Mental health stigma

Mental health stigma is presented as a set of social expectations and encounters that make distress difficult for Queenie to name, disclose, or seek help for. It appears in family assumptions about prayer and endurance, in her fear that professionals will misread her, and in her own urge to hide symptoms and get better quickly. The novel places these barriers alongside racism, sexualized treatment, and personal loss: Queenie’s distress is not presented as an isolated weakness, but as an experience shaped by the people and institutions around her, and by the explanations she has learned to give herself.

Social expectations and the language of distress

Queenie’s family initially approaches her acute anxiety through a vocabulary that does not readily recognize mental health care. When she describes a frightening sense that something bad is about to happen, her cousin Diana identifies the experience as a panic attack, drawing on a classmate’s history. Maggie, however, asks whether Queenie is under stress and whether she has been praying. The exchange places a possible mental-health explanation beside a spiritual response, without showing Maggie treating therapy as an obvious next step. Queenie says she has never had a panic attack, even as another wave of acute panic arrives. The scene conveys how difficult it can be to recognize a new kind of suffering while the family’s available explanations remain limited.

The pressure to endure is also voiced by Queenie’s friend Kyazike. When Queenie asks what Kyazike thinks about counseling, Kyazike explains that in her Ugandan family a person is expected to bury the need for help and move on; she imagines that her mother would respond harshly if she sought counseling. Kyazike does not tell Queenie to avoid treatment: she says Queenie should pursue it if she needs it, while admitting she is not the best person to discuss therapy with. That combination matters. The inherited prohibition is real, but friendship leaves room for a different choice. Queenie, in turn, tells Kyazike that she feels awful all the time and that the feeling is not shifting. She also recounts that a clinic worker first suspected exploitation and then understood her sexual activity differently. Her account is defensive and rambling, suggesting how being assessed through a frame she rejects can make it harder to speak plainly about distress.

Clinical encounters and fear of being misread

Queenie’s repeated visits to the sexual-health clinic bring the conflict between care and judgment into an institutional setting. During one visit, a nurse raises concern that her injuries may be consistent with sexual violence and asks whether a work friend is someone she can confide in. Queenie denies that she is concealing an abusive relationship. At another appointment, when a worker raises the possibility of counseling and exploitation, Queenie objects that the earlier implication offended her and insists that the encounter she is discussing was consensual. The account does not establish that the clinic’s concern was malicious; it does show that Queenie experiences its questions as judgmental and responds by forcefully defending her own account.

At a later visit, Queenie has returned for a third appointment within a short period. Elspeth has learned from another nurse that Queenie is not visibly battered, but seems vacant, and tells her that she needs to speak to someone. Elspeth mentions that she has a daughter Queenie’s age, prompting Queenie to ask whether the daughter is Black. The question exposes a concern about whether the worker’s personal identification can extend across race, rather than assuming that concern alone will create understanding. Elspeth says her daughter is not Black, but explains that she has already found a therapist’s number in case Queenie came back. Queenie asks to leave for work, takes the referral without reading it, and pushes it to the bottom of her rucksack. Help is offered, yet she initially keeps its practical means out of sight.

Concealment, panic, and the wish to appear normal

The referral’s presence does not immediately end Queenie’s avoidance. After moving back to her grandparents’ home, she experiences panic in the bath: she becomes unable to stand, her vision blurs, and she hyperventilates until the water turns cold. When she tries to explain that she is shaking, her grandmother compares it with her own past physical suffering and tells her to get out of the bath. The response treats the symptom as something to withstand, not as a reason to seek mental-health support. For the next two weeks, Queenie performs chores, feels ill, refuses calls, ignores messages, and tries to panic silently so that her grandparents will not see what she considers weakness. Concealment becomes an everyday practice, not a single decision.

A call from South London and Maudsley interrupts that silence. The service has received Queenie’s referral and offers an initial assessment for talk therapy in Camberwell, explaining that an opening is available unusually quickly. Queenie is surprised and asks to think about it before agreeing. In messages with Darcy, she admits that there is a rush for her: she has felt bad for a long time and wants to be better and normal. Darcy counters that much has happened and will take time to process. Their exchange sets Queenie’s demand for a rapid return to normality against a friend’s recognition that recovery has a longer, less controllable pace.

The pattern recurs in public. At Brockwell Lido, Queenie interprets the looks of strangers as hatred and feels that she does not belong. As she leaves, a bystander characterizes her as aggressive; the surrounding voices grow louder to her, and she ends up sitting outside with her head down before calling Janet. A waitress brings her towel and dress after seeing her leave in her swimsuit. The episode shows panic unfolding amid a social environment in which Queenie expects hostility and is quickly read through a stereotype. It also shows her reaching for support rather than remaining entirely alone: she calls her therapist while still distressed.

Structural pressure and the meaning of recovery

The novel connects Queenie’s difficulty seeking help to pressures beyond family attitudes toward counseling. At work, she argues that Black Lives Matter names a historical and continuing disregard for Black lives, but the meeting ends with her feeling isolated among white colleagues who had seemed liberal. Walking back to her desk, she tries to remind herself that the community is enough. In therapy, she later explains that she cannot step outside being a Black woman and lists the degrading and reductive descriptions imposed on her in everyday settings. She contrasts the romantic attention her friends receive with the sexualized treatment directed at her. The account makes clear that emotional distress is entangled with repeated racial and gendered encounters; it is not adequately explained by individual fragility.

Queenie’s understanding of her distress also changes as she talks with Janet. She wonders whether her pregnancy and miscarriage brought her unresolved feelings about her mother to the surface. She begins to see her mother not only as the person who should have protected her, but as a person who suffered: after Roy’s abuse, her mother lost her home, lived in a hostel, became isolated, faced a court case over money, and was too fragile to work. Queenie recognizes a resemblance between their suffering but turns that recognition against herself, blaming herself for her own circumstances. The conversation quiets her dark thoughts for a time, but does not resolve her distress. Later, at the Lido, she continues tracing the sources of her emotional decline and reaches a new understanding of her mother without claiming to feel well.

Mental health stigma in Queenie’s story therefore operates through more than explicit disbelief. It is sustained by family and cultural expectations to endure, by fear of professional misinterpretation, by withdrawal intended to hide vulnerability, and by a social world that repeatedly places racialized judgments on her. Against those forces, counseling becomes a difficult but increasingly available form of care: first a paper referral left unread, then a service assessment, and eventually conversations with Janet in which Queenie can connect present distress to loss, family history, and racism. The movement is not a simple conversion from denial to recovery. It is a gradual shift from hiding symptoms and demanding normality toward naming the pressures that shape her experience and allowing another person to witness them.