Should we be worried about the rise of antidepressants? #PillShaming

Another post where I’ve set out my thoughts in tweets and hope to write it up into a blog post but, in the meantime, here are the tweets:

• My tweets and retweets on #pillshaming – What it is, what’s wrong with it and what can we do about it, following the piece by the same name in today’s Indendent in which I’m quoted by writer Rachel Hobbs (formerly of Rethink Mental Illness)
• Some responses of the lovely twitter people
• A conversation with US psychiatrist Allen Frances whose a firm believer in the evils of Big Pharma as drug pushers and doctors handing out happy pills like sweeties

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Related links (in date order):

• Independent – Should we be worried about the rise of antidepressants? – “Mental health funding has been cut for three years in a row, while demand is increasing. With news that prescriptions for antidepressants in Britain have doubled over the last 10 years, some say this shows people are being medicated unnecessarily, but is it that simple?” – By Rachel Hobbs (today) (quotes me)
• Guardian – Spare us the moralising on prescription drugs. Many of us need them – “Calling us ‘pill poppers’ makes it sound like a fun lifestyle choice. Do high cholesterol, post-op pain or depression sound like fun?” – By Fay Schopen (December 2014)
• British Medical Journal  – Overprescribing antidepressants: where’s the evidence? By Dr Margaret MacCartney (June 2014)
• British Journal of General Practice – Appropriateness of antidepressant prescribing: an observational study in a Scottish primary-care setting – Study reported in the journal of the Royal College of General Practitioners (2009)

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How’s your day been? A Day in the Life

How’s your day been? That’s a question you’ve probably asked many times, and been asked a fair few too. It’s part of the normal everyday engagement between people that oils the social wheels. Often it’s not a genuine enquiry in the sense that a detailed response is not expected: instead, it’s a baton being passed, with you expected to pass it back and say, “Fine thanks. How about you?” That “fine” can mask a lot of days that aren’t fine, whether better or worse, but we’re all expected to join in the general cheerleading, pretending to be “fine” too.

For people struggling with mental health problems or managing a long-term mental health condition, how our day has been is probably a bit of a mystery to the general public. This can be a source of assumptions, stereotypes and prejudice, whether that’s the “lazy faker” of depression who just needs to take themselves in hand and go for a brisk walk; or the “dangerous maniac” of schizophrenia who should be monitored and contained for public safety. These prejudices and stereotypes can feed into self-stigma that brings about a sense of isolation.

Our daily lives are also likely to be a bit of a mystery to the professionals who provide our care, whether that’s a therapist an hour a week, 20 minutes with a psychiatrist every 3 months or 10 minutes with a GP every few weeks. What it’s actually like to live with a mental health problem can be pretty uncharted territory unless you’re doing it yourself or living with someone who is. There’s so much more to good mental health, and to good mental health services and support, than the NHS, drugs and talking treatments. People just like me are out there, living our lives, quietly getting on with things day to day, and there’s a new project that aims to capture that reality. It’s called A Day in the Life.

A Day in the Life (the mental health project, not the Beatles song) asks people with mental health problems to share what their day has been like – and what has helped or made the day worse – on four set days over a year.

The project aims to shine a light on the everyday lives of people with mental health problems to raise awareness and to help the general public better gain a better understanding: to challenge myths and bust some stigma. It also aims to get people who may never have blogged before writing about how their day went – and perhaps then finding an online voice they never knew they had. There’s guidance on how beginner bloggers can start writing.

But another objective – and the reason the project is funded by Public Health England – is to help policy-makers understand what makes a difference – good or bad – to the lives of people with mental health problems. Although not a scientific study, the project will provide an insight to help influence policy decisions on services provided in future. The online snapshot diaries will also help to highlight emerging themes and suggest future areas for investigation.

I’ve signed up to take part in the project and have already posted my entry for the first day, Friday 7th November. The remaining three days will be in winter, spring and summer 2015.

Follow the project on twitter using hashtag #DayInTheLifeMH and scroll down to find out more about the project and how you can take part.

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Below is my entry for 7th November, which will appear on the Day in the Life website when everyone’s contributions so far – totalling around 370 – go live on Monday 17th.

Please note: I chose to speak very candidly about what I experienced that day, so please read with care if you’ve been affected by suicide, suicidal thoughts or depression – or simply scroll down to the bottom where you’ll find useful links.

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I’m on Twitter – a lot! So, as usual, after turning off my alarm, the first thing I did this morning was to check what tweeps I follow had posted, to catch up on news in the mental health world. Then, returning to bed with breakfast and my pet, as it was the last day to sign up to #ADayintheLifeMH, I sent out a series of tweets to encourage as many people as possible to sign up. The more sign-ups, the more varied a picture of living with mental health problems it will provide.

Next, I checked what had been happening on the #SamaritansRadar hashtag. Samaritans Radar was launched by the Samaritans in October and, ironically, had had a disastrous impact on the Twitter mental health community. Numerous tweeps had contacted the Samaritans by Twitter, email, phone and letter to beg them to take the secret automated surveillance and alert app offline. Experts in various different professions had written about legal and ethical concerns. Mental health experts by experience had blogged about their pain and distress. There was an online petition, an investigation by the Information Commission and even a group proposing legal action against the Samaritans. I was involved in the campaign to have the app taken offline till it could be made safe.

On checking Twitter, it was clear that the outcry was continuing. And the Samaritans had tweeted their followers about A Day in The Life Mental Health!

Next, I tried to work on a blog post about the app. The powerful psychiatric medications I take have an impact on motivation, focus and concentration and, since I’d started taking them, I couldn’t quite connect the dots. It was cripplingly frustrating and is one reason I spend so much time on Twitter: 140 characters just about matches my attention span! Being sedated so your higher functions no longer work properly makes it hard to manage a home and get everyday tasks done, let alone get anywhere near organising your own healthcare in a system that relies on people being pushy. Being a sedated blob doesn’t get you very far and is one reason I haven’t been able to get proper treatment for myself over 3 years since I was discharged from hospital. Here I am, still parked on welfare benefits.

I struggled for a while to try to gather together my thoughts on Radar down on paper, but was unable to do so. I tried to make an overdue phone call, but couldn’t. So I had lunch, then caught the bus to a medical appointment.

Later, as I walked back through a tree-lined park on a beautiful autumn afternoon listening to the radio, I heard a trailer for this evening’s BBC Radio 4 Any Questions saying that one of the topics the panel would discuss was the Assisted Dying Bill. This caused my own “suicide radar” to go off.

Ever since getting notice of eviction from my home so my landlord could sell it (2 months’ notice, out of the blue, after over a decade), I’d been tipped into a deep, debilitating depression. At times, I was utterly tortured by suicidal thoughts. My home had been my security and stability and now I was losing that. And the awful Radar app had thrown a spotlight on suicide, meaning my Twitter feed was full of intellectual suicide talk.

Suicide was being discussed as a fascinating concept, rather than what it was to me and many other mental health folks using twitter: a very real mental pain we were struggling with at that very moment. At times, it seems as if there’s a part of my mind monitoring everything just in case it might be useful in some way in despatching myself – my own “suicide radar”. That’s why the Assisted Suicide Bill caught my attention. Being able to die with dignity alongside friends and family – rather than experience years of unalleviated suffering or go for a secret and uncertain DIY method –  was an option I’d like to have available too.

