Review - The Institution by Helen Fields

Review - The Institution by Helen Fields

On a locked ward in the world’s highest-security prison hospital for the criminally insane, a nurse has been murdered and her newborn baby kidnapped. A ransom must be paid, and the clock is ticking.

Forensic profiler Dr Connie Woolwine is renowned for her ability to get inside the mind of a murderer. Now she must go deep undercover among the most deranged and dangerous men on earth, and use her unique skills to find the baby – before it’s too late.

She has five days to catch the killer.

But with the walls of The Institution closing in on her, will her sanity last that long?

The Institution is utterly terrifying!

It's such a remarkable premise. Imagine looking for a murderer on a high-security ward full of serial killers. That idea alone had me totally gripped, as Dr Connie goes undercover to assess and analyse the staff and patients (or "guests") of the highest security ward in a remote institution for the criminally insane. It's an incredibly dangerous and highly unsettling assignment, particularly as her own past traumas arise, but with a dead nurse and a missing premature baby she's prepared to go to any lengths to solve this crime and only has days at best before the missing baby becomes another murder to solve.

The time-sensitive nature of Connie's mission means that there's always so much tension and pressure in this book. Every hour that goes by feels like precious life slipping away. Then nature takes a hand, and as a fire rages and the tension rises like the floodwaters. There are strong elements of isolation and loss of control, all exaggerated and made so much more immediate by the clinical setting. It's scary, it's disorienting. It's impossible to know who to trust, who to fear and which way to turn and through the urgency of the writing the reader is right there alongside Dr Connie. 

This is also a book about mental health, particularly at the more extreme end of psychopathy. It's about the people who suffer from it and what it can drive them to do but it's also about the people who treat them, and why they do it. It feels very critical of a lot of the treatment and practitioners, from outdated beliefs about treating female hysteria to newer, softer methods. Running through it all is the grimness of being committed, of losing any control over what happens to you, of not being treated as a human but talked over, forcibly medicated or restrained. It's dark and unpleasant and so very effective.

For all of the darkness, this is a book with some touchingly tender moments, particularly the emotional exchanges Connie has with the dead nurse, Tara, and her support of Tara's mother. It really reinforces why Connie put herself in such a precarious position, risking everything to save one precious baby.

It's also very different from The Last Girl to Die, the last book I read by Helen Fields. (You can find my review here). Where Last Girl to Die drew on myths and folklore, The Institution is very scientific. This gives it more of an analytical coldness where Last Girl to Die was all about emotions. Also, location played a huge part in Last Girl to Die, to the extent that it was hard to imagine it being set anywhere other than Mull. In contrast, by the end of the book I had no idea where in the world the Institution was. It's a building completely removed from the world around it.

Dark and terrifying, the Institution had me committed to finishing it from the first chapter!

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The Institution by Helen Fields is published on 2nd March 2023 by Avon Books.

I was given a review copy via Netgalley in return for an honest review.