Author Archives: mark

Fancy pitching an article to mental health magazine One in Four? Editor Mark Brown tells you what he’s looking for.

At One in Four we love to publish writing from new voices.

Consequently, we love to get article pitches and do commission articles from pitches we receive.

As I’m the editor, you’ll be pitching to me.

So I thought it would be a good idea to give you an idea of what I’m looking for in a pitch:

1. Remember is One in Four is journalism FOR people with mental health difficulties

In your pitch I’m looking for a sense that you get the idea that One in Four is a magazine for people with mental health difficulties written by people with mental health difficulties. Tell me why your idea is of interest to other people with mental health difficulties.

Generally, One in Four is about getting on with life while having a mental health difficulty. We also have a dollop of opinion, a dash of discussion and a bit of stuff about services but all of them have to answer the question ‘what does this mean for people with mental health difficulties?’

One in Four is pretty much always through the eyes of people with mental health difficulties (apart from day in the life where we talk to various professionals).

In the case of interviews, we think it’s really interesting to have people with mental health difficulties interviewing people who either do or don’t have mental health difficulties about things relevant to readers.

2. Tell me what will be in your article

I need to know what kind of article you are proposing. Is it an opinion piece? Is it a piece of reporting? Will it include interview material? Where is your information going to come from? Does it tie in to any other big stories in mental health?

3. Give me an idea of what the headline and subhead might be

This will give me an idea of what you think the story is about so give me a headline that sums it up and a very short description of what the article is about.

4. Give me an idea of how long you think the article will be

We tend to work to 600 for one page, 1200 for two pages and 1700 for three pages approximately.

5. Give me a bit of background about yourself

Give me a very short biography and links to any other bits of writing you’ve done (including blogs) for me to have a look at.

If you do all five of the above it’ll make it much easier for me to see where you’re coming from and if what you’re pitching is right for One in Four.

It’s also worth reading the editorial principles of One in Four:

Statement of Editorial Principles

‘One In Four’ wants to widen understanding of mental illness and mental difficulty.

‘One In Four’ aims to challenge the stigma of having a mental health condition or experiencing mental health difficulties.

‘One In Four’ does not have a sectarian position on the treatment, diagnosis, nature and cause of mental illness or mental difficulty.

‘One In Four’ believes that there needs to be an authoritative source of information about mental illness and mental health difficulty, and that this source should deliver information to the widest range of people possible.

‘One In Four’ presents information and ideas about mental illness and mental difficulty in a measured, balanced format.

‘One In Four’ believes that media representations of mental illness affect both the perception of mental health difficulty in the wider community and the ways that people who have mental illnesses or mental health difficulties understand their condition.

‘One In Four’ believes that people with mental illness and mental health difficulty have the same interests and aspirations as people who do not have mental health conditions or mental health difficulty.

‘One In Four’ believes that helping people to access unbiased and balanced
information about mental illness and mental health difficulty is important, reinforcing positive messages and countering negative views, ideas and understandings.

‘One In Four’ presents positive images of people with mental illness and mental health difficulty and positive, aspirational information for people with mental illness and mental health difficulty.

‘One In Four’ believes the experience of mental illness and mental health difficulty should be situated within the realm of normal experience; that those experiencing these conditions should be helped to feel part of the wider community and that the wider community, through a greater understanding of these conditions, should look upon mental illness and mental health difficulty more positively.

‘One In Four’ believes that a professional, well-written, well-publicised and well- distributed regular magazine is key to guaranteeing the success of this editorial statement

All that done, read and digested get pitching to me at editor@oneinfourmag.org

Looking forward to hearing from you!

Mark Brown, Editor, One in Four magazine

William Gibson, famous ‘father of cyberpunk’ science fiction writer, in response to people congratulating him on the correctness of his predictions for the future, has been quoted as saying “The future is already here – it’s just not very evenly distributed.” (Or at least seems he said words to that effect, but that’s another interesting story.)

It’s an idea that I’ve found myself falling back on a lot over the last couple of weeks when thinking about mental health and changing attitudes.