I’ve had thoughts about suicide in all sorts of places, with all sorts of people and whilst doing all sorts of things. Sometimes I’ll be plagued by all-consuming thoughts of suicide; other times they’d be a background hum, like a reflex response to every turn of events, a mental tic; and sometimes, as today, there’d be calm planning. These thoughts were going through my mind as I walked through the warm autumn afternoon, kicking up piles of fallen leaves. No-one looking at me would have known.

Back home, I checked Twitter again. At 6pm, the Samaritans tweeted to say that, after 10 days of uproar, the Radar app had been suspended! It was a begrudging statement which did not acknowledge the distress the app had caused, and the so-called apology was an example of how not to apologise. But, nevertheless, the announcement meant that mental health folks could sleep easier in their beds over the weekend. I continue to feel uneasy as to what “suspension” means in practice. Whilst no-one doubts the app was developed with good intensions, the way it was imposed on everyone had damaged trust in the Samaritans.

I spent the evening debating with people on Twitter about Samaritans Radar, listening to Any Questions, then retiring to bed to read Everyday Medical Ethics and Law. It didn’t use to be my sort of book at all, but that was before I was unlawfully arrested, sectioned, held in seclusion and treated by force. Nowadays, chapters on patient autonomy and choice and how they are glibly brushed aside for mental health patients concern me deeply.

Sadly, lack of concentration scuppered my attempts to read the book – so it was back to Twitter.

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Related links:

• A Day in the Life
  • Home page
  • How to use the website, including finding posts to read and contributing
  • Writing guidelines – and, if this inspires you to give blogging a go yourself, here’s the blogging tool I use, WordPress
  • On twitter #ADayInTheLifeMH
  • Social Spider (the community interest company behind A Day in the Life and creators of One in Four magazine)
  • Public Health England (which provided support for the project)
  • A day in the life – Beatles
• Mainstream media
  • BBC news – People asked to blog about their mental health illness (with video) (1st November)
• Background
  • The New Mental Health website – A Day in the Life: A new project to snapshot day-to-day life with #mentalhealth difficulties #adayinthelifeMH – “Four days; the people of England who experience mental health difficulties; a snapshot never seen before” (14 October)
• Here‘s what happened to me on Friday 7th November (Storify of tweets)

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That question: So, what do you do?

I was at a party last tweek when, out of the blue, I was asked That Question. You know the one. The one you avoid answering (or even avoid being asked) if you don’t currently have paid work or if you’re working in a job you’re not especially proud of.

So, what do you do?

A pleasant, friendly enquiry, not unexpected at a social gathering, meaning, “What’s your job? How do you earn a crust? What useful function do you serve in the economy?”  It seems such a harmless question when you have a job, income and place in society in the conventional sense. But not all of us do.

My response? In this case, I trotted out the old “portfolio career” cover story. I mentioned a bit of this and a bit of that, brushing the enquiry aside with as few details as possible and then quickly asking about the other person, so as to change the focus onto them. Luckily, he was a talker. I’d side-stepped the need to disclose anything about my current status (which I would describe to myself or family and close friends as convalescence or sick leave). I learned a lot more about the guy I was chatting to.

Then, on Monday evening when participating in a hobby, that same question popped out again. Except, this time, it came with added emphasis, including a reference to the fact that I used to wear a suit to work:

So, you used to be a high-powered executive* What do you do now?

*(His words, not mine!)

This caught me off guard. I realised just how much of a gulf there was between what this guy (mistakenly) perceived my old job to bes and what I’d actually done that day. In fact, I’d let the gas man in to take a reading and written out 4 Christmas cards. Oh, and I’d opened a card from my mother containing a postal order (which had felt a bit weird at my age). But that’s how I’d spent my day. My plan for the following day was to buy stamps. Hardly a high-powered executive.

How did I respond? Surprised, I went for a transparent dodge. It left the questioner in no doubt that I was avoiding answering, and left me wishing I’d had a bit more practice at lying. He stepped away, I stepped away, and we both pretended we were just getting on with our hobby.

In both cases, I’d succeeded in concealing the truth of my situation. In both cases, I’d put distance between myself and the other person. In both cases, I felt I’d had a lucky escape.

During a recession, it’s probably more socially acceptable to be “between jobs”. But on the other hand it’s probably a less good time to ask the question. What do you say when asked “So, what do you do?” Here are some options, including suggestions by the lovely twitter people, for how to respond.

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• .Respond with a vague job description

I end up saying I’m now freelance, which is a total lie. – James (@polarbear3127)

“I’m a consultant” suitably vague? -Lexx Clarke (@LexxClarke)

Some retired people say the R word proved offputting to others so they may dress something up into ‘consultancy’ to ward off any negative reactions, especially when dating. – Roslyn Byfield (@RosylynByfield)

Ah, the portfolio career. This was the option I took at the party last Friday. It’s a delicate balance. I mumble about this (which I used to do) and that (which I’ve also done) and the other (which I’ve done a bit of in the past). I’m always hoping the questioner doesn’t do this, that or the other and therefore see through my story. I try to make this, that and the other all sound pretty dull, so the questioner doesn’t enquire further. But then, at the same time, I try to make it sound a little interesting so they don’t think I’m a total waste of time to chat to.

I think that probably I should sit down and write out a fake portfolio for my portfolio career (which did once exist but now doesn’t), so I can reel it off as needed. And also so I remember what I’ve said to people!

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• Lie
  

I lie to taxi drivers and the women on the check out because I am so mortified. I know I don’t look ill, either. – Velveteen Rabbit (@velveteen85)

A Sufi master once said to me, “Ask a man no questions, for you may force him to lie.” That is true. If you put someone on the spot in a social situation by asking them a direct question like this, you may create distance by forcing them to fend you off with a lie.

Personally, I’m a terrible liar. If I’m going to lie, I know I’ll need warning and time to practice. When surprised, my lies are unconvincing – as they were on Monday. And I do believe that, if you’re going to lie, you really should take the trouble to lie convincingly. It’s only polite to put the questioner at ease rather than embarrass them with a bad lie.

I rarely ask people a direct question like “What do you do?” It’s not that I’m not fascinated and curious about what other people do. I am! It’s just that I’d rather let people tell their own story, in their own time. That way they reveal what they’re comfortable with you knowing. I’m not sure if people think I’m dreadfully self-centred for not asking what they do. Or perhaps, when engaged in a hobby, it just doesn’t matter.

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• Deflect with a reference to personal issues

“I’ve had some family issues” is a good short term cover, and also technically not a lie as you are in your family … – ZaFoosBoootla (@dav0lah)

An alternative could be, “Ooh, I’ve been off this past week. Women’s problems.” I’d imagine that would probably curtail someone’s curiosity.

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• A defensive response that keeps people at a distance

Ask them to ask you an easier question. – Meliora Rose (@meliorarose)

 I hate that question, and need to find a suitable sarcastic answer. Sure someone will come up with one … – Martin (@msmithbass)

I always answer, “what do you mean, what do I *do*??!” Sometimes it makes them realise the rudeness & stupidity of the question – PWX (@flossiepie)

On the one hand, this response means you keep private what you want to keep private. On the other, it creates distance rather than intimacy. It doesn’t help develop friendships or potential work contacts. It just says “no”.

