The media's relationship with the subject of mental health has always been a rocky one at best.
From ABC News using a helicopter to produce a livestream of Robin Williams’ house in the days after he took his own life, to the Sun proclaiming that "mental patients" have killed 1200 people over the course of a decade, the media shapes the way that mental health conditions are seen by their audience
The media therefore have a responsibility to ensure that the image they are presenting to the world is an accurate one.
Presented in this guide are the regulatory bodies for mental health organisations, the appropriate terminology to use when reporting on specific conditions, and the major ethical issues typically faced when covering a mental health related story.
Regulatory Bodies
The Care Quality Commission
All health and social services in the UK are regulated by the Care Quality Commission (CQC). In terms of mental health services, this includes:
+ Hospitals
+ Care Homes
+ Home care agencies
+ Psychiatric Intensive Care Units (PICU)
+ Substance misuse services
+ Forensic inpatient/secure wards
Providers must apply to their local CQC for registration before they can begin to provide any kind of regulated service. The CQC monitor and routinely inspect all of these services to ensure they meet national standards.
Inspections
Comprehensive inspections of all services under the care of the CQC are carried out at least once every three years.
They typically consist of an announced visit that lasts one to four days, and at least one unannounced visit.
The CQC also carry out 'focused’ inspections, which either follow up on a previous inspection or respond to a particular concern -for example if a particular area of a service receives an unusual number of complaints. These are as frequent as required and the length is flexible.
The CQC are currently in the process of updating their inspection model to better include independent organisations as opposed to those run by the NHS.
A February 2018 report by the CQC also found that the quality of care received by those detained under the Mental Health Act was not to the standard that it should be. The report was published to coincide with an independent review in to the Mental Health Act itself, the findings of which will be published in autumn 2018.
The CQC are also the appropriate body to whistleblow to if an individual has concerns about the standard of quality of an entire service (rather than a complaint about an individual member of staff).
The CQC have the power to:
+ Issue a warning notice
+ Limit the services that can be offered
+ Restrict admissions in the case of a hospital
+ Issue a fixed penalty notice
+ Prosecute someone who has carried out a criminal offence
+ Suspend or cancel an organisation's registration with the CQC.
Professional titles and their regulatory bodieS
Counsellors and Psychotherapists
Counsellors use psychotherapy to help clients. While the term is often considered interchangeable with 'psychotherapist', some experts feel that psychotherapists focus their work on long term goals while counsellors help people going through acute mental health difficulties – for example, a 24-hour helpline for people suffering panic attacks or suicidal thoughts.
A person does not need to have a degree in medicine or psychology to become a counsellor, just training in some form of talking therapy, and the title is not legally restricted.
British Association for Behavioural and Cognitive Psychotherapies (BABCP)
The BABCP are a voluntary interest group for those involved in the practice and theory of cognitive and behavioural psychotherapy (CBT). The BABCP is the only organisation that awards accreditation to counsellors who practice CBT therapy. However, membership is open to anyone with an interest in the subject of psychotherapy, so accreditation by the BABCP does not necessarily indicate a person's professional standing. The BABCP can investigate complaints made in to individuals who are members of the organisation, however if that investigation concludes that action is necessary, the BABCP contacts the subject of the complaint’s employer or primary regulating body.
Psychologists
Psychologist is a title gained through a degree in psychology, and then some may also have a specialist title such as 'counselling psychologist', which require a doctorate in a chosen specialty. Psychologists are typically involved in research more than patient care and are usually described as being either ‘applied’, which uses research to solve practical problems, or ‘research-oriented’, where the aim is to further society’s knowledge of the human mind. ‘Psychologist’ is a protected title.
Health & Care Professions Council (HCPC)
Health care professionals that act under a protected title – a title within the medical profession that is protected by the law from being misused – are regulated by the Health and Care Professions Council (HCPC). Examples of protected titles in mental health are clinical psychologist, counselling psychologist, and occupational psychologist.
