‘The day was fair and warm. She walked slowly, careful on the rutted earth. On either side of the lane were meadows, and the meadows were filled with cattle, lazy in the sun. Summer flowers grew wild from the cracks in the tumbled stone walls. The land was green. Somewhere at the edge of things she could smell the sea.’

Set in 1911, John and Ella are both patients at an asylum on the edge of the Yorkshire moors. Men and women are kept separate at all times, except on Friday evenings, when they come together to dance in the ballroom. When John and Ella meet, it will change their lives forever.

I recently read Hope’s debut novel, Wake, set in the aftermath of World War I, and really enjoyed the intertwining stories of the three female protagonists. The Ballroom likewise focuses on three main characters – John, Ella and Dr Charles Fuller – with chapters told from alternating points of view. This works particularly well when recounting the same event from different perspectives, as Hope shows how our personal opinions and delusions can shape the world around us.

The relationship between John and Ella is the heart of this novel. It is a difficult one, as they only see each other for a few hours a week in the ballroom, when they are surrounded by nurses and other patients. Neither one knows if their brief exchanges during this precious time together are indicative of their true feelings, or whether it is just the desperation of their surroundings that drives them to say these things.

For a novel centred on romance, it is quite dark at times. Hope doesn’t shy away from the grim reality of hundreds of mentally ill men and women forced to live in close quarters with each other. The stark and terrible environment makes you root for John and Ella all the more, until by the end you’re desperate for them to escape the asylum and find their way to freedom.

Dr Fuller is a truly intriguing character. With enough delusions and unsettling thoughts to warrant admission to the asylum himself, he has somehow found himself in charge of it. The dark turn he takes, about halfway through the novel, makes you fear for the patients under his care, increasing the tension by even greater degrees.

Hope writes very well, with vivid descriptions conjuring the stifling atmosphere of the heatwave summer of 1911. She finds beauty in the small things, the pattern of a flock of birds in the sky or the dappled sunlight falling through the tree branches. However, the use of Irish slang every now and again is quite jarring if you don’t know what it means.

Hope also explores issues of gender within the confines of the asylum. While the male patients work outside in the fields, the women are forced to spend all day working in overheated rooms. Behaviour acceptable in the men is a sign of madness in women, and even reading books is seen as a dangerous sign of dissent.

The historical setting is a fascinating one, on the eve of legalised forced sterilisation of asylum patients, but I feel like Hope could have spent a little more time on the asylum itself. There was little mention of treatments; although Dr Fuller talks extensively about his own opinions on treating his patients, we rarely get to see these treatments from the patients’ perspectives. Similarly, we are given scant detail about what John and Ella did to wind up in the asylum. We are told the basics, but I would have liked a little more information so as to get to know the characters better.

Overall, despite these issues, I enjoyed this book. It was an engrossing story written with sensitivity and skill, and proves that beauty can be found in even the most unlikely of places.