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• Humour

Just tell them “I kill people with my mind.” Government pay is great! – My System (@JazzyJ1112)

Replying “for business or for pleasure?” normally gets a laugh, so then you can change the subject! come to the woods (@cometothewoods)

I spend most of my time drugged up to the eyeballs in a psychiatric ward, just out for the day. Now, where’s the hors d’ouerves? – Martin (@msmithbass )

You put the swirls in cats eyes marbles … Design new chocolates … Taste tester for mouthwash … The voice on the lottery show … “I read, I write, I cook, I dance …” Sally Price (@saspist)

You’re an activist! Now people will avoid you for new reasons! – Verity Allan (@verityallan)

“I could tell you, but then I’d have to kill you.” – FWT (@FWT4)

The most popular response was humour. Always a winner.

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• Avoidance 

My personal favourite and, it appears, popular with others too as a means for not having to give a vague job description, lie or deflect the question with sarcasm or humour. Just keep away from social situations where you might meet new people. That’s one I employed to good effect for a long time after coming out of hospital: I stuck to socialising with people I knew well.

I was speaking to a guy last Friday who’d isolated himself from other people since the 1980s. That’s when he’d lost his job and got his diagnosis. Ever since then, he’d kept himself to himself. He went to the gym, worked out, left – without making eye contact with anyone (except at the day centre we both attend). All for fear of being asked, “So, what do you do?” He was too ashamed he wasn’t working.

I suggested we sit down together, work out some lies, then go out and practice them on people! Thirty years is too long for a lovely guy like him to steer clear of people. Perhaps, if we each have our own convincing cover story to throw people off the scent, we might be more comfortable with meeting new people. Until then, we’ll both continue in our small social circles.

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• Honesty

During the twitter conversation that led to the writing of this blog post, no one said they’d come clean and say they weren’t working at the moment due to mental illness. It could be a bit like marching into a nursery school in the 1980s and announcing you had HIV/Aids. That would have guaranteed a frosty reception.

Times are changing, but people who feel comfortable saying they’re not working due to mental ill health still seem in the minority, and understandably so: there’s still a huge amount of prejudice and discrimination against people with mental ill health. I long for the day when I can talk about my convalescence from mental ill health in the same way as people do about their experiences of physical illness. But we’re not there yet.

So, in the meantime, I think it’s time to polish off my portfolio career patter and practice those lies so that next time I’m not caught off guard.

 

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• Tweets last Friday and on Tuesday – So, what do you do? That question.

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Tweet chats part 3: Troubleshooting

Following parts 1 and 2, here is the third instalment of my introduction to tweet chats. Most tweet chats are great fun and informative, though occasionally you can run into problems. Here’s some advice, just in case things start to go wrong.

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• The tweet chat is too fast – I can’t keep up!

  Tweet chats are meant to be enjoyable, so don’t worry about missing things. Popular chats can move very fast. Just follow the topics or lines of conversation that interest you, and chip in when you can. You can always catch up later by reading the transcript.

• I’m a bit lost / I don’t understand!

  Lurk for a bit to try to tune in, but don’t be afraid to speak up and ask for help. Generally, tweeps are a friendly bunch who really enjoy helping others. And, if you have a question about what’s going on, there are bound to be others thinking the same thing.

• Someone’s arguing with me!

  It’s fine to disagree on a tweet chat, and often controversial topics are chosen to generate heated debate! But keep it to a discussion, not an argument. If you don’t want tweets from a particular tweep, block them and ignore them in the tweet chat. Simples.

• I’m being harassed, intimidated or abused!

  Sometimes people can get passionate about a topic they care about. Sometimes misunderstandings can occur, given the brief nature of the tweet. Sometimes a tweep or two will be downright nasty. If you feel you’ve been harassed, intimidated or abused in a tweet chat, here are some options to consider:

  1. Take a screen shot of the offending tweets. This provides a record for later.
  2. Save the offending tweets using a service like Storify – ditto.
  3. Block and report the offending tweeter using the button on the screen. If enough people do this, it can result in their account being suspended temporarily. And, at the very least, you won’t have to see their nasty tweets any more.
  4. Send a direct message (DM) to the tweet chat organiser. They may be able to take action at the time or (more likely) afterwards. (You’ll both need to be following each other to be able to send a DM.)
  5. Email the tweet chat organiser with copies of the offending tweets.
  6. If warranted, report the matter to your local police. You’ll need copies of the offending tweets as evidence.
  7. If the offending tweets are from a professional (such as a doctor, nurse or solicitor) whose conduct online is governed by a code of professional conduct (like one of these), consider reporting them to their governing body. You’ll need evidence for this.

• Someone’s spamming the hashtag / trying to derail the tweet chat!

  Sometimes someone will spam the hashtag or try to derail the tweet chat for their own purposes (eg to push their own agenda or promote a product). Consider whether any of the measures above may be appropriate (other than calling the police). Or just ignore the tweep.

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Here are some suggestions received earlier:

• If in doubt … pause. – Ian Hulatt (twitter @IanHulattRCN)
• Enlist someone to back you up in helping lead the chat to greet people, catch important questions or take over if you have technical problems. – Nedra Weinreich (twitter @Nedra)

If you have some personal favourite top tips for tweet chats or have comments on mine, let me know by adding them to the comments below – or tweet me!

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• Tweet chats for newbies: Getting started
• Tweet chats part 2: What to expect and some do’s and don’ts
• Suggestions from the lovely twitter people

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Tweet chats part 2: What to expect and some do’s and don’ts

Last month, I put together a beginner’s guide to tweet chats. Here, I develop that further, sharing some more of the things I’ve learned along the way about tweet chats. The aim is to help those new to tweet chats to join in and get the most from them!

If you’ve ever wanted to take part in a tweet chat, wanted a few tips to help you along, or wanted to send someone else a guide to encourage them to join in, I’m hoping my tweet chat guides will be a good starting point. In part 1, I covered:

• What is a tweet chat? – tweet chats in a nutshell
• What’s in it for me? – what can I gain from participating in a tweet chat?
• How do I follow a tweet chat? – how do I sign up and join in?
• How do I find tweet chats?

Here in part 2, I cover:

• Tweet chat do’s and don’ts – some suggestions for getting the most from your tweet chats
• What can I expect during a tweet chat? – The 8 stages of a (well-run) tweet chat. This might also be helpful if you’re thinking of running your own tweet chat

If you have some personal favourite top tips for tweet chats or have comments on mine, let me know by adding them to the comments below – or tweet me!

[Update: Here’s tweet chats part 3]

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Tweet chat do’s and don’ts:

Here are my suggestions for getting the most from tweet chats.