When I was #mindtech (as detailed in this blog post) I was very struck by the different level exposure various attendees had to particular mental health ideas, services or ways of working.

How could it be, I wondered, that millions of people have been exposed to the message of anti-stigma campaign Time to Change during its four years so far of existence but a room of ten people interested enough in mental health to come to an all-day event during the working week precisely because they were interested in mental health had never heard of it?

When people were trying to come up with solutions for mental health challenges, how was it that so often they suggested things that were very similar to things that were already happening?

This led me to me to think about why there were such huge disparities between what between people’s exposure to various ideas, projects, initiatives and ways of working.

That’s where I hit upon it: “The future is already here – it’s just not very evenly distributed.”

When William Gibson used it he was trying to say that most of the things in his novels that seemed futuristic at the time they were published (big mega corporations, hackers, cyberspace etc.) weren’t in fact futuristic, but were things from the present that weren’t new, but were new to most of the people reading. Hacking had been going on since computers began to be networked and had origins in 1960s phone phreaking, using dialcodes and phone equipment usually used by repair people to fool telephone exchanges and make free phonecalls, create party lines and the like.

The point being, big jumps forward in thinking or technology don’t reach all people at the same time. That’s where we’re at with mental health.

I think that there’s a new generation of mental health projects, campaigners and organisations that are developing new ways of thinking about mental health. Over the last decade there have been a number of successful projects and people that have answered the question ‘How do we do services and projects by and for people with mental health difficulties differently?’ by just getting on and doing services and projects by and for people with mental health difficulties differently.

I think that there is a new mental health, one that isn’t defined by the term service user. More than ever people with mental health difficulties are finding themselves in situations that would probably not have happened to previous generations. We’re running into questions that don’t have established answers.

I think one of the shifts that I’m noticing is people with mental health difficulties moving beyond seeing their identity being defined by their interactions with services, moving beyond seeing themselves as ‘service users’ but as people in our right with complex needs, wishes, aspirations and ideas.

I also see a move away from the illness / cure model of mental health and toward a disability view of mental health where we don’t feel it’s acceptable to be judged as somehow ‘lesser’ because of the mental health challenges that we face.

When I read twitter or look at the madosphere (the mental health blogosphere as captured by TWIM ) I see fiercely clever people running headlong into the fact that things aren’t changing as fast as we want or need them to, hitting every glitch in the way services work and uncovering every inconsistency in public attitudes or the conduct of organisations or individuals because they have moved into the mental health future more quickly than those around them – the future that isn’t distributed evenly.

But this isn’t where everyone is at. There isn’t a consensus view or a consensus opinion. There isn’t ever a point where you can draw a line and say ‘now we’ve reached the future’. The bits that will make up the future are already around us in the present.

When it comes to anti-stigma work and public attitudes to mental health, good information doesn’t permeate every group of people at the same speed. The same is true of good ideas.

It’s easy for us to assume that either everyone is on the same page as us or they are wallowing in the stickiness of the past, refusing to move. Change takes time and most people only notice it once it’s happened, not while it’s happening.

I think we’re seeing that sort of change in mental health. Not everywhere at once, but in certain places and certain situations. It’s a change that isn’t controlled by anyone group of people, and which might go in all manner of different directions, but is based on people with mental health difficulties taking control in ways that haven’t happened before.

What I think is extremely interesting is that this change isn’t just coming from tradition sources or traditional power blocs: It’s coming from people who see mental health as something worth thinking about who are coming from various walks of life and situations.  It’s not just doctors or self defined ‘service users’.

I’m trying to crowdsource funds to look at some of the ways that change is happening (you can click below to watch the terrifying video and try to guess my accent).

Sometimes it’s easier to see where things are getting stuck. (Personalisation I’m looking at you) but it’s often hard to see why they’re getting stuck. Sometimes it’s because, actually, things are fine as they are. Judging by the experiences of many people with mental health difficulties things staying the same because they’re great isn’t always the case in mental health.

Can you spot places where the future happening in mental health? Where and who do you think the future is coming from and how do you think it’s shaping up?

