These masks lack insight & dignity; shouldn’t they be the values we want to teach?

Another day, another story about the harmful depiction of people with mental health problems. But it’s not Halloween, and far from being aimed at tasteless party-goers, these particular stereotypes are aimed at tomorrow’s mental health nurses. Robert Gorden PR 1

The initiative, ‘championed’ by mental health nursing lecturer Inga Heyman from Robert Gordon University, has teaching staff wearing ‘Hollywood-style silicone masks’ to provide what the university describe as an ‘ethically appropriate…’ way ‘…to give our students experience of complex mental health situations’. Or, if you ask those of use with lived experience of mental health problems it’s anything from ‘strange and misguided‘, to ‘soulless, desensitising, and monstrous‘.

I don’t dispute that role-play is an important part of the clinical training process. We can’t go releasing untrained students straight into the (often scary) real world. But I’m extremely sceptical about how this process – which one might naively expect to focus on values such dignity, respect, and common humanity – might be aided by the introduction of these grotesque masks, which are clearly designed to shock and disgust. Robert Gordon PR 2

Such depictions are damaging because of the insidious implication that people with mental health problems are somehow recognisably different to those without them. In fact – and this really ought not to be surprising – people with mental health problems just look like people. Some scary, some peaceful, some ugly, some beautiful, some interesting, some ordinary. Once you start suggesting that people with mental health problems have a certain ‘look’ then you cause all kinds of problems for those who don’t conform to the stereotypes. Such as those poor fools who naively turn up to a disability assessment expecting to be judged on their real-life challenges, only to hear remarks about how well they’re dressed and how recently they’ve washed. Mental illness can strike anyone, and perpetuating cheap stereotypes only hinders the recognition of that pretty basic fact.

To counter the myth, the #MHmasks movement, like the #Mentalpatient one before it, seeks to reclaim the human face of mental illness, by sharing the many and varied faces of real people who have experienced mental health problems. But as heart-warming as the gesture – and don’t get me wrong, every time someone shares a photo I feel both solidarity and pride – I’m not sure it’s necessarily ideal. Because, again, it concentrates on appearance, and not all of us are comfortable with our appearance.

But there’s a bigger problem here, one that speaks to larger concerns around mental health care generally. Why would anyone think appearance matters? It’s entirely irrelevant to judging a person’s mental health, and it’s entirely irrelevant to showing good, compassionate care. And shouldn’t that be the primary focus for teaching our next generation of nurses? By investing in these masks, Robert Gordon University may well be unfurling an ‘education first‘; but it’s not one that’s needed. And it leaves me worrying about the underlying attitudes within a setting where you’d expect a lot more in the way of insight and respect.

UPDATE: 15-February-2014

Following a social media outcry, Robert Gordon University have issued a statement, apologising for causing offence, and promising to curtail use of the masks until they have carried out a review, which they say will consider views from those with lived experience of mental health problems. Although I still have some reservations, Robert Gordon should be commended for the speed of their reaction. More than anything, however, I hope this will present an opportunity for dialogue and learning. It’s vital that everyone understands that people with mental health problems can appear entirely articulate – sometimes even surprisingly composed and humorous – yet still be experiencing tremendous and very dangerous levels of anguish. We need to train our health care professionals to recognise the subtleties of suffering, not distract them with props and gimmicky.

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Thinking of running a half-marathon for a mental health charity? ‘Just do it’!

The following is a recent interview with mental health charity Mind about my experiences of training and running for a half-marathon. 

Why did you decide to run the Great North Run for Mind?

I had a mental health crisis! I’d been in remission for nearly a decade and although I was on antidepressants I naively thought I was over it. When it came back, it hit me really hard. Although I got myself quickly onto the list for therapy, it was a while to wait, and every day is an age when you’re feeling that desperate. I needed a project to focus on; something meaningful that could provide a sense of purpose. That’s where the idea to run the GNR came from. I chose Mind because I wanted to help raise awareness of depression. And because I think their work is vital. Not just giving advice and support to those in need, but also campaigning and raising awareness

What was the idea behind running as a black dog?