• Have fun! … Or at least get something positive from it.
• Use the hashtag. Use the hashtag. Use the hashtag. Er so, in other words, remember to use the hashtag in every tweet. That way, peeps following the tweet chat in tweetchat.com or equivalent (see part 1) will see your contribution to the conversation. No hashtag, no visibility in the tweet chat. Simples.
• Don’t be afraid to ask! If you have a “stupid question”, there are bound to be others with the same query too.
• Encourage and help others. You’ll soon learn that Twitter people love to help others. And, soon enough, you’ll be offering your own advice and examples to newbies too.
• Debate – don’t argue. Do feel free to disagree and engage in robust debate! On the other hand, don’t turn it into an argument or slanging match.
• Give people the benefit of the doubt. It’s easy for misunderstandings to arise in 140 characters, especially in a fast moving tweet chat.
• Take care of yourself. Tweet chats can sometimes be pretty intense and stimulating – a bit of a bear pit – especially the popular ones. Is this what you need right now? Sometimes, it’s a good idea to just lurk – you can always catch up later with the transcript.
• To swear or not to swear – it’s a contentious issue. Some feel uncomfortable with swearing in tweet chats, finding it aggressive and rude, and will back off from engaging. Some feel strongly that Twitter should be a reservoir of courtesy and will claim the moral high ground if “language” is used: for them, one swear word is enough to invalidate any otherwise valid point you may have made. Forever. So be warned.
• If you’re a professional, be professional. Take a look at your professional code of conduct (if you have one) for advice on how to conduct yourself on Twitter. Some professional duties apply at all times, even when off duty.
• Respect the topic. Tweeps have come together to discuss a particular topic, so keep your contribution relevant. Questions and comments are encouraged, but please don’t try to derail the focus of the chat. If it’s a topic you’re unsure of, maybe read up a little in advance so you can get something out of it. If unsure, consider contacting the tweet chat organiser in advance for guidance.

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What can I expect during a tweet chat?

A well-organised tweet chat will typically have the following 8 stages. And, if you’re thinking of organising your own tweet chat, this is how I’d recommend doing so.

1. Advertising – In advance of the tweet chat, the tweet chat organiser will give notice that the tweet chat will take place. This might be on a tweet chat listing, in a blog post or via social media such as twitter. Some tweet chats are general get togethers at a particular time using a hashtag, whereas others will have a topic set by the organiser. Sometimes the organiser will post links to brief reading material or questions to be discussed.
2. Advance notice – In advance of the chat (for example, at the same time the week before; at the same time the day before; and then starting from a couple of hours before), the tweet chat organiser will tweet reminders of the time, and hashtag, together with any topic, reading material or questions.
3. Introduction – At the start of the tweet chat, the organiser will introduce the topic to be discussed, and tweet links to any advance reading or guidelines.
4. Hello’s – As tweeps join the chat (whether to lurk or participate), some will say hi (and later goodbye). Many will not and will just tweet in when they have something to say! (I’m usually one of those!) Tweet chats generally take a little while to get going, so don’t be afraid to lurk till you catch the vibe.
5. Questions – To get the tweet chat going (and to give it a boost if it starts to flag), the tweet chat organiser may post questions at the start and along the way. This helps to prompt and guide the discussion. Feel free to respond to these questions at the time or later. But you don’t need to respond to the questions specifically: they are just a guide.
6. Conclusion – The tweet chat organiser will give an alert when the tweet chat is coming towards the end, so people can make last minute points, then draw it to a close. That’s the end of the official tweet chat – though of course you can keep on tweeting. These tweets may not make it into the official transcript (see below) – but they may be the part of the tweet chat you get most from. This is especially so if you prefer a slower pace, or if you’ve made connections you want to follow up.
7. Transcript – Some tweet chat organisers will post a transcript of all the tweets made using the hashtag shortly after the event (or the next day), together with a summary and maybe a word cloud. This can be a helpful catch-up, whether or not you participated in the tweet chat.
8. Follow up – One of the great things about participating in tweet chats is you can find interesting new people to engage with, so you’ll find tweeps following each other and making contact long afterwards.

I hope that’s given you an idea of what to expect from a tweet chat and how you can get the most from taking part. Let me know you top tips for tweet chats!

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Still to come:

• Tweet chat trouble shooting – some tips for when things go a bit eek!
• Mental health tweet chats – links to popular ones, how to find others & some extra things to think about

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My links:

• Tweet chats for newbies: getting started – Part 1 of my guide to tweet chats
• Mental health nurse & patient tweet chat: what do newbies need to know? – A tweet chat still in the offing … watch this space!
• Top tips for Twitter newbies – My blog from earlier in the year

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Tweet chats for newbies: Getting started

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See also Part 2 (tweet chat do’s and don’ts; and what you can expect during a tweet chat) and Part 3 (tweet chat trouble shooting)

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Whenever I have the chance to participate in a tweet chat, I always get a great deal from it. Whether it’s finding interesting new people to follow, learning something new, or having a view challenged or confirmed, it’s never dull.

I’d been on Twitter for a while before I learned what a tweet chat was, another little while before I dipped my toe in the water and it was another while longer before I realised I didn’t have to sit at a computer watching tweets then tweet in on my phone! If you haven’t heard of tweet chats, are curious but cautious or would like a little help to get you going, here’s my introduction – what Americans would probably call “Tweet chat 101” – in the spirit of sharing.

Initially it was one big fat blog post, so I’ve broken it up into bite-sized chunks, of which this is the first. It covers the following topics:

• What is a tweet chat? – tweet chats in a nutshell
• What’s in it for me? – what can I gain from participating in a tweet chat?
• How do I follow a tweet chat? – how do I sign up and join in?
• How do I find tweet chats?

Follow up posts will cover topics such as:

• Tweet chats on mental health topics – with links to some of the best!
• What can I expect during a tweet chat? – what format does a well-run tweet chat follow?
• Tweet chat do’s and don’ts – tweet chat etiquette & suggestions for getting the most from your tweet chats
• Tweet chat troubleshooting – some common problems and what to do about them

If you have some personal favourite top tips for tweet chats or have comments on mine, let me know by adding them to the comments below – or tweet me!

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What is a tweet chat?

A tweet chat (or Twitter chat) can simply mean a spontaneous discussion on Twitter between several tweeps (people with Twitter accounts) on a particular topic. In this post, I use the term to mean when the following:

A tweet chat is when people with a common interest gather together on Twitter at a designated time to discuss and share ideas.

So that everyone interested can follow along, people include a unique tag (#) called a hashtag (such as #mhchat) in each tweet. Typically a tweet chat will take place once a week or once a fortnight and will last an hour.

What’s in it for me?

What can you gain from participating in a tweet chat? The benefits depend to a large extent on why you’re using Twitter in the first place. There are so many different reasons. In general, however, here are some good reasons to join in:

• Find follows – Engaging in a tweet chat on a topic you’re interested in can be a great way to find like-minded people to follow from amongst the millions around the world on Twitter – and to make new online friends – in one concentrated blast.
• Share and learn – A tweet chat is an excellent way to communicate and share knowledge on a topic- and to learn in ways you may never have anticipated.
• Engage – As tweet chats are open. public and in real time, you get the opportunity to engage with, make an impact on and learn from people you might never meet in real life.
• Spread awareness – Engaging in tweet chats can help you spread awareness of your own brand and ideas, and create content and connections to enhance your personal influence. That’s a bit of a mouthful but what it means is that, if you’re starting out or branching out, tweet chats can give you a leg up.

How do I follow a tweet chat?

First, you’ll need to sign up to get a free Twitter account. Then, once you’ve found some relevant chats (see below), you can check the designated hashtag at the time the chat is scheduled to take place. Alternatively, follow the tweeps who run the chats (the organisers or moderators) to get updates on their upcoming sessions.

This is what you’ll see when you first log in to tweetchat.com (though with your Twitter background, not mine) – type the hashtag into the box

Once a tweet chat starts, an easy way to follow along is to use a free service like TweetChat (the one I use) or Twitterfall. Just log in with your Twitter user name and password, type the relevant hashtag in the box in the top middle … and you’re off!  (You can also follow a hashtag in services such as  Tweetdeck or Hootsuite: set up a search for the hashtag, and all of the tweets with that hashtag should show up in the search window.)