Mark Brown is the editor of One in Four magazine and the development director of Social Spider CIC.

I spent Friday at http://unconferencementalhealth.wordpress.com/ An unconference to discuss using technology to make mental health better at Coin Street Community Centre on London’s South Bank.

The idea of the day was to get a load of people together in a big room, get them thinking and talking then get them to split up into groups and come up with ideas for projects. It was similar idea to the Innovation Labs I attended a few months ago.

Once people had come up with ideas for what could be discussed and we began to divide ourselves into groups, me and a couple of other people realised that what we were interested in didn’t seem to quite fit into the broad themes that others had identified. We decided it would make more sense for us to set up a little breakaway group of our own and see if we could come up with some ideas to present back to the unconference as a whole at the end of the day.

We made a break for the roof garden. As people who are intimately involved in mental health innovation rather than coming to it as a new idea, we tried to dig down into questions about how we do mental health innovation, how we can make it sustainable and what innovation actually means in mental health.

Below are some of my observations  on the day and some of the things we ( Chris O’Sullivan ( @mentalcapital ), Katie Brown (@Re_connection) and Clodagh Miskelly (@miskellaneous )and me @markoneinfour) discussed up on the roof, sitting under a beautiful blue London sky.

Observation 1: There were less tech people than I would have expected

At an unconference about mental health and technology, I would have expected there to have been a larger contingent of people who were not mental health specialists but who were specialists in ‘doing tech’.

I think we sometimes have the idea that mental health is such a mystical and secluded area of endeavour that no outsiders will never get it. Tech people like solving problems. That’s why they are an asset (of which more further down).

Observation 2: Think big doesn’t mean make big things

Lots of people at #mindtech had big ideas.

This is brilliant. What we in our little rebel group explored a bit was what that actually means in terms of business models and sustainability.

The thing about things like apps and websites, that is tech that doesn’t involve manufacturing or giving people actual nuts and bolts bits of kit, is that the actual cost of development and delivery is more or less the same whether one person uses that app or website or one hundred thousand.

So, if you have a brilliant idea for an app and you spend £200.00 making it and twenty people use it and like it, you’ve spent £10.00 per person on making something positive happen. If a hundred people use it and like it, you’ve spent £2.00 per positive outcome.

The value of that form of tech is low-cost multiplication of impacts, like having a photocopier where you never have to refill the paper drawer or buy more ink. Once it’s built and launched, you should know exactly what you’re spending on each person who uses it and you should see the cost per person come down over time as more people use it.

At #mindtech I picked up a bias towards thinking about web applications or websites that would take on huge a weighty challenges and would provide all-singing, all-dancing solutions to them. This is a great and laudable aim, but it’s not how innovation or tech really works.

When presented with the question of how we can use technology to make the lives of people with mental health difficulties better, people can find themselves thinking about magic bullet solutions to make everything better which leads to very big, very broad project ideas.

The problem with massive ideas is that they have massive development costs. ‘ So what?’ you might say. The problem is that massive development costs massively increase the amount of people you need to use the thing you’ve created to make it worthwhile.  Or in other words, to get a reasonable return on your investment you need a large amount of users and outcomes.

To come up with a tech answer that would provide an all-singing, all-dancing solution to a series of broad challenges that people with mental health difficulties will be time consuming, complicated and costly. If it’s taking on a massive range of challenges faced by a massive range of people, then I’d say that the cost of developing that will mean that you’ll also need a massive amount of people to use it to make for a good return in outcomes from the cash you’ve spent (or, more usually, the cash other people have spent by investing in you. It’s rare to find people who risk their own in developing stuff in mental health.)

If you want to be all things to all people by doing general things, then your innovation is going to need to be used by nearly all people to make it worth the investment.

The point that we would raise is: What’s wrong with small projects for specific purposes and people?

Observation 3: Improving mental health services isn’t synonymous with helping people with mental health difficulties to have a better life

This is a fairly self-explanatory observation.

