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A mental health tale that's both droll and bittersweet

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Nathan Filer gestures during his award speech after winning the Costa Book Award for his book "The Shock of the Fall"  at the Costa Book Awards in London January 28, 2014.

Nathan Filer gestures during his award speech after winning the Costa Book Award for his book "The Shock of the Fall" at the Costa Book Awards in London January 28, 2014.

REUTERS

Nathan Filer gestures during his award speech after winning the Costa Book Award for his book "The Shock of the Fall" at the Costa Book Awards in London January 28, 2014.

The aftershock of a cruel accident is the core of Nathan Filer's debut novel, The Shock Of The Fall, winner of the best first novel at the 2014 Costa Book Awards last month.

We see the incident, at a Dorset cove, through the eyes of 19-year-old Matthew Homes, a mentally anguished boy whose guilt at the death of his brother Simon leaves him needing to be "managed" by his local community health team.

The novel has earned high praise from comedian and former nurse Jo Brand, who said it was the best fiction about mental illness she had ever read. Filer was a mental health nurse.

The scenes in which Matthew is sectioned are bittersweet and full of sharply droll details. "The mugs are provided by Drug Reps," Matthew notes in his journal. "They have the brands of the medication we hate stamped all over them." Patients are referred to as "Service Users" and it's a place where the over-riding sensation is of mind-numbing tedium.

These scenes are a small part of the novel, though. Matthew is a painfully haunted character. There is "too much small print" in life he says plaintively. He's no fool – and suspicious of people with scripted conversations – but, alas, he believes he can talk to his dead brother. Filer presents someone helpless in the face of his grief, a burden he can't share with his own damaged parents.

The descriptions of family life before and after the tragedy are wonderfully etched, especially Matthew's relationship with his nan and his sole friend, Jacob. The tragedy, when it is fully revealed, is stark.

It's an unsettling read but a perceptive and moving one. One image stayed with me. Matthew refers to his life as "watching my helium balloon slowly die".

Irish Independent