Anyone using a protected title must be registered with the HCPC, anyone found to be using a protected title without be on the register is breaking the law and can be prosecuted. A person must be registered with the HCPC if they want to work as a practicing psychologist in the UK. Following a government inquiry after the Soham murders, the HCPC has the power to pass along any information it deems troubling to the Disclosure and Barring Service (DBS), which can permanently ban someone from working with children and vulnerable adults.
Psychiatrist
A psychiatrist is a person with a medical degree who has chosen to specialise in the study of mental disorders, the same way some doctors choose to specialise in oncology or paediatrics. Psychiatrists are often involved with individual patient cases as well as research and an area of expertise. As this is the most highly qualified area of mental health care, psychiatrists tend to deal with the most severe cases of mental illness, that require intervention. They are the only mental health professionals that are qualified to prescribe medication and carry out medical procedures like blood tests and CAT scans.
Psychiatrists can work within the NHS, private practice, or in other institutions like prisons or social work.
Royal College of Psychiatrists (RC Psych)
The RC Psych is the body responsible for the education of psychiatrists, promoting research, and setting of standards within psychiatry. They also publish the British Journal of Psychiatry. Membership is voluntary and so they do not have powers to inspect or regulate the behaviour of individual members or the organisations that they belong to.
British Psychological Society (BPS)
The British Psychological Society is a registered charity that acts as the "representative body for psychology and psychologists in the UK and is responsible for the promotion of excellence and ethical practice in the…discipline". They are the main organisation in the UK for psychology and mental health professionals. As it is a voluntary organisation, they can investigate complaints against members if they violate the Member Conduct Rules, but advise people to contact the “appropriate third party”.
Ethical Issues
Time To Change, a campaign aiming to lower stigma around mental health, recommends that when covering a story concerning mental health, to use the voice of someone who has experienced that particular issue.
When interviewing a person about their own mental health, be wary of the ethical issues:
+ Informed consent – do they know the purpose of the interview, and the context in which it will be used? Consider providing the interviewee with a list of questions beforehand so they know what to expect.
+ Quotes – wherever possible, use the interviewees own words to best represent their own experiences and prevent the interviewee's intended meaning being lost.
+ Anonymity – Get explicit consent from the interviewee before using their name or any other identifying information, including photos and videos.
Suicide
When covering a story containing suicide be careful not to report details of the method – this could act as instructions to a reader.
You should also avoid using the word 'suicide’ in the headline of a story, as according to the NUJ’s guidelines it can encourage ‘copycats’ by glamourizing and normalising suicide.
The NUJ also recommend avoiding naming the exact location of a suicide, especially if it is a well-known location in the local community, as it can lead to a location becoming a popular spot for suicide attempts. For the same reason, you should also avoid naming somewhere as a ‘suicide hotspot’
Using the right images
The 'Time To Change' campaign has also urged the media to consider the impact of images used in stories about mental health. They encourage journalists to stop using the ‘head clutching’ image that is common in mental health reporting, as well as images of people that suggest they are isolated or alone.
There is an image library available for editorial use by the media that categorises more appropriate images by the condition they represent.
When reporting on suicide, the NUJ recommends avoiding using photographs of grieving loved ones or funerals, as this could make a vulnerable person see suicide as a way of extracting revenge by making people feel guilty.
Language
Useful Resources
Responsible reporting on mental health, mental illness & death by suicide - National Union of Journalists
The Ethical Journalist - Tony Harcup. Particularly p.262: "Case Study No.17: Covering a Public Official's Public Suicide"
BBC Editorial Guidelines - Section 5: Harm and Offence
Media guidelines - Time to Change
How to report on mental health - MIND
Supplementary Factsheets - Samaritans
Samaritans also have a designated media advisory team for journalists with questions about how to sensitively report on suicide and mental health:
Samaritans: +44 (0)20 8394 8300
BBC Academy - Reporting mental health: Sian Williams
Office For National Statistics: Mental health of children, adolescents, and adults
MIND - A selection of reports commissioned by the charity on various topics and how they impact mental health in the UK, including sport, crisis care, and personal debt.
Miscellaneous
How CQC regulates: Specialist mental health services - Care Quality Commission