Observation 4: We are awful at market research in mental health 1

One of the things that really struck me at #mindtech is that for the most part we still seem to be tit-awful at market research in mental health.

Market research is, very simply, the process you go through to take a product to market. It’s simple A level business studies stuff.

You find out what value the potential market has, you find out what other people are doing or have done in the past, you look for gaps or opportunities, you come up with products, you find what would be reasonable to charge for them, you find out how you offer them to the people you hope will buy them.

What really hit home to me in our rooftop discussion a #mindtech was just how disconnected and jumbled up this process is mental health. I was asked by John Loder of The Young Foundation to come and talk to the group he was helping out who were looking at ways to change perceptions of people with mental health difficulties. When they explained that they thought it would be great to do a big campaign collecting peoples stories and sharing them via social media to reduce stigma and that it could lead off with famous successful people through history who’ve experienced mental health difficulties I had to congratulate them. In the space of a few hours, a group of ten folk who’d never met before had run through all of the issues and ideas and possible solutions and had, in essence, come up with a plan that was pretty much the same as Time to Change’s plan for the first three year phase of their existence.

This is awesome, and shows that from a standing start, there are solutions that people will hit upon following logic, but that’s not really where the process of innovation begins.

Our small rooftop breakaway group was rooted, to an extent, in the fact that we have been doing that market research, we do know what others are doing or have been doing. In essence, our starting point was different. We spend our days thinking and working on projects that are about innovating and to do that we need to know what other people have done and are doing because that’s how we learn and how we make sure the time and resources we have can be used to their greatest value.

At present there isn’t really a primer in mental health innovation. I’m trying to raise the money to write and research one, but at present there isn’t really an easy starting point.

The first rule of Fight Club is you don’t talk about Fight Club. The first rule of mental health is that next to no one knows what anyone else is doing or has done in mental health.

There is isn’t a trade journal for mental health innovation, there are few websites, there isn’t a network. There’s some people doing stuff.

As Chris O’Sullivan suggested, we need a way of somehow creating a repository for stuff about mental health innovation so that we don’t reinvent the wheel.

For me, I wonder whether the default expectation that the state and the NHS will be the ultimate solution to the challenges that a mental health difficulty presents actually prevents us from seeing mental health innovation as an intellectual area in its own right.

When it comes to people with mental health difficulties trying to sort stuff out it sometimes feels that rather than speaking to each other, we go straight to speak to services. I wonder if we mirror that in our thinking about projects and innovation by just talking to funders and decision makers and failing to actually speak to our peers?

More broadly than that, at a very basic level you can’t innovate without knowing what’s happened before, which makes me think some thing even more intriguing: Maybe all of these ideas really were new to people who were used to working within services and structures? What seemed like a revolutionary eye opener to someone new to this notion of innovation and change in mental health may have been what had me sticking my hand up and saying ‘that’s great. There’s been projects that have done similar before.’

Innovation of course doesn’t need to be a new idea. It can be a very old idea applied in a new way. What to someone all wide-eyed with the rush of excitement that comes with first exploring a new ideas  sounded like me pooh-poohing and saying ‘it’s all been done’ was actually me saying ‘the paths that have been explored in that direction have been interesting, explore further’.

At a more fundamental level, most people don’t know what people with mental health difficulties actually want, because they’ve never asked them. More broadly, most people don’t have a broad idea of where mental health difficulty fits into a life.  We don’t see people with mental health difficulties in demographic terms.   It’s still ‘take your medicine’. It’s like identifying that a) people like tea b) teapots sometimes leak and then trying to issue each person who likes tea in the country with a galvanised steel tea funnel which needs to be fitted to their tea cup by a qualified fitter.

The point we would raise is: How are people going to get ‘up to speed’ with what’s been happening and what does it say about the current situation that they aren’t?

Observation 5: We are awful at market research in mental health 2: The mental health pound

In our roof top breakout we were thinking a lot about sustainability, or to put it more bluntly, where’s the money?

What we realised is that in a situation where 82% percent of mental health services are still commissioned by by the NHS, it’s going to be a challenge to unshackle innovation in mental health from the particular needs and wishes of existing mental health services. They have the cash. They may not think they do, but they do.