Only tweets which include the hashtag will appear on screen; they’ll be in a stream, updated as new ones come in – like the screen below right. This means you won’t be distracted by seeing tweets by people you follow who aren’t using the hashtag; and you won’t miss out on tweets by people you don’t follow.

You can watch the chat, tweet into it and reply to others’ tweets – all at the same time, in the same screen

This is what a tweet chat looks like in tweetchat.com (though it will have your Twitter background)

Popular tweet chats can have tweets coming in at a furious rate, so you might want to just observe (“lurk”) for a while – maybe even the first couple of times – till you feel comfortable joining in. When you want to tweet into the chat, remember to include the relevant hashtag so others following the chat can see them. If you’re signed in with a service like TweetChat, the hashtag will be added automatically.

How do I find tweet chats?

To find a relevant tweet chat, ask tweeps you know, search Twitter or search online for “tweet chat schedule”.

In my next post on tweet chats, I’ll post tweet chats which cover mental health topics. In the meantime, if you have some personal favourite top tips for tweet chats, have comments on mine or know of some great tweet chats, let me know by adding them to the comments below – or tweet me!

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• Let’s talk about poo! – Tweet chat with We Nurses, including transcript and links to lots of other websites, on the topic of constipation
• Mental health nurse & patient tweet chat: what do newbies need to know? – A tweet chat still in the offing … watch this space!
• Top tips for Twitter newbies – My blog from earlier in the year
• Tweet chats made simple – By We Nurses

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What does mental illness look like? Asda and the mental patient

Have you been thinking along these lines or have things like this been said to you? Do you want to understand the other side of the argument or know how others have responded?

• Isn’t this all a bit over the top? Don’t get so het up about it, it’s just a fancy dress costume! There are more important things to worry about. Get your priorities straight! You’re blowing this all out of proportion.
• It’s just a bit of fun! Go on, get a sense of humour, laugh a little, don’t be such a killjoy!
• No offence was intended – it wasn’t intentional!
• You’re just drawing attention to all this. Ignore it and it’ll go away.
• It’s freedom of expression1 You’re trying to censor me! It’s a dangerous slippery slope when you start trying to ban things!

If so, read on to find out what people have written on this subject, why it’s important, and what comes next.

Blog post to follow hopefully in the future, once it’s all percolating through the medication haze. In the meantime, here are my tweets from the evening of 25th. A

Please let me know of any additional links to add to the page so it’s as complete as possible.

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My related links:

• Storify stories of tweets
  • What does mental illness look like? Halloween – my tweets (25th September)
  • Responses from tweeps to my tweets (25th September)
  • When hashtags go bad – #chosenbyme (25th September)
• What does mental illness look like? Panorama & the Great Disability Scam (29th January)
• What does mental illness look like? The head clutcher (31st May)

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Responses from health and mental health organisations:

• Centre for Mental Health – #mentalpatient – the end of the beginning, by Andy Bell, deputy chief executive (twitter @andy_bell_, @centreformh) (27th September)
• Merseycare NHS Trust – Open letter to Asda from chairman & chief executive
• Mind charity – Fighting stigma – Everyday #Mentalpatient (short Storify of tweets) (26th September)
• Rethink Mental Illness 
  • A spooky tale with a happy ending, by CEO Paul Jenkins (twitter @pauljrethink, @rethink_)
  • The Can You Tell? campaign #canyoutell
• South West Yorkshire Partnership NHS Foundation Trust – “Following Asda’s #mentalpatient mistake we have offered to work with them locally on education and staff training” (27th September) (twitter @allofusinmind)
• Time to Change
  • Asda’s “mental health patient” costume is staggeringly offensive (26th September) (twitter @timetochange)
  • #mentalpatient trends on Twitter as people show the real face of mental health (26th September)
  • Challenging stigma on Twitter: Asda and Tesco’s ‘mental health patient’ costume (26th September) by Sarah Robbo (twitter @sarah_robbo)

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Other organisations:

• Finchley Reform Synagogue – sermon of Rabbi Miriam Berger (28th September) (twitter @finchleyreform)
• Neo (communications agency) – Asda inspires the mental health campaign of the year – “The explosive power of reactive campaigning online was again shown yesterday, when Asda accidentally inspired the best mental health campaign of the year” (27th September) by Charlie Peverett (twitter @cpev, @weareneo)
• Social Slurp (weekly Social Media campaign watchdog for the digital advertising/marketing industry, from Blue Claw) – #MentalPatient Campaign Fights Inappropriate Halloween Costumes (27th September) (twitter @blueclawsocial)
• Time Bank volunteering charity – Changing our attitudes to mental health by Becky Mumford, project coordinator, the Switch

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Blogosphere:

• Adventures in Madness blog – What does a mental patient look like? (28th September)
• Amy Chose Life blog – The ‘Mental Patient’ scandal – my thoughts (27th September) by Amy-Louise (twitter @a_louisem)
• Beauty From Pain blog – ‘I don’t know what type of nutters are out there…’ (with pictures) (29th September)
• Be Mindfull, Not Mindless blog – ‘Mental Patient’ Costumes – A Blessing In Disguise (27th September) by Emma Harris (twitter @harris_emma)
• Card Therapy blog – Dear Mr. A. Clarke, CEO Asda and Mr. P. Clarke, CEO Tesco (26th September) by Emma Sheppard
• Digital Mental Health blog by Victoria Betton (twitter: @victoriabetton) – #MentalPatient – where it all started and what it all means – “When I sneaked a peak at my emails (ironically in the middle of a Time to Change Leeds steering group meeting) and clicked on an Asda link from one of our consultant psychiatrists, my heart started palpitating. I couldn’t believe the image in front of me. Surely this Halloween costume was a wind up? But the URL was legit. I shared it with colleagues around the table. We all gasped. “ (27th September)
• Dippyman blog – How a ‘mental patient’ fancy dress costume can be a force for good, by Paul Brook (twitter @paulbrook76) (26th September)
• The Fementalists blog – Storify story – This is what a #mentalpatient looks like, #canyoutell? now with more pictures! – “In response to some seriously distasteful and stigmatising “mental patient” costumes from ASDA, Tesco, and Amazon, mental health activists shared photos of what people with mental ill-health actually look like” -Storify story of tweets
• Graham Shaw Storify story – Using social media to effect change: a short story (26th September)
• I am, I am, I am blog – This is what a “mental patient” looks like, by Christie Mackie (27th September) (twitter @cefmac94)
• It’s Madness blog – Confessions of a mentalist part 3 – It ‘Asda’ be a joke (27th September)
• Lindy B blog – Can you tell? (27th September) (twitter @lapsangsusie)
• Mozbloke Storify story – Asda and the ‘mental patient’ fail, by Steve Morris (26th September
• Psychology Magpie blog – Supermarket ‘mental patient’ costume stigmatises children as well as adults (28th September)
• Skepchick blog – What a Mental Patient Looks Like (26th September) (twitter @skepchicks)
• The World of Mentalists blog – This Week in Mentalists – What’s in a Word Edition (28th September) (twitter @TWOM_blog)
• Zen and the art of tightrope walking blog – Asda, axes and the persistent myths of mental illness, by Vivienne Tuffnell (27th September) (twitter @guineapig66)

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Mainstream media coverage:

