'We need to talk about mental health responsibly'

The DfE’s former mental health champion calls on organisations – including schools – to join Tes and sign her Mental Health Media Charter

Natasha Devon

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Strap yourselves in, for this week’s column is a long (yet, I sincerely hope, worth it) read.

For the past couple of months, I’ve been thinking about language and why it matters. This is chiefly because I’m writing a book (A Beginner’s Guide to Being Mental, out May 2018), the central conceit of which is that we have an incredibly restricted emotional vocabulary to play with in the English-speaking world; hence so much miscommunication and misunderstanding around mental health.

It’s also because, during these Brexiteering, Trumpian times, there has been a lot of discussion about "political correctness" and how it relates to "freedom of speech". I’m someone who instinctively allies themselves with the PC brigade, yet I also believe there is an element of truth in what comedian Ricky Gervais and many others before him have said – "offence cannot be given, only taken".

I have always felt that if I am unknowingly using a word that is hurtful to people who are more directly affected by its use than myself, the kindest and most logical thing is to stop. It hasn’t taken a huge amount of effort on my part, for example, to evolve from saying LGB to LGBT, to LGBTQ to LGBT+, and I’m totally open to the idea that it might change again in the future. I want lesbian, gay, bisexual, transgender, queer, non-binary, in fact, anyone of any gender identity or sexuality to feel comfortable and acknowledged in my presence, and I understand that using appropriate language is one way I can achieve that. I rely on people I know at the forefront of LGBT+ campaigning to tell me what the most acceptable names and acronyms are considered to be.

"Freedom of speech" only works as a concept if one fully understands both the historical and current contexts of the words one is using. It also doesn’t protect one from any potential consequence. As a white-passing mixed-race person, for example, I’m perfectly happy with the idea that the N word isn’t something it would be appropriate for me to use and I see no double standard in the notion that Kanye West is permitted to rap it (take note, please, Piers Morgan).

If you are living a word, day in day out, that word belongs to you and your community. It is you and others like you who should debate and discuss its import and acceptability, and broadcast these to the rest of the world.

That’s why I felt justified in wading in on language around mental health: not only do I have a 26-year history of mental health issues, but I’ve been campaigning in this sphere for a decade, have spoken to about 100,000 teenagers about it and had the privilege of access to the latest research from the world’s most prominent experts.

I also understand, however, that I can’t speak for everyone who has been affected, whether directly or by proximity to a loved-one, by mental illness. That’s why for the past three months I ran a social media campaign asking people what terminology they did and didn’t like in mental health reporting. I also deferred to two UK charities – the Samaritans and Beat, as well as Mental Health First Aid England, for their recommendations.

Avoiding the language of stigma

Not everyone was in agreement, of course. A good example was the use of "head clutcher" stock images to illustrate mental health stories: while many of the people thought they were lazy and stigma-producing, others felt they were a good visual representation of how they felt when they were struggling.

After weeks of assembling and crystallising, I came up with seven guidelines for anyone who wants to talk about mental health in a way that is genuinely educational, responsible and stigma-free, and called it the Mental Health Media Charter. I collaborated with the fantastically talented illustrator Ruby Elliot (aka @Rubyetc), who designed a special "stamp" that can be used by traditional media outlets as well as bloggers, YouTubers and, crucially, in the context of this column, schools, to signal that they have signed up to the charter.

As someone with a background in journalism, I also knew that I had to make it as easy as possible for individuals and organisations to sign up to. I have acknowledged that the odd headline or image might slip through the net in a high-turnover newsroom environment. I’ve explained clearly why the language or imagery is inappropriate and even suggested a range of alternatives.

This isn’t an attempt to shut down mental health conversation or curtail free speech. Fantastic allies like Bryony Gordon, Princes William and Harry, Jonny Benjamin, Matt Haig and Ruby Wax, as well as campaigns like Time to Change, have done a stellar job of ensuring that we’re able to talk about mental health openly and without fear of judgement – I’m simply trying to ensure that this happens in the most effective way possible, without propagating unhelpful myths and stereotypes.

I am delighted to say that Ann Mroz at Tes was the first editor to sign up to the charter. Our other "pioneer" media outlets are Grazia magazine, the Eastern Daily Press and Heat Radio. To mark World Mental Health Day tomorrow, I’ll be issuing an invitation to the editor of every major news outlet in the UK, inviting them to sign up, too. I’ll then be sharing their responses on social media.

