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Mental Health Matters: An Honest Conversation about Mental Health in the Publishing Industry

By Alfie Kimmins


Photo by Hannah Knowles

Hannah Knowles, current Editorial Director at Canongate Books and future Editorial Director at Faber and Faber has dedicated her career to building a diverse and socially responsible list. Having worked in publishing for seventeen years, Knowles has an experienced perspective on the attitudes and responsibilities of the industry in its portrayals of certain social groups. Mental health is a subject which appears frequently on her list in various formats including autobiography, narrative non-fiction and novels.


Hannah kindly agreed to an interview with me where we discussed her career, what she looks for in manuscripts relating to mental health and what the publishing industry can do to improve its portrayals of these illnesses.


As a commissioner, what are you looking for in manuscripts which heavily feature mental health as a subject or theme?


I don’t specifically look for particular subjects or angles, but what I seek out in any manuscript is clarity of thought and writing, nuance, integrity and most importantly, that it is written with honesty and from the heart. Terri White’s Coming Undone was the epitome of those things for me, in terms of her writing about her experiences with mental illness and its causes. It made my skin prickle with a mixture of disquiet and excitement when I read it on submission.


Is it important for mental health to be portrayed in books beyond the self-help/personal development format?


Definitely. Personally, I have never found reading self-help books on mental health useful (though many do), or even possible when I’ve been struggling mentally myself. Reading full stop can become impossible, which isn’t easy in this job! Generally, I have found people’s first-hand accounts of their own experiences most useful. I guess it’s that old adage of needing to see yourself reflected in stories. Clinical/major mental illness can be ugly and alienating. Seeing the often-brutal reality of mental illness written about honestly certainly makes me feel more acceptable somehow. Perhaps it’s that what we find monstrous in ourselves we can find compassion for in others, which in turn permits a degree of self-acceptance.

Your list tends to incorporate a range of social issues into their stories. Why is this something that you look for in particular?


I’m not sure it’s something I’ve sought out – more that I’m drawn to people who have something important to say and who communicate that clearly and passionately. It comes back to that thing of speaking from the heart. People who want to change society for the better tend not to be led by cynicism and that sincerity usually sings through in their writing.

How do you think the industry could improve when handling manuscripts featuring social issues such as mental health, race, class and LGBTQ+ rights?


A full answer would be too long to fit here! Proper representation in terms of the people writing, agenting, publishing, selling, promoting and reviewing the books, obviously. Social issues should never be treated as trends or tick boxes, but as fundamental to publishing that reflects the world we live in.

What impact do you believe representations of mental illnesses in books have on those affected?


That’s difficult to answer as it’s different for different people… A book that some might find helps them and speaks to their experiences can leave others completely cold. So, a diverse range of books on mental illness is key – and avoiding making mental illness a loose synonym for stress-related issues, which I’m not sure is particularly helpful.


Are there any authors who you believe are leading significant change in this area?


Possibly showing bias here, but I do think Susannah Cahalan is an extremely important writer in this area. The Great Pretender is her account of how a fraudulent paper led to the undermining of the psychiatric field at large – it’s a troubling and revelatory piece of writing. Speaking of troubling, David Harewood’s memoir, Maybe I Don’t Belong Here is an extraordinary book – deeply disturbing in its depiction of Harewood’s treatment as a Black man with a mental illness in the UK health system and of the scars of racial trauma. A crucial read.


In your experience, do you think the publishing industry is trying to improve in this area? If you believe they are, do you believe it’s for the right reasons and do you think it’ll last?


Truthfully, I’m not sure. There does seem to be some more diversity in publishing on mental health, but I think there is still reticence around publishing anything that doesn’t come with a happy ending, or that isn’t neatly tied up in an easily quotable package. I get why – it’s reassuring. However, I don’t think as an industry we will help tackle the real stigma over mental illness if we don’t look at the tougher realities of it. That goes for how we support employees, too. There is a lot more being done at a surface level within the industry than when I started out – initiatives being launched, etc. But is the reality for staff with mental illness issues significantly better than it was ten years ago? Are they more protected? I’m not convinced. It’s good to see more people speaking up on this, however social media has allowed people a voice where they might not have had any in the past.


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