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Hepworth has made women’s mental health her declared subject across ten novels, each one finding a fresh angle on the same persistent gap between a woman’s inner reality and the story the world tells about her. She named that gap explicitly in 2018, years before she titled a book after the word society uses to dismiss women.
As a novelist, I am interested in all aspects of women’s health, particularly mental health, as it seems to be so misunderstood in society. People would never ask someone with cancer to ‘snap out of it’ yet people regularly ask this of people with depression, or bipolar or schizophrenia. We’ve come some way in recent years bringing mental illness out of the darkness, but I think we have further to go.
She doesn’t treat fiction as a gentler substitute for policy or medicine. In the same 2018 conversation she drew a line between what funding and research can do and what a novel can do that neither can replace.
We need more funding and more study, absolutely, but my role as a novelist is to explore these issues more fully in fiction.
Mad Mabel puts the label itself on trial: the word ‘mad’ sits in the title, and the book’s dual timeline, following Elsie at eighty-one and Mabel as a teenager in the 1950s, tests how a reputation for madness is built, inherited, and finally examined.
Her conviction about character runs parallel to her conviction about mental health. Where both could tip into diagnosis or condemnation, she pulls back toward context. This position, stated in 2019, shapes every unreliable or morally ambiguous woman she has written.
I don’t tend to think anyone is evil. My philosophy is that we’re all capable of good and bad, and we are all products of our upbringing and experiences.
The question of who narrates is where every Hepworth novel begins. She doesn’t start with plot or structure; she starts with the person whose vantage point will make the central tension legible. For a book built around a contested reputation, finding the right pair of voices was the structural decision everything else depended on.
I always start my novels by asking myself the question — who should be telling this story? If I can find two people who sit at opposite corners of the same issue it’s ideal, but even finding people on the same side — but facing different challenges — can serve the story’s overall theme.
Once the voices are chosen, her drafting method keeps the daily target small enough to stay manageable. She developed a six-session structure when larger targets felt unmanageable, and she described the aim behind the prose those sessions produce.
My aim is to make the reader feel like they are overhearing a conversation, or having a conversation, instead of reading. When it works, I think this is a great technique to making the writer feel engaged.
Her relationship to plotting shifted across her first decade. She began methodically, with index cards and scene-by-scene plans. By her sixth book she had reached a different conclusion, and she committed it to a public essay so she couldn’t take it back.
Once I’ve written the synopsis and my publisher has approved it, from now on I will be putting the plan away and writing from the gut.
The essay was an act of self-recognition as much as a craft statement. She had resisted naming her actual process for years, and the admission that followed was as much a relief as a discovery.
Six books into my career, I think I’ve realised that chaos = my process.
That acceptance of disorder sits behind every book she has written since, including Mad Mabel, where a mystery whose answer keeps shifting would reward a writer comfortable with not knowing the ending before she reaches it.
In 2021 she gave The Guardian a candid account of where writing sits in her life relative to everything else she does. The list she drew up was more self-deprecating than most authors allow in print, and it made the final item land harder.
Writing is still my favourite thing… There is a craft, there is hard work, but it’s what I’m good at. I am terrible at sport, my parenting is very subpar and my editing is shocking, but creating characters with wisdom and truth, fostering empathy through telling stories, that makes me happy.
She is precise about the order of priorities. Escape comes before insight; if a book fails as a story, its ideas don’t reach anyone. She said this in 2020, mid-pandemic, and the word ‘ecstatic’ was not a throwaway.
First and foremost, I hope they will have enjoyed the story. In the current climate, if I can help someone find pleasure and escape, I’m ecstatic. If I can go further and make them think, analyse their own relationships, and look at something a different way… even better.
The corollary to that hope is a practiced refusal to dictate the lesson. She has watched readers arrive at meanings she never planted, and she has come to see that as the mechanism, not the failure.
I try not to anticipate what readers will take from my books. Each reader comes to my books with their own lens — their own experiences, values and morals, and they will take different things from the book because of that. I’m constantly surprised by what people take from my books, and often it’s little things that I never even intended. That is part of the wonder of fiction.
For a book that asks whether the women called mad were ever given the chance to tell their own stories, that openness is its own argument. What a reader brings to Mabel’s silence will say as much about them as about her.