The ‘black dog’ – that miserable presence that follows you around and darkens your world – is a fairly old metaphor for depression. I personally don’t think it entirely grasps the complexity, but I do find it helpful to think of my depression as separate from me; something I’m struggling against. Running became a bit of a symbol of that struggle; although my black dog had me on the run, I hadn’t stopped running. I thought it’d be fun to represent that. I also hoped it would help raise awareness. A lot of people with depression hide their black dogs because of shame and stigma. I hoped that running in a nine-foot costume would show that we don’t have anything to hide.

My half-marathon proved to be a pretty good metaphor for depression
My half-marathon proved to be a pretty good metaphor for depression

You say running had become a symbol of your struggle; do you find running helps your mental health?

Yes, but not how I expected. I started running out of desperation; I was looking for any source of hope. With all those posts claiming ‘running is the best antidepressant’ I thought it was worth a try.  When I first started, I was a bit disappointed. I’d been expecting a miracle, but the boost seemed quite small, I certainly didn’t get a ‘runner’s high’. Now I’ve been running a bit more, I think I have more reasonable expectations. It definitely helps me sleep, which is extremely important to my mood. A good run also really helps reduce my anxiety, albeit only for the next two to three hours.

Had you done much running before you signed up to the GNR?

Nope! I only started a few months beforehand, when I had my crisis. I’m definitely not a natural athlete. When I started, I was just a sweating, wheezing blob. I was so anxious about being seen in public that I used to take a route by the sewerage works, where few others dare to venture.

How did you find training?

Tough! I found it particularly hard to get out in the cold or wet. But the fear of knowing I’d eventually have to run 13.1 miles was a good motivator. The biggest challenge was my health. About four months before the race I had a terrible bout of fatigue; I could barely run a few hundred yards. That was my lowest point; I very nearly gave up. Luckily a few weeks of proper rest seemed to shake it.

What was it like, taking part in the Great North Run?

Absolutely amazing! I was completely unprepared for the scale. 57,000 runners… And then there’s the crowd. It was a hot sunny day, so people were cheering along the whole route. The kids got very excited by my outfit. During the first few miles I was waving and giving lots of hi-fives but by the end I could barely lift my arms! The truth is I underestimated the challenge; 13.1 miles is no leisurely run-in-the-park. It was a hot day and the costume proved extremely impractical. I ended up in the medical tent, but they were lovely and I even collected a few donations!

How was Mind’s support during your training and fundraising and on the day of the run?

I was so proud to be running for Mind; they made me feel really valued. I treasured my running pack, and I’ve kept my good luck and thank-you cards. But, for me, it was the support on the day that helped most – I really welcomed the cheer at the Mind charity point, not to mention the encouragement of all the other Mind runners. In fact, just seeing someone in a Mind vest gave me a glow of pride! Mental health may never get the same attention as cancer or heart disease, but the tide is turning, people are starting to recognise what an effect it has.

How does it feel to have raised so much money?

When I signed up, I was worried I’d manage to raise the target £300, so to get nearly £3,000 (with gift aid) was unbelievable. I got over 200 donations from all walks of life – it was really really humbling. And it really helped when I was struggling to finish; it was like they were all there cheering me on.

Are you still running?

I am! I’ve been suffering from severe anxiety over the past couple of months, so the running has been vital. But I’m looking forward to Spring, this winter weather is evil!

Do you think you will ever run in a black dog costume again?

I can’t for now, due to problems with my medication. But in the future, I’d love to! I poured a lot of energy into that blasted costume so it’d be a shame to leave it in the attic. But I might add a few more air holes, so it’s less like running with a sofa on my head.

Do you have any advice for anyone thinking of running in the GNR or Royal Parks Run for Mind?

Ha! I’m no expert, but how about:

  1. Get a good pair of running shoes and train in them for at least three months before the race
  2. If you’ve got health problems then be sensible – don’t push yourself too hard and make yourself worse.
  3. Just do it – it’s an incredible experience, and Mind are a wonderful and worthwhile charity.

You can find out more about running the Great North Run or Royal Parks Half-Marathon for Mind on their website