They All Fall Down

They All Fall Down by Tammy Cohen
Pegasus Books: 3/6/2018
eBook review copy; 384 pages
ISBN-13: 9781681776477

They All Fall Down by Tammy Cohen is a highly recommended psychological thriller set in a high-risk psychiatric institute.

Hannah is currently receiving help at the Meadows, a private psychiatric clinic in the country. She has done something that results in her being admitted, but we don't know quite what. She is married, although her marriage is in trouble and was before her admittance. She was pregnant, and we know she lost her baby, Emily, although we don't know how. What we do know is that two patients have died since she's been admitted, including Charlie, one of her closest friends at the Meadows. While it is a high-risk unit, Hannah knows that Charlie would not have killed herself. She firmly believes that someone is killing patients and making their deaths look like suicides. But who is going to believe her?

Corinne, Hannah's mother, knows that her daughter needs help and wants to support her to help in her recovery. The question is how can she help her daughter get better? At first she is reluctant to believe Hannah's conviction that a killer is loose, but to alleviate her daughter's concerns Corinne begins to look into the background of the clinic's founder, Dr. Oliver Roberts. As she uncovers secrets and discrepancies from the doctor's past, she also begins to look into the woman with whom Hannah's husband had an affair. As she begins to find numerous irregularities that are disconcerting, Corinne's belief in Hannah increases.

This was an interesting, compelling thriller. The narrative alternates mainly between the voices of Hannah and Corinne, and occasionally with Laura (the art therapist). Placing Hannah in a psychiatric institute automatically means that she is an unreliable narrator and we can't necessarily trust her character. Could her beliefs be a manifestation of her illness? On the other hand, she is a great character and you get a sense that although she is fragile, she can be rational on some levels. Corinne is an equally great character, smart, insightful, and resourceful. She wants to support her daughter and does what she can to help her. The supporting characters are equally interesting.

The quality of the writing in They All Fall Down is quite good. Cohen does an exceptional job with the pacing and we get twisty little reveals of more information, along with additional suspects being added, as the novel progresses. The tension keeps increasing as the sense that something terrible is going to happen looms larger. Why Hannah was admitted is revealed before the ending, which gives an added dimension to the plot. This is a suspenseful story that should hold your attention throughout the whole novel.

Disclosure: My review copy was courtesy of Pegasus Books.