This set us thinking more broadly about models for sustainable projects and sustainable innovation in mental health.

For something to be economically sustainable and to be able to offer a financial return on investment it needs to do the following: “it needs to sell people something they want, on terms they understand, at a price they’ll pay”.

Again, so far, so A level business studies. But, this gets complicated in mental health. Who really is the customer for mental health innovations? In other words, who is actually the consumer?

When we’re innovating we tend to think first of selling it to funders in mental health. We tend to think about selling to people with mental health difficulties last.

Let that sink in: We think last about selling our projects to the people who will use and benefit from them.

What kind of a sustainable business model is that? Think of the customer last?

What we realised is that no actually thinks of people with mental health difficulties as consumers in the classic sense, as people who can vote with the feet, purses and wallets.  We didn’t even know any stats about how people with mental health difficulties actually use tech like the internet and smartphones, which you’d think would be important for something like #mindtech.

We realised that a major barrier to investment from beyond the NHS was the fact that we don’t actually know what people will and won’t pay for and at what price, because we’ve never found out. This set us wondering: What is the value of the overall mental health economy in the UK? How much is actually spent? We can get figures for NHS spending and perhaps social care spend and maybe charity spend. What about self funders? What about things that people with mental health difficulties spend their money on to help them to feel well?

Just what is the value of the mental health pound in the UK?

This may seem like an odd question but look at it in these terms: We complain about the under-investment in mental health, by which we usually mean the lack of money collected via taxation that in given to mental health services delivered by the NHS. If that is going to be increasingly squeezed by recession, what steps can we take to bring other investment into mental health and specifically mental health innovation?

The money has to come from somewhere (although there are ways of making money go much further by using it differently)

The NHS can be an excellent catalyst in mental health, but it still holds too many of the reins to make it possible for innovation to be truly disruptive.  Very often it’s the people making the investment decision who are most challenged by radical innovations in mental health because those innovations don’t just modify how they do something but, in the way that the recovery model conflicts with the medical model, they modify what that something is.

In the spirit of disruptive innovation we would ask: Just what is the value of the mental pound in the UK and why don’t we find out what people want and would pay for?

Observation 6: Everyone can’t use it so no one can?

One thing I found really interesting at #mindtech was the idea that using a tech platform that more people use is better than using a specific platform that you definitely know some people use. When one of the introductory speakers was talking about Buddy, the mood feedback system, they said that they had decided against creating what they did as a smartphone app because many of their potential users don’t have smartphones.

This seemed to be translated by most at #mindtech into the assertion that most people with mental health difficulties don’t have smart phones therefore projects should be only be done on the platform that most people have access to, so in the case of all of the ideas that came out of #mindtech that meant doing websites.

In response to the point about smartphones, I tweeted that maybe we could stop whinging about people with mental health difficulties not having smartphones and just give people one if they don’t have one. Chris O’Sullivan pointed out that there are projects that have done just that and that it was a far cheaper thing to do than you’d imagine.

I think everyone who came to #mindtech passionately wants to change things for all people with mental health difficulties and this lent a utilitarian tone to many of the projects and ideas: the greats possible good for the greatest number of people.

I think that this either comes at tech innovation from a services improvement angle (How can we make tech part of services so services run better?) or an information provision angle (How can we give lots of information to lots of people?)

What was left out, I think, was the idea that tech is elective: You chose what you do and don’t choose to use. In existing services even the most simple forms of technology are elective; for example, some people choose to telephone to make an appointment, some would choose to do so in person, others might choose to use a different method if it was available.

There was still an air of medical thinking hanging over #mindtech, at least for me. There was a sense that the (probably accidental) consensus in some of the groups was how do we do a project for people to use? rather than how do we do a project that people will choose to use?

Yes, it’s obviously wrong to make the only way to book an appointment for your services an i-phone only app. That would be stupid. However, what if there is something that i-phones can do really well that an application related to people’s mental health might make use of?

