renders the ordinary unfamiliar. Names of people and everyday objects are forgotten; life becomes a mystery to be solved. This aspect of the condition is beautifully played out in the novel as Maud attempts to resolve the dual mysteries of the sudden absence of her good friend, Elizabeth, as well as the disappearance of her elder sister in her 1940s childhood. If you haven’t read Elizabeth Is Missing, I urge you to give it a try.

I’m reassured to imagine the ghost of Maud lodged within my laptop in the years I toiled on Matilda Windsor Is Coming Home. Of course, there were other influences, but none with the same kind of humour. But I’ve read a couple in the space between turning in my manuscript and publication. If you didn’t think mental ill-health could be both funny and serious, get hold of these and think again.

Humour and depression

As the world prepares to see out 2008 with a party, forty-year-old New York writer, Bunny, is clinically depressed. If she wasn’t, it would be a fine excuse to opt out of dinner with her husband and two other couples at a pretentious restaurant, followed by a party hosted by people she hates. But one of the paradoxes of depression is that those who are prone to it often aren’t very good at taking care of themselves, and they’re especially bad at taking care of themselves when they need it most. So despite her husband’s best efforts to dissuade her, despite not having had the energy to wash for a week, Bunny is determined to go. And where does that determination take her? Seeing in the New Year on a psychiatric ward.

It’s hard to write honestly about depression without sucking the reader into the mire; Rabbits for Food by Binnie Kirshenbaum must be the best fictional representation I’ve read.

Humour and hearing voices

Tom doesn’t expect life to be easy; it’s more important to follow true path. Single, jobless and reliant on benefits, he prioritises abstinence, spreading kindness, and devotion to his god. For twenty years he’s trod the tightrope between sanity and madness, with those who police the boundary as much a hindrance as a help. When the novel opens, Tom is under pressure from both his sister and his care coordinator to participate in a drug trial, for a substance initially developed to treat athlete’s foot. His psychiatrist refuses to prescribe the only medication Tom deems effective but, in the British mental health system, the patient’s assessment of his own well-being is often overruled.

Jasper Gibson was inspired to research and write The Octopus Man after the death of a family member who had a schizophrenia diagnosis. In my work as a clinical psychologist, I met many people like Tom. They also had a love-hate relationship with voices that would both protect and persecute. They felt a similar ambivalence about their dependence on a service system that defined their cherished beliefs as insane. They experienced the daily humiliation of underperforming, and being patronised by care staff who were younger, and/or less intelligent, than them.

But this is a novel, not a case study. It’s a beautifully written and absorbing story, narrated by an unusual character who is as lyrical communing with nature as he is conversing with his personal god. I strongly recommend it for its compassion and humour, and, most of all, and in every sense, for the voice.

Which – if any – of these novels takes your fancy? Can you recommend any that portray mental ill-health authentically and with humour?

Anne Goodwin is a clinical psychologist turned author who writes entertaining fiction about identity, mental health and social justice. She is the author of three novels and a short story collection with small independent press Inspired Quill. Anne posts about reading and writing on her blog Annecdotal.