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Katya Apekina's debut novel opens with a scene that sets the tone for everything that follows: sixteen-year-old Edie discovers her mother Marianne hanging from a rafter in their Louisiana home, barely alive, while her younger sister Mae lies upstairs in one of her trance-like states, too attuned to Marianne's disintegrating mind to stay tethered to the world herself. What follows is a novel as unsettling as its premise suggests, and as strange and accomplished as any debut in recent memory.

After Marianne is committed to a psychiatric hospital, Edie and Mae are shipped off to New York to live with Dennis, the estranged father they barely know. Dennis is a celebrated novelist whose best work is behind him, a former civil-rights activist who has spent decades mining the people closest to him for material. His reunion with his daughters is less a rescue than an opportunity: here, finally, is the raw nerve he needs to write his next book. Edie, fiercely loyal to her mother, recognises him as the predator he is. Mae, uncanny and impressionable, mistakes his attention for love.

What makes the novel remarkable is not the premise, which flirts with Southern Gothic melodrama, but the architecture Apekina builds around it. The story unfurls through a kaleidoscope of first-person narrators - the sisters, Dennis, Marianne, aunts, neighbours, lovers, doctors, old friends - and through letters and interview fragments that span from the late 1960s to the late 1990s. Edie's sections sit in an urgent present tense, while Mae narrates from the vantage of adulthood, looking back at what happened to her and what she allowed to happen. The effect is of standing at the centre of a room while opposing accounts pull at both hands, each voice insisting on its own version of the truth.

The writing itself is crisp and often startlingly good, laced with a sinister wit that keeps the darkness from curdling into misery. Mae's lines in particular carry a haunted, hypnotic quality; one of the most quoted passages in the book - "My mind was a radio turned to her station and her misery paralyzed me" - could stand as a thesis for the whole novel. Apekina writes about mental illness without pity and about sexual and artistic exploitation without euphemism, and she refuses to apologise for any of it.

The book is not flawless. Its ambition occasionally outruns it, with some of the minor narrators serving little more than observational duty, and a few of its larger themes - the civil-rights backstory, questions of artistic consent - left with threads trailing at the close. These are small complaints against a novel this self-assured.

The novel will not be for everyone. The psychosexual undertones and the unflinching treatment of suicide and coercion are genuinely hard to sit with. But for those willing to go in, it is one of the most inventive and affecting debuts of the last decade - a dark and unforgettable book by a writer worth watching closely.