Just because you can’t replicate the experience of using something for all people doesn’t mean that it should be discounted. My GP doesn’t know my email address because the practice has never asked. For my GP to send me emails rather than letters would be great for me, would save them money on postage and would be all together more efficient. I’d love it. It wouldn’t mean that alternative forms of communication shouldn’t be available. By the access logic, there’s no point in my GP exploring sending emails because we know ‘some’ people don’t have email addresses.

The point I’m driving at is that the idea of being able to build tech solutions to challenges that can be applied universally from day one is flawed.

The observation I’d feed back: Specific projects that do specific things with or for specific people are cheaper and less risky than big ones that do lots of things apparently for everybody

The observations we actually presented back to #mindtech (more or less)

High cost developments that need to be rolled out across thousands of people to justify the money that has been spent on them just mean that, counter intuitively, far more money is being risked, even if the universal nature seems to make them a better bet.

The NHS is rich with assets. Those assets are people and their knowledge, skills and ideas. At present they are sitting like funds in a dormant bank account, their additional potential to unlock mental health innovation unused.

Similarly, there is a huge amount of people with technical and business skills who want to make their communities a better place. These are assets that are not currently drawn into the world of mental health either.

Rather than bringing people to mental health tech projects that have been made by people with ‘their best interests at heart’, we would ask how can we take tech and mental health assets to people?

Instead of keeping assets locked up in statutory services and using them only to draw further funds into those services, instead of reinventing the wheel or do-gooding on behalf of people with mental health difficulties, why don’t we work on ways of giving knowledge and tech assets to existing groups to find ways of using those assets to come up with projects that meet their mental health needs?

Or even to come up with micro enterprise ideas that involve coming up with services that can be sold or invested in?

We’d suggest small amounts of money can go a long way to supporting the process of innovation for solving problems for small groups of people and that fostering small innovations in communities in mental health and tech might actually come up with more ideas that can be developed or tried in other places or with other groups.

People in communities may not have specialist knowledge but they have ideas and experiences. If we are sitting on a huge store of knowledge and expertise then we should be looking to spread innovation to community level so that when mental health and tech ideas happen they happen with the full involvement of the people who are supposed to benefit from them.

Big isn’t always better and for innovation to be disruptive and really change things it needs freedom to happen. Improving services is awesome, but that’s not the only thing innovation in mental health can do.

There’s a lot more that I could say about what we were discussing up on the roof, but I think that’s enough to be going on with. Hopefully Chris O’Sullivan ( @mentalcapital ), Katie Brown (@Re_connection) and Clodagh Miskelly (@miskellaneous ) will be blogging or writing up some of their thoughts.

Mark Brown is the editor of One in Four magazine and the development director of Social Spider CIC.

Article history: Updated 1/4/2012

I was reading this interesting piece of research today about the bias in reporting of mental health stories.

The headline conclusion is that there is a difference between what stories about mental health New Scientist magazine chooses to cover and what stories the BBC chooses to cover.

The research was conducted by George Szmukler at the Institute of Psychiatry and his colleagues. It focused on coverage of mental disorders research on the BBC news website from 1999 to 2008, and in New Scientist magazine news and features from Aug 2008 to April 2010. This led to the identification of 1015 relevant stories on the BBC (102 per year) and 133 stories from New Scientist (76 per year).

The researchers concluded that both tended to focus more on medicalised discourses around mental health with seventy-five per cent of the BBC’s coverage on biological research; New Scientist showed a similar trend. There was less discussion of psychological approaches.

What really interested me were their findings about commentators. They found that while most BBC stories included quotes from commentators intended to provide some context, including from 973 named individual: “There was a bias towards medical commentary. The six most frequently quoted commentators included three from the Alzheimer’s Society, two from the Alzheimer’s Research Trust and one from SANE.”

In short, most stories about research into mental disorders written up for BBC online were about biology and most had commentary from a medical perspective; so in those stories we had doctors mostly talking about brains.

Where are we in this?

