Archive | May, 2013

What does mental illness look like? The head clutcher

31 May
The Scream by Edvard Munch, 1895

The Scream by Edvard Munch, 1895

Once you start to notice them, they seem to be everywhere: the head clutcher. What are they? Not the image above, The Scream, an iconic portrayal of human misery, which has been much copied and parodied. Instead, they are stock pictures trotted out to illustrate media stories with a mental health angle, typically showing someone with their head in their hands.

I’ve tweeted about them before and, last week, I started to do so using the hashtag #headclutcher after seeing one stock photo (below right) appear in 3 separate media stories in the same day! Poor woman.

Head clutcher woman - she's popular with the press

Head clutcher woman – she’s popular with the press

In this blog post, I’ve drawn together what others have written about the head clutcher, including the blog by tweeter @Huwtube. After seeing my #headclutcher tweets, he wrote an hilarious post entitled The Rise of the Headclutcher, critiquing various such shots. It’s well worth checking out if you want a laugh.

Of course the serious side of this is that using stock head clutcher photos perpetuates an image in the public mind of what mental distress looks like. And, if you don’t meet that stereotype, well clearly you’re not deserving of help.

I’ve commented on this before (here) and I’ve experienced this myself. I can appear confident and cheerful and this counted against me in an Atos medical assessment (for eligibility for state sickness benefits): after checking I could touch my toes and reach overhead, the assessor noted in his written report that, because I had made eye contact, I must be fine. No mental health problems whatsoever. Perhaps if I’d spent the assessment with my head in my hands I’d have met with his expectations of what mental illness looks like and scored more than the zero points I was awarded.

As national anti-stigma campaign Time to Change says (in its guidance to journalists on choosing images to accompany stories with a mental health angle), “Some really strong stories that may include great content and have educational value can be weakened by the use of an inappropriate image”. We can do better. We should do better. We must do better.

Check out the links below for more examples of head clutcher shots, together with others’ blogs on the subject. And, if you come across more head clutcher shots or other stereotypical representations of mental illness in the media, please feel free to add them in the comments below.

Happy head clutching!

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My head clutcher Storify stories (with links):

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Links to others’ stories on the head clutcher and other media representations of mental illness:

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Media guidance:Head clutcher Simpsons The Scream

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Other stories about the use of stock photos:

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Mainstream media stories illustrated by head clutcher pictures (often the same one):

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Headclutchers in stories by other commentators:

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Patients as whistle blowers – the CQC and rooting out bad practice in restraint of psychiatric patients

30 May

Whistleblower

(Just a very quick tweet-dump to get these thoughts out there and hopefully start them percolating through into a full blog post.)

It seems that the Care Quality Commission (the CQC) is relying on individual psychiatric patients to make complaints in order to trigger improvements in service standards and uncover bad practice. Seems to me that’s akin to expecting us to act as whistle blowers – and we know how hard that is for NHS staff who are in good health. It’s too much of a risk if you’re receiving continuing treatment from the organisation you’d be making a complaint about; & it’s too difficult a task when you’re vulnerable. It’s important that other means are found to weed out bad practice & abuse.

In these conversations with Prof L Appleby, Mental Health Cop, the CQC and others, I suggest a way the CQC can make things better in the restraint, forced treatment & injury of psychiatric patients.

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web links 5My Storify stories

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Mental capacity, mental illness and pregnancy – Miss B and the “bipolar abortion” case

29 May

Mental Capacity Act 2005

Some thoughts (here, here & here) on the recent case of Miss B, a woman in  her 30s with a diagnosis of bipolar disorder who was sectioned to prevent her from exercising her reproductive health choices. She had to go to court and reveal the most personal details of her psychiatric and gynaecological health, as well as her sexual history, in order to be able to do so. In the end, just a few days before the legal time limit for abortion, the judge in the case came down very clearly on the side of mental capacity.

It’s all set out in the tweets (including conversations with a psychiatrist and a Mental Capacity Act trainer, as well as a woman of reproductive age with a bipolar diagnosis). I may put it into written form but here it is for now. It’s something that I and a lot of women of reproductive age feel strongly about.

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My Storify stories:

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A watershed moment? The Adebowale Report into Mental Health and Policing

10 May
 Lord Victor Adebowale, Turning Point chief executive, led the Commission

Lord Victor Adebowale, Turning Point chief executive, who led the Commission

Today, the Adebowale Report into Mental Health and Policing in London was published. Below are links to the report itself (the 4-page executive summary and full 80-page report), as well as media coverage and commentary. More links will be added as they come in. It will be interesting to see how the story is reported and what actions result from the report. Let’s hope that, as one of the Adebowale Commissioners Professor Louis Appleby says, the report is a watershed moment for the police handling of mental illness.

Naturally the report and commission are very much creatures of the police. The focus is on the shortcomings in the performance of the Metropolitan Police Service (MPS) in the context of crime and policing, rather than the wider picture of mental health provision in the UK. Yet many of the recommendations have ramifications for mental healthcare and social welfare provision across the country.  So, now that the Adebowale report has been published, when do we get the NHS and social care equivalent? After all, mental illness is a healthcare issue, not a crime.

As background, the Independent Commission on Mental Health and Policing was set up in September 2012 at the request of the Metropolitan Police Commissioner, Sir Bernard Hogan-Howe, in the wake of the inquest into the death of Sean Rigg. Its brief was to review the work of the MPS in relation to people who had died or been seriously injured following police contact or in police custody, and to make recommendations to inform MPS conduct, response and actions where mental health is, or is perceived to be, a key issue.
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The Commission reviewed 50 cases where people had died and 5 were they had sustained a serious injury during or following contact with the police, as well as taking evidence from people with relevant experience in surveys, meetings and visits. It interviewed people with mental health problems, their relatives, NHS and social services staff and serving police officers including Insp Michael Brown (twitter: @MentalHealthCop). Chief Executive of mental health charity Mind, Paul Farmer, was one of the commissioners.
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The Commission found there were problems in the following areas:
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  • Failure of the Central Communications Command to deal effectively with calls in relation to mental health
  • The lack of mental health awareness amongst staff and officers
  • Frontline police lack of training and policy guidance in suicide prevention
  • Failure of procedures to provide adequate care to vulnerable people in custody
  • Problems of inter-agency working
  • The disproportionate use of force and restraint
  • Discriminatory attitudes and behaviour
  • Failures in operational learning
  • A disconnect between policy and practice
  • The internal MPS culture
  • Poor record keeping
  • Failure to communicate with families
That’s a lot. The Commission’s findings lead to 28 recommendations for change, falling under three areas for action:
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  • Leadership
  • Frontline policing
  • Inter-agency working

There are lots of links to explore below. Where to start? For an overview of the report, it’s findings and recommendations, see its 4-page executive summary and Paul Farmer’s blog (Mind charity chief executive and Commissioner). There are is also detailed response by Insp Michael Brown and finally two excellent pieces by Andy McNicoll at Community Care (here and here).

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Independent Report – Commission on Mental Health and Policing in London

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Background to the report

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