• BBC
  • Asda ‘mental patient’ costume withdrawn from sale online (25th September)
  • Asda and Tesco withdraw ‘mental’ patient outfits (video report by Emma Simpson) (26th September)
  • Radio Five Live drive time show (at 40 mins & 2 hr 53) with Laura May (twitter @lauramaywritten) and Jane Hughes (twitter @janehug) of Rethink Mental Illness (26th September)
• Bournmouth Echo newspaper – Bournemouth fancy dress store defends controversial “mental patient” costumes after outrage (27th September) (twitter @Bournemouthecho)
• Channel 4 news
  • I’m a real person – a wife and a mother. And I am bipolar, with Shea Wong (26th September)
  • Mental patients tweet outfits in riposte to Asda & Tesco (26th September)
• Daily Mail newspaper – Now it is revealed Tesco had an ‘inflatable gay best friend’ in its online store… day after it stopped selling mental patient costumes (27th September)
• Guardian  newspaper
  • Asda withdraws ‘mental patient’ Halloween costume – “Thousands react angrily after supermarket website advertises fancy-dress costume that stigmatises mental illness” (26th September)
  • Tesco pulls ‘psycho ward’ costume as consumer complaints mount – “Tesco apologises for ‘Committed’ costume as Asda is forced to withdraw a mental patient fancy dress costume” (26th September)
  • ‘Mental patient’ fancy dress shows how deep offensive stereotypes go in society – “Tesco and Asda have done the decent thing. But we must work to end the stigma about mental health in work, communities, friends – even the NHS” (26th September) by Alistair Campbell (twitter @campbellclaret)
  • Asda, offensive halloween costumes and mental health stigma – “The sale of costumes offensively portraying mental health patients shows there is still a great deal of stigma that needs to be challenged” by Dean Burnett (twitter @garwboy) (26th September)
• Independent newspaper
  • Asda and Tesco apologise over ‘psycho’ costumes (26th September)
  • Tesco apologises after ‘Gay best friend’ doll blows up into a PR disaster (27th September)
  • If it’s not okay to dress as a cancer patient for Halloween, it’s not okay to dress as a mental patient – “We all have physical health and we all have mental health. The two are equal and should be treated that way.” by Ilona Burton (26th September)
• ITV – Asda ‘deeply sorry’ for selling ‘mental patient’ fancy dress costume (25th September)
• Nursing Times – Asda withdraws ‘mental patient’ fancy dress costume – “Supermarket chain Asda has withdrawn a “mental patient” fancy dress costume from sale after the product was deemed distasteful by the public” (26th September) (twitter @nursingtimes)
• Western Mail – What separates a comedian’s exploration of mental illness from a supermarket ‘psycho’ costume? by Darren Devine, interviewing comedian Juliette Burton (twitter @julietteburton)
• Yorkshire Evening Post – Leeds charity’s outrage over fancy dress costume (27th September)

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Overseas media:

• Aljazeera America (US) – Outrage over ‘mental patient’ Halloween costume in UK (27th September) (twitter @amjamstream)
• The Blaze website (US) – Why Were ‘Mental Patient’ And ‘Psycho Ward’ Costumes Pulled From Walmart-Owned Stores? (27th September) Interestingly, the story was filed in the entertainment section of the website – and, when I looked, it was underneath an advertisement for ammunition for a .22 long rifle with the headline, “We supply patriots, not the government”. A poll at the foot of the article asks, Did these Halloween costumes offend you? The choice of answers was “no”, “yes, mental health is no joke” or “I would be OK with them if they didn’t say “psycho2 or “mental”” 76% chose the first option (followed by 14% and 11%).
• Mr Conservative website – Walmart Removes Turban-Themed Bin Laden Halloween Costume From Website After Muslims Complain (28th September)
• Stand Up Kid blog – ‘It’s 2013, not 1813′: From stigma to stunning: brilliant social media response creates community around controversy (27th September) by Mark Joyella, US TV news anchor & reporter (twitter @standupkid)

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Criticisms of the anti-stigma campaign:

• Spiked online-only current affairs mag – Who’s afraid of a Halloween costume? by Ken McLaughlin, senior lecturer in social work at Manchester Metropolitan University

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Madsplaining … as it was mansplained to me. On offering advice to people with mental health problems

The Yolkr – teach your granny a new way to suck eggs (or at least to suck yolks from whites)

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Madsplaining: Offering unsolicited advice to someone on how they should manage their mental health (especially by peers and mental health professionals)

On twitter (and no doubt on other social media platforms), we mental health folks share a lot of detail about our lives. We talk about our good and bad experiences of mental health treatment, medications, symptoms, cheese sandwiches, our lives in general. Sometimes, when someone’s sharing a problem they’re experiencing with managing their mental health, other tweeps – those with lived experience or mental health professionals (or both) – will chip in with helpful tips.  We can be a sharing, caring bunch.

“Oh, I tried X and it works wonders for me. Why not give it a go?” “I saw a documentary about this new thing the other day that I thought would help you with that thing you mentioned.” Sometimes this moves towards more generic helpful tips, along the lines of, “Have you tried a nice cup of tea / hot bath / going for a walk / phoning a friend?” Advice and tips on all sorts of things. It happens offline too.  It can be good advice. Generally it’s well-meant. But …  is it welcome? Well, maybe yes. And maybe no.

The thing is, if someone is managing a mental health (or physical) condition, especially if they’ve been doing so for a while, they’ve probably had a good old go at trying the various drugs, treatments, therapies, supplements and diets on offer. They may be working their way through them with their healthcare team. They may be researching in the library or online. They may have joined a self-help group or forum. They may even have tried any number of hocus pocus remedies that make it into the Daily Mail or documentaries. So, when someone tweets about their condition and you’re tempted to mention something off the top of your head, think: are they asking for advice?

If it’s an offline friend or family member you know well, do they see a doctor and take medication regularly for their condition? Do they have a self-management plan? If someone is managing a long-term condition, the likelihood is they’re keeping some sort of track of how they’re doing. “Are you sure you’re not doing too much and, you know, starting to go hypo?” “Isn’t it time to go to bed now?” “Did you forget to take your medication today? You seem a bit … you know.”

Such comments can be helpful: sometimes we can ignore our own self-management early warning signs and only pay attention when we hear it from someone we trust. If you know someone well enough, or if they’ve asked you to be part of their self-management team – an early warning ally, as it were – it may be appropriate to chip in. But otherwise?

Unsolicited advice to someone managing a long term health condition can be seen as patronising. It may feel like criticism. It can be viewed as a sign that the advice-giver does not respect the person’s ability to manage their own healthcare needs properly. It can be seen as a suggestion that the person does not know their own mind … which, in the context of managing a  mental health problem, puts the advice-giver in really dodgy territory. Really dodgy.

Why am I writing this post now? Because only today I was reminded of how quick I can be to offer unsolicited advice. To leap in with handy hints and tips about how they could make their life better … if only they’d do as I suggest.  Partly that comes from my work background; partly because, being fairly long in the tooth, I (think I) know a lot of stuff; and party because I have a caring nature & like to help. Once, in response to a tweet from veteran mental health writer and thought leader Mark Brown (twitter: @MarkOneinFour), I tweeted “helpful advice” about light boxes. Of course, he’d tried that back at the dawn of time. Luckily he let me off the hook graciously.  Earlier today, I spotted a tweet about a medication issue I had faced myself. I replied with several helpful practical tips … Or so I thought. Because then I remembered … no advice had been sought. And that’s when I coined the term “madsplaining“. Let me explain.