While this research covered only stories about medical research into mental disorders, it set me thinking about how mental health related stories are represented in the media. The question it posed for me was: ‘Why don’t we get more people who experience mental health difficulties as commentators in news media?’

We’re all familiar with the ways that television, radio and print represent news. There are ‘on the spot’ news stories where journalists themselves are present as something unfolds. These could be called ‘went there, found something out’ stories. These will usually contain input from people ‘at the scene’ who contribute what they saw or experienced.

The problem is that a lot of things that happen in the world don’t happen in ‘on the spot’ ways. It’s quite easy to report a building on fire, but it’s a bit more difficult to report the reasons why the building is on fire if it’s related to the choice of building materials or a series of pieces of legislation. Print media is much better suited to covering complicated stories that unfold over time and require context and knowledge for you to make sense of them.

Television news does something that you might call ‘pseudo on the spot’ reporting, where reporters go to where something is or has happened and broadcast as if the story is unfolding, despite the fact that the real action has either already happened or is actually happening somewhere else. Think of freezing cold reporters standing outside of government buildings talking about something that happened there earlier that day.

As not that much really happens in ‘real time’ news reporting of television and radio relies far more ‘talking heads’ to create stories. You’ll get your reporter standing in the drizzle somewhere, but you’ll also get a series of spokespeople, talking heads, pundits, experts, correspondents or sundry other figures who’ll be used to add further information to the story. Radio works in a similar way.

Often there’ll be a space for a spokesperson to make a response. Spokespeople are always representing the interests of a particular organisation, body or group.

Sometimes, there’ll be a contribution from someone affected by the subject of the news story. If it’s a story about mental health this is where you’ll see a contribution, if you’re lucky, from a person who experiences mental health difficulties or someone who knows one.

What happens a lot is the use of people talking to provide different points of view on a story or to add additional information or points of interest. They are used to try to work out what a story actually means. The classic format for this is ‘here’s a person who agrees with what is happening in this news story, here’s a person who disagrees and it’s over to our expert for more details’.

Often these people are not directly concerned with the events that make up the news story but people who know something about it, or have something to say about it, and, if you’re lucky, people who both know about it and have something to say about it. The format can set different views against each other or bring differing points of view to addressing a particular issue. More often than not, the format tends to be based on speculation (“what effect do you think this story will have?”) or statement of position (“where do you stand on this?”). Sometimes it’s not clear whether a given contributor is occupying one or the other of these positions.

What I wondered is: Why aren’t there more mental health talking heads? Or to put it another way; why aren’t more people with mental health difficulties asked what stories about mental health mean?

Who is asked to speak and why?

It would seem that we will get a medical view in the role of expert, often a charity view from the point of view of spokesperson and a person with mental health difficulties in the role of personal experience (if there’s space for that) but we’ll very rarely, if ever, get a person with mental health difficulties in the role of commentator or person with an interesting point of view on the issues involved in a story or the ability to explain what a story means.

I was recently at #transcamp, organised by TransMediaWatch, a day devoted to trying to find ways to make media coverage of trans people and trans issues better and more accurate. A lot of the discussion revolved around the fact that there were very few accurate portrayals of trans people in the media. One of the things that was recognised was there wasn’t many trans people who could communicate the experiences of the trans community in a direct and engaging manner. The subtext to this was that somehow trans people needed to find ways to transcend the stereotypical ways in which trans issues were represented.

Trans people are often represented in ways that fit existing media narratives. In other words the media finds trans people to be trans in the way that the media expects trans people to be. Trans is treated as an issue (with for and against) as much as it is represented as an experience. The people were enlisted by the media to tell the story that the media had already decided it was telling. One of the main themes that came out of the day was that trans people need to find ways of telling stories in mainstream media that manage to ‘jump the rails’ of established stories, so shaking off the position that the story assigns to them.

In that discussion, it occurred to me that the issue of ‘speaking for’ or ‘speaking on behalf of’ was not a simple one. It set me in mind of a segment from mid-nineties satirical news masterpiece The Day Today where the news anchor character played by Chris Morris was interviewing a black man subtitled as ‘speaking for every black person’.