You can see the charter below. If you’re a school, college or university that wants to sign up and receive your stamp, please get in touch. In the meantime, you can share examples of good and bad media reporting, or lobby organisations you believe should sign up to the charter on Facebook, Twitter and Instagram. Search @MHMediaCharter.

Natasha Devon MBE is the former government mental health champion. She is a writer and campaigner and visits an average of three schools per week all over the UK. She tweets @_natashadevon. Find out more about her work here


The Mental Health Media Charter

Created in collaboration with Mental Health First Aid England, the Samaritans and Beat. Endorsed by Girlguiding, the Coalition for Men & Boys and the Labour Campaign for Mental Health

Mission Statement

In endorsing the Mental Health Media Charter you are signalling that you are committed to discussing mental health responsibly, helpfully and in a way that takes into account the needs of the most vulnerable members of the population. You are acknowledging the power of language and imagery in shaping social attitudes and declaring your intention to genuinely educate and to reduce stigma around mental illness.

If work in a high-pressure, high-turnover press office, it is understood that occasionally headlines or pictures will "slip through the net". However, by signing up to the charter you are confirming you will do your best not to:

1. Use the phrase "commit suicide" or "successful suicide".

The term "commit" suggests criminality and blame. We now understand that suicide happens when pain exceeds resources for coping with pain. It is not a criminal act in the UK and has not been since 1961.

"Successful suicide" contravenes what we now understand about the act – most people who take their own life are ambivalent, in that part of them wants to live.

Better alternatives: "Attempted/completed suicide", "took/ended their own life", or even "killed themselves".

2. Show "before" images in eating disorder stories or pictures that could be triggering to people who self-harm.

For people who are in a healthy mindset, seeing "before" pictures of people in the grips of anorexia or who have self-harmed can act as a deterrent. However, for people who are either experiencing or in recovery from eating disorders or self-harm, we now understand that these pictures can become something to "aspire to".

3. Use the term "anorexics", "bulimics", "depressives" or "schizophrenics".

It is important to understand that a person is distinct from their illness. To label someone an "anorexic", for example, suggests that they are defined by their eating disorder. This is not only unhelpful in terms of the way they are perceived by others but it might also hinder their recovery process.

Better alternative: "people experiencing anorexia/bulimia/depression/psychosis". 

4. Avoid giving too much detail on suicide/self-harm or eating disorder methodology.

We now understand that giving a lot of detail about how people have harmed themselves can inspire imitational behaviour – there is a delicate balance to be struck with your responsibility to report the facts of the case. Try to avoid going into too much detail, which will ensure the report is safe for all audiences.

As a general rule, stories should focus on "whys", not "hows".

5. Avoid using generic terms like "mental health issues" when describing terrorists and other violent criminals.

Ninety-nine per cent of people with mental illnesses are more likely to harm themselves than others. In establishing a link between generic poor mental health and terrorism/violent crime, stigma and fear is increased.

Instead be specific – which mental health "issue" did the perpetrator have? Was it, in fact, a personality disorder (being a psychopath or a sociopath is not technically a "mental illness")?

You might also add a disclaimer along the lines of "note that most people with mental health ‘issues’/personality disorders would not commit a crime of this nature, which occur as a result of a rare combination of circumstances".

6. Understand the difference between mental health and mental ill health.

Everyone with a brain has a mental health, just as everyone with a body has a physical health. By using the term "mental health" to describe mental illness, an important discussion which impacts 100 per cent of the population is effectively confined to one quarter of it.

Instead of "battles with mental health" it is therefore much more helpful to say "issues with mental ill health" so that the public can understand the distinction.

7. Include links to good quality sources of support if content might trigger need for help in a reader.

The best charities and support organisations ensure that their web forums are monitored for triggering content (ie, users sharing self-harm or suicide techniques). They do not promote one form of therapy for financial gain but instead describe various treatment methods. They base their content on reliable evidence and have good links with research institutions.

Charities that have this ethos and you may wish to signpost to include: Young Minds (www.youngminds.org.uk), The Samaritans (www.samaritans.org), CALM (www.thecalmzone.net), The Mix (www.themix.org.uk), The Self-Harm Network (www.nshn.co.uk), B-eat (www.beateatingdisorders.org.uk), Mind (www.mind.org.uk)

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Natasha Devon

Natasha Devon

Natasha Devon MBE is the former government mental health champion. She is a writer and campaigner and visits an average of three schools per week all over the UK.

Find me on Twitter @_natashadevon

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