Mel’s ongoing struggle with mental health concerns, specifically OCD, is a major component of the novel. As Salmah considers her options regarding her daughter’s mental health, her sister recommends seeing a psychologist, to which Salmah responds, “Those quacks will just send her to the asylum, or worse. I hear they cut up people’s brains, trying to fix them” (24). This primarily reflects the common feelings toward psychology as the field developed across the 20th century and into the 21st. Fear of psychologists prevents people from getting the assistance they need, allowing public perceptions of mental health struggles to worsen as people cannot seek out the proper care. For Mel, this means losing much of her extended family members, who begin to abandon her to avoid bringing a curse or disease into their own families. By the end of the novel, Mel does not miraculously resolve her mental health struggle—by framing her lasting relationship with the Djinn as an ongoing battle for control of herself, she represents the reality of such issues.

Throughout the work, Mel focuses a considerable effort on avoiding being seen during her tapping and counting, emphasizing the stigma placed on those who struggle with mental health concerns.