I first came across the term “mansplaining” (with an “n”) when tweeter Phil Dore (twitter @thus_spake_z) used it.  When I did an online search, this (from Urban Dictionary) was on the first page that came up:

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“Mansplaining: To explain in a patronizing manner, assuming total ignorance on the part of those listening. The mansplainer is often shocked and hurt when their mansplanation is not taken as absolute fact, criticized or even rejected altogether. Named for a behavior commonly exhibited by male newbies on internet forums frequented primarily by women. Often leads to a flounce. Either sex can be guilty of mansplaining.

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A lot of the terribly clever online debate passes right over my head, and that’s as far as my knowledge of “mansplaining” goes (though I understand it’s been used online in feminist discourse for several years).  As it happened, it fitted perfectly with an encounter I’d recently had with a trainee psychiatrist: he was very new to twitter, had dived into an ongoing conversation with a patronising explanation, and was then flumoxed when I pointed that out. The “flounce” went on for quite some time.

And so what do you think happened when I first tweeted the word madsplaining …? Yes, you guessed it: I got mansplained!

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So after “mansplaining”, do we have madsplaining? ie offering unsolicited advice to someone on how they should manage their mental health (My tweet)

I think that would be psychsplaining. mad folks being splained to. but i notice your rhetoric is from feminist & poc activism… – Erick Fabris (twitter: @exic)

Oh hi Erick, are you mansplaining to me what I mean when I say madsplaining …? (My tweet)

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Priceless. Well, thanks for asking, Erick, but I do mean just that: madsplaining. As other tweeps chipped in:

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This is perfect! madsplaining gets right on my tits! “Have you just tried….?” “Everyone worries…” Hahahahaha my new word! – Molly Teaser (twitter @mollteaser36)

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Always fascinated about how much they know about their advice and how little they know of me. It’s the assumption that just because their advice works on their own neurosis, it works for everyone else. – MH Extremist (twitter @wildwalkerwoman)

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“You mean: “Snap out of it” “cheer up!” It’s all in your mind” “What have you got to be depressed about?” YES. Can you imagine this: “Cancer? You don’t look like you have cancer. Pull yourself together, get over it.” Ect” – MScarlet Wilde (twitter @wilde)

 

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I draw a distinction between madsplaining and what I call “patienting“, which is when someone uses your status as a “mental patient” to try to shut you up. An example would be (as has happened to me several times on twitter) a mental health professional will say to me something along the lines of, “Think you’d better take your meds now, love”.  Perhaps that’s a topic for another blog.

And, finally, here’s a little interchange to bring a smile to your face:

Or will this all turn meta and become splainsplaining? – Phil 

I blame you entirely, Phil, for introducing me to the word “mansplaining” … which you can take any way you like ;-D (My tweet)

The concept of splainsplaining is kinda blowing my mind – Dr Sarah Knowles (twitter: @dr_know)

Don’t worry, I’ll splainsplainsplain it to you – Phil

*head explodes* – Sarah

 

Sometimes I love twitter. And sometimes I need to take my own advice.

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• My twitter conversation on Storify:
  • Madsplaining (a short one this time!)
  • Follow up – Sanesplaining and psychsplaining – my online research on the origins & use of these terms (another short one)
• What have you got to be so depressed about? – Men Will Pause blog by Scarlet Wilde (twitter: @wilde), written in response to the madsplaining twitter conversation
• Eric Fabris‘s website – Mr Fabris is a Canadian researcher, artist and writer. Amongst other things, he lectures at the Ryerson University School of Disability Studies.

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But we’re not all like that …

“But we’re not all like that!” We’ve all said it, haven’t we? Read or heard something that seems to criticise a group we belong to or feel part of and said, “But we’re not all like that!” I know I have. It’s instinctive. Especially so for those working in social care or the NHS, perhaps even more so for those working in mental health which seems to get criticism from every angle. There are many committed, hard-working, professional, compassionate staff who do the best they can in difficult circumstances, make a  positive difference to people’s lives and do a really good job.

So when a dedicated  GP or mental health occupational therapist hears a story on the news about terrible care in a service elsewhere, he might say, “But not all of us are like that!” A compassionate doctor or psychiatric nurse will read a story about a patient abused in another hospital and say, “We don’t all do that!” A social worker will see a story on a soap about a child being taken from its mother and say, “Not all social workers!” A psychiatrist or mental health healthcare assistant will read a patient describing their experience of poor care and tweet back, “But we’re not all like that!” It’s true: we’re not. But … And there is a but.

What happens when someone – such as a patient who’s had a brutal experience of mental health care or been badly let down by the NHS when she needed help – describes their experience and gets the response, “But we’re not all like that!”? What happens? The conversation stops being about the person who’s describing their own difficult experience and becomes … all about the person who’s interrupted. It becomes all about the interrupter talking about me,  me, me.

Now that’s understandable … to an extent. We all have our own experiences and perspectives. We all have our own hot buttons or soft spots. Many working in the mental health field have, I’ve come to learn through twitter, their own personal experience of mental health problems – whether directly or through family members. It really isn’t them and us.

It’s always easiest to see our own perspective. But … there is a time and a place for raising it. When someone is describing their own experience of pain, abuse or neglect it may, I’d suggest, not be the time to butt in defensively and talk about yourself. Sometimes, a sense of perspective is needed. This is well illustrated, it seems to me, with this simple anecdote:

Me: Someone driving a blue Toyota just hit and killed my four year old child.

You: I drive a blue Toyota. Not everyone who drives a blue Toyota hits four year old children.

What does this do? I was talking about having been recently bereaved: you turn the conversation around to … you being a good driver. No doubt that’s true or, if not, you sincerely believe it to be the case, are a conscientious driver and are genuinely offended at any suggestion you might not be. Perhaps there have even recently been stories in the press about bad drivers. But … was I criticising drivers of blue Toyotas? No. Was I criticising drivers? No. Was I criticising you? No. I was talking about the painful personal experience of bereavement.

Or, as mental health researcher Dr Sarah Knowles tweeted:

“I broke my leg :(” “Okay, but not all legs are broken. Why do you generalise? For example my leg is intact.” “I … what?!”

Put like that, it should, I hope, be obvious why the response, “But we’re not like that!” is inappropriate. And how responding or butting in with, “But we’re not all like that!” derails the conversation and belittles the experience of the person describing it.

It’s not about you.

Why do I raise this now? Because the “But we’re not all like that!” argument was raised earlier this evening in a twitter conversation. The conversation did – as these sorts of things so often do on twitter – broaden out to include many other tweeps and move on to other debating gambits, such as victim blaming, “if you can’t stand the heat, stay out of the kitchen” and the “them and us” culture. Read on for some fascinating insights and well-made points.

As Charlotte Walker (twitter @BipolarBlogger) tweeted:

“If someone has a terrible experience, I am going to honour that experience. There is no point in saying to someone who’s waited 18 months for CBT, ‘Oh don’t be harsh, in other Trusts it’s better.’ No use at all.”

And as NHS doctor Elin Roddy (twitter: @elinlowri) tweeted:

“I always remember you saying – just because you don’t work in a bad service doesn’t mean they don’t exist … It stuck with me and stops me getting too defensive (I hope) when people criticise health care.”

