Posted in Netgalley

The Institution by Helen Fields.

I was eager to read this having loved her previous novel The Last Girl To Die, so I’ve felt very lucky to be granted early access to it on NetGalley. Our heroine is Dr. Connie Woolwine, a behaviourist and profiler rather than a psychiatrist, she works privately alongside her investigator Brodie. She has access to The Institution to look for a killer within the high security wing. Housed in one of the towers, the wing is known as ‘heaven’ and has six inmates, all of whom are either serial or spree killers. Her cover story is an unusual one. Brodie will go deep undercover as a potential inmate, with Connie as his current therapist. Brodie has been in the millitary and suffers from PTSD amongst other issues, so Connie is there to assess the ward, meet the inmates and decide whether it’s the best place for Brodie to be treated. The truth is a lot more gruesome. A nurse from the ward has been found dead on one of it’s treatment rooms. Tara was restrained and had a rudimentary caesarean performed on her, but was then left to bleed to death. The baby has not been found and the killer could only have been on the unit. With a grieving family waiting for a ransom demand, staff and inmates at the unit have been given a different story about this well-liked member of staff. They are told that Tara will be resting at home for the final stages of her pregnancy. Now Connie is on the clock, desperately trying to find baby Aurora and which one of the killers could have murdered the ward’s most popular nurse in such a brutal way.

Connie seems maverick, with strange methods such as talking to, sniffing and touching Tara’s body. She’s an unusual narrator because I didn’t always feel sure of her. We find out that when she was a young woman she was admitted to a mental health unit after an accident left her mute and doctors couldn’t find a physical cause. She was given ECT and treated by psychiatrists until a new doctor decided to re-scan her brain and found a previously hidden blood clot. Once removed, Connie could speak again. This experience has left it’s mark and it seems very important to her, even when self-disclosing to a patient, that they know she wasn’t really mentally unwell. We’re mainly in Connie’s world with interspersed short chapters on an assessment session, each subject’s name as the title. These sections read like session notes and give us Connie’s views of each inmate. Rubio for example, acts like a baby and wants to be cuddled and nursed. He gave me the creeps, especially when he’s wearing a nappy. The Professor is more on Connie’s level intellectually, but acts very superior. I didn’t feel that the sessions were helping me understand who might have done this. In fact I think I learned more about Connie than the patients. In the meantime, poor Brodie is living with these inmates and has gone through being sedated and restrained by staff. The staff are incredibly suspicious, with orderlies who enjoy their power too much, nurses who seem to resent Connie’s presence and a male doctor who makes a pass at her almost immediately. I kept wondering who would choose to work here, in such a dangerous and bleak place?

I felt it was clever to keep the reader questioning Connie and it wasn’t just her inner world that worried me. There were points in the story where her instincts really concerned me, such as going off alone to very remote places in the building and on the grounds. There was also a major flaw in the plan, in that her investigator is so confined by his role as a patient he can only observe. This really does leave Connie to take on the more dangerous part of physically investigating, but as she’s untrained for this role and potentially more easily overpowered, it left me feeling on edge. Also someone who is thinking ahead of her could use her seemingly erratic behaviour and appearance to make her worst fears comes true. The tension is unrelenting and nowhere is safe, including rooms that have a lock! The claustrophobia is intense and works like a set of Chinese boxes: from the location and the effects of the storm, the compound, the locked building, the high security tower within the whole institution, all the way down to the treatment room and it’s restraints. These layers of confinement did make me uncomfortable and when a character is further confined with drugs or the threat of ECT, it brings it home how powerless patients and the murder victim were. These layers also emphasise the brutality about drugging someone and stealing a baby from the ultimate place of safety, their mother’s womb.

There is a strange fascination in hearing about the inmate’s crimes, mainly because they seem so at odds with the men we encounter through Connie. Her sessions feel slightly strange from a therapy perspective, but of course Connie is not really there to engage in a therapeutic relationship. Unknown to them and the staff, she’s using the session to assess whether they’re behind the crime and I was interested in the ethics of this approach. As disaster strikes and the ward has to be evacuated, the tension jumps up a level with men who are usually in their cells now roaming free. For those left on the ward it becomes a fight for survival, with only a basic knowledge of the inmates to inform them about which ones can be trusted and those who must be avoided. This was an exciting end to the novel and really did keep me gripped to the bitter end, waiting for the perpetrator to admit their role in the murder and kidnap plot. I was biting my nails, worried that Connie wouldn’t find baby Aurora before it was too late. This was an intelligent thriller, full of tension and unexpected twists and turns. It’s cemented my suspicion that Helen Fields really is a must-buy author.

Meet the Author

An international and Amazon #1 best-selling author, Helen is a former criminal and family law barrister. Every book in the Callanach series has claimed an Amazon #1 bestseller flag. ‘Perfect Kill’ was longlisted for the Crime Writers Association Ian Fleming Steel Dagger in 2020, and others have been longlisted for the McIlvanney Prize, Scottish crime novel of the year. Helen also writes as HS Chandler, and has released legal thriller ‘Degrees of Guilt’. In 2020 Perfect Remains was shortlisted for the Bronze Bat, Dutch debut crime novel of the year. In 2022, Helen was nominated for Best Crime Novel and Best Author in the Netherlands. Now translated into more than 20 languages, and also selling in the USA, Canada & Australasia, Helen’s books have won global recognition. She has written standalone novels, The Last Girl To Die, These Lost & Broken Things and The Shadow Man. Her first UK hardback, The Institution, comes out in March 2022. She regularly commutes between West Sussex, USA and Scotland. She lives with her husband and three children. Helen can be found on Twitter @Helen_Fields for up to date news and information or at


Hello, I am Hayley and I run Lotus Writing Therapy and The Lotus Readers blog. I am a counsellor, workshop facilitator and avid reader.

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