When you get a spokesperson it’s acknowledged that they represent a partial point of view. When you get someone with direct experience they are often somehow seen to embody all possible points of view or all people affected, like speaking for every black person.

When we were discussing this at #transcamp, I raised the case of the Tax Payer Alliance. They are regularly wheeled into news coverage to make a statement about the use of ‘tax payer’s money’, usually in opposition to someone suggesting how some of it should be spent. You’ll most often see them as presenting the ‘balancing’ point of view in a segment discussing changes to public spending. The Tax Payers Alliance is on the news because it represents a very clear set of ideas in a clear way representing a clear interest group. In other words people know what they’re trying to make happen and where they fit in to the story. They provide the taking heads that are needed by the people making news coverage.

This set me wondering; why isn’t there a similar set of people providing trans opinion or indeed mental health opinion?

Where are the mental health talking heads?

Interestingly, I think that trans people in the UK are closer to carving out that space than people with mental health difficulties in the UK.

I’d hazard to guess (and am very open to being corrected) it’s because trans people in the UK don’t really have the same history of others speaking for them and are not also seen as a ‘social challenge’ in the same way that people with mental health difficulties are.

They also aren’t seen as part of an amorphous group, because they have managed through the work of previous campaigners to avoid being pigeon-holed, but also because trans people aren’t seen as ‘afflicted’ in the same way that people with mental health difficulties are, despite experiencing high levels of very real discrimination and prejudice. As such, they are seen as a minority carving a way through life, rather than a collection of symptoms who may potentially one day be ‘cured’. They are seen as the people who have the answers about what it means to be trans. With mental health it sometimes feels like the instinct is to turn to everyone but people with mental health difficulties to explain what an event that affects us actually means.

As the research outlined above suggests, mental health is still seen as primarily a medical issue rather than as a disability. To put it another way, it is seen as an abstract experience of ill health rather than something that people live with over a period of time. Eventually, the research model suggests, mental health difficulty will be eradicated like rickets or TB. Mental health difficulty is seen as something that can be solved, and as such, does not represent something that is weaved through all of the elements of the life of the individual that experiences it.

Both the major charities and the medical establish still continue to present mental health difficulty through the prism of ‘problem/solution’ rather than through the prism of lived experience. This is in contrast to the ways in which people with other disabilities have developed the social model of disability as way of building a story about disability that does not rely on society doing something for people with disabilities but demands that society gets out of the way and stops making disability the issue rather than recognising it is society that disables by the way it is put together in favour of those without disabilities.

There is still an over-riding bias toward seeing people with mental health difficulties as a group that others do good for without seeing us a discrete group in society who may have opinions and ideas of our own.

Debate is still couched in terms of ‘we need to do something about or on behalf of people with mental health difficulties’. This is part of the reason why celebrity spokespeople remain as ‘taking heads by proxy’, in theory members of the group being spoken about but in actuality still occupying the paternal role of requesting that someone do something on behalf of the those poor unfortunates.

In short, we are not seen as people who may have insight or ideas into our position in society because we are not recognised as an actual minority group with specific challenges.

Imagine, if you will, a spokesperson appearing on mainstream news coverage and beginning a sentence with ‘People with mental health difficulties in this country feel that…’ or ‘The effect of this legislation on people with mental health difficulties will be…’

Then imagine BBC Question Time featuring a person representing the ideas of people with mental health difficulties as a specific group in society in the way that, say, Owen Jones represents the ideas of a specific strand of socialist thought or Melanie Philips represents a certain strain of centre right opinion.

It could be concluded that for us as people with mental health difficulties we have not yet passed the point where we are ‘allowed’ by news media to have ideas about our condition and our place in life. We can contribute information about our experience to provide context and colour, but, as yet, we don’t have a strong enough voice to be allowed to make arguments about what it actually means to us as a group of people.

So, what’re we going to do about it?

For an idea of what disabled talking heads might look like, have a look at this archive footage from 1990 (hat tip to @e_lisney on twitter)

Mark Brown is the editor of One in Four Magazine

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