Next time you’re tempted to butt in and say, “But we’re not all like that!”, take a breath, pause and think … Maybe it’s not the right time to interrupt and hijack the conversation. Maybe  it’s time, instead, to listen.  Maybe it’s not about you. And, next time someone tries to stop you in your tracks with a “But we’re not all like that!”, maybe send them a link to this blog!

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• My Storify stories:
  • This evening’s twitter conversation
  • A continuation of the conversation on twitter (But we’re not all like that – part 2)
  • Some twitter comments on the blog piece (But we’re not all like that – part 3) – it’s funny how how much push back I got to a blog piece on being defensive!
  • But we’re not all like that (again) – 17th October
• The Racism School website (which I found a hard but illuminating read), where I first read the “blue Toyota” anecdote – HT @stavvers
• The positive effects of social media (mainly twitter!) on my mental health – My Journey Down the Road Less Travelled blog – read more about her here for another insight into why, sometimes, it might be inappropriate to butt in and disagree when someone is describing a painful personal topic – Simply Positive (twitter – @positivesimply)
  
• Reflections on “But we’re not like that!” – twitter, criticism & PPI – by Dr Sarah Knowles (twitter @dr_know) (19th August) – An excellent example of the learning that can come through engagement on twitter
• Derailing for Dummies – A how-to guide for trivialising and dismissing someone else’s perspective and experience. “After reading this guide, you’ll be able to marginalise anyone!”

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Using mental illness as an insult – Mick Philpott, Jon Snow & lunatics

We’ve all done it: casually thrown around as insults terms related to mental illness. This evening, Jon Snow, Channel 4’s lead news anchor, posted a blog in which he used the term “lunatic” as an insult in the tragic Philpott case. When picked up on it, Snow swiftly apologised and earned brownie points for doing so. At present, however, Snow’s blog post still contains the term.

The problem with calling someone convicted of manslaughter a lunatic is that lunacy is a synonym for insanity, a legal defence to murder; its use in relation to the Philpott case is sloppy and inaccurate. And the trouble with casually using terms related to mental illness to insult people is that it turns mental illness into an insult.

As background, Snow’s blog post was in reference to distasteful and misleading political posturing reported during the day. Various pundits and politicians (in particular the Chancellor, George Osborne, later endorsed by the Prime Minster, David Campbell) sought to capitalise on the sentencing of the Philpotts and their friend for the manslaughter of 6 children. (Take a look at the links at the foot of this page to explore the subject further.) To take one example of the coverage, the Telegraph newspaper said:

“The Chancellor has questioned why British taxpayers should be “subsidising lifestyles” such as those of Mick Philpott, who was today sentenced to life in prison for killing six children. Mr Osborne made the controversial comments during a visit to Derby shortly after Philpott and his wife Mairead were handed their sentences for intentionally setting fire to their home. Asked whether the Philpotts were a product of Britain’s benefit system, Mr Osborne said: “It’s right we ask questions as a Government, a society and as taxpayers, why we are subsidising lifestyles like these.”

Jon Snow has, in addition to his platform on a national broadcaster, nearly 300,000 twitter followers. He also introduced Channel 4’s 4 Goes Mad mental health season. He’s influential. Earlier this evening, I saw a tweet of his containing a link to a post on his Snow Blog about the tragic Philpott case. Snow’s post was titled: Can abnormal behaviour affect the welfare policy debate?

Snow, in a strongly worded rebuttal, asked whether there really was a case for regarding Mick Philpott’s behaviour as a valid ground for reforming welfare policy. He referenced, amongst others, statistics showing there were just 50 families in the UK with the same number of children as the Philpotts.

Philpott is not representative of people who are currently in need of the state safety net due to ill health, lack of private pension or inability to find paid work. And of course it is highly distasteful to use the tragedy of the deaths of 6 children for political purposes. Snow’s blog was robust and well-written, apart from this, which caught my eye:

“The idea that an entire system should be re-jigged to cope with a lunatic who burnt to death half the children he’d fathered seems questionable at the least.”

Here, Snow uses the word “lunatic” as an insult, in order very deliberately to convey the deepest disapproval. The trouble with using terms related to mental illness as insults – especially when it’s done by a figure as prominent as Snow – is that it’s just this sort of casual stigma that adds to the big fat stigma pie we’re being served extra helpings of at the moment.

As I then tweeted:

Disappointed @jonsnowC4 refers to Philpott as a “lunatic” when he was judged criminally responsible #casualstigma

Snow swiftly responded:

I apologise..that was sloppy of me.

And, in a response to another tweep, Snow tweeted:

I’m sorry the word ‘lunatic’ was very absuive [sic] usage..thoughtless..I should know better

I tweeted in response:

Credit to @jonsnowC4 for apologising so quickly for calling Philpott a lunatic. (Wish I was so good at apologising when I stuff up.)

Snow received plaudits for his quick apology, as my Storify of tweets shows. His fans hold him in even more affection now. For example, Rich Humphrey (@RichMHumphrey) tweeted:

“completely agree! Few in the media would hold their hands up like that. Even more respect for him now”

Finally, I also asked Snow:

Could you tweak the blog to remove the reference to lunatic? That’d be good.

At present, the blog has yet to be revised. Fingers crossed. There are so many expressive insults in the English language that there’s really no need to resort to using references to mental health as insults.

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Links related to the story above

• My Storify of tweets, including comments from Jon Snow – Using mental illness as an insult (4th April)
• Snow Blog, Jon Snow’s blog – Can abnormal behaviour affect the welfare policy debate? (4th April)
• BBC news – Derby fire deaths: Philpotts and Mosley jailed (4th April)
• BBC News magazine, Washington, US – How offensive is the word ‘lunatic’? ( 9th May 2012)
• Links to guidance on the use of language & reporting mental illness
• Guardian newspaper (2012) – Crazy talk: The language of mental illness stigma – “Terms used to denote mental illness are so common in modern language they regularly pass without comment.” David Steele

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Links on the debate about what (if anything) the Philpott case tells us about welfare benefits, in light of the notorious Daily Mail headline (pictured below right) and George Osborne’s subsequent comments:

Firstly, coverage on 4th April:

• BBC news – Osborne’s Philpott remarks spark row
• Guardian newspaper – Osborne ‘cynical’ to link Philpott deaths with welfare cuts, says Ed Balls
• Not So Big Society blog – The Philpott Case – A Lesson from History
• Telegraph newspaper – George Osborne criticises Philpott’s benefit ‘lifestyle’

Coverage from later dates (added to this blog subsequently):

• Guardian newspaper – Mick Philpott: if welfare’s to blame, so is the army, prison, feminism, TV etc – “Calls for benefit reform in the wake of Philpott’s conviction for manslaughter are predictable but troubling. Can one man’s sick psyche really be a political issue?” (5th April)
• Independent – Mrs Justice Thirlwall: The one woman Philpott couldn’t defeat (5th April)
• ITV (TV) – Debate: Is Mick Philpott a product of the welfare state? – with Owen Jones (Independent newspaper) & Paul Staines (Sun Columnist and editor of the Guido Fawkes blog ) (5th April)
• Sky News (TV) – Owen Jones & Harry Cole debate whether Philpott says anything about the welfare system (an example of the worst sort of taunting & point scoring) (5th April)
• Blog by Mark Thompson – The Daily Mail front page you’ll never see (6th April)

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