Bedlam trust: why we let cameras in

Allowing television cameras to film vulnerable patients being cared by mental health services is irresponsible, unethical and intrusive.

‘The risks of allowing the cameras in to film were considerable, the ethics debatable and the practicalities complex’

These were some of the potential criticisms I was braced for when the Channel 4 series Bedlam, filmed over the course of a year at South London and Maudsley Foundation Trust, hit the screens this autumn.  

The risks of allowing the cameras in to film were considerable, the ethics debatable and the practicalities complex. So why did we get involved?

One very good answer to that question comes courtesy of The Sun newspaper. Its decision to run the “1,200 killed by mental patients” front page splash in October shows we have a way to go  to challenge the stigma and discrimination all too often associated with mental illness. Sadly, you do not have to look too hard to find other equally offensive examples. In the past few months alone, you can take your pick from Thorpe Park’s “Asylum” attraction, Asda’s “mental health patient fancy dress costume” or Tesco’s “psycho ward” Halloween outfit (note to Thorpe Park: the costumes were withdrawn after a public outcry).

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This kind of language isn’t just offensive, it can have a direct and damaging effect on people with mental health problems − preventing people from seeking help, acting as a barrier to employment, making it more difficult to discuss things with family or friends (one study found that 72 per cent of people with schizophrenia felt the need to conceal their diagnosis).

Changing attitudes

Thankfully, the Time to Change anti-stigma campaign led by mental health charities Mind and Rethink has established itself as a significant, powerful force in changing attitudes to mental health. And there are some very effective mental health campaigners out there on social media − such as the blogger who goes by the Twitter handle @Sectioned_ − persistently and directly challenging stigma wherever they find it.

In my view, it would be remiss of mental health trusts not to step up to the plate and add their weight to the cause of promoting better understanding of mental health. Moreover, research from where I work at the Maudsley shows that films are as good as social contact in helping to do this.

‘About 2 million people watched the first episode, giving us a great opportunity to help shift public attitudes to mental health’

Another answer to the question of why we got involved is that mental health services still remain much misunderstood. That’s a risk at the best of times, let alone when there is such a squeeze on healthcare finances. When the financial times are tough, it is all the more important  to do everything we can to explain what mental health services do, why we need them and why it is vital that they have “parity of esteem” with other areas of healthcare.

After a year of negotiation and planning, the first filming took place on our triage ward at Lambeth Hospital, which acts as the point of assessment for people with severe mental illness as they first come into inpatient services. In the months that followed, the cameras followed an adult community mental health team, our specialist unit for people with anxiety disorders and older adult services.

I think the four-part documentary series that resulted is a bold, innovative piece of television unlike anything I have seen on mental health before. The stories of the patients who took part were moving, sympathetic and sensitively handled. About 2 million people watched the first episode, giving us a great opportunity to help change public attitudes to mental health.

Positive feedback

Watching the response to the documentaries unfold on social media as the programmes went out provided us with an immediate sense of how they were being received. I was struck − and relieved − by how much of this direct feedback was positive.

‘Too often, too much is left unsaid when it comes to mental health’

There were criticisms, too. For example, some people felt that by signing up to a series called Bedlam we were guilty of being complicit in or naïve about Channel 4’s chase for ratings. I disagree, but I take the point on board and welcome the fact that we were able to have an honest and open debate with people about this.

As well as doing its bit to help challenge stigma, I hope the series will help persuade more NHS mental health clinicians and managers that this kind of thing can and should be done. Too often, too much is left unsaid when it comes to mental health.

Dan Charlton is head of communications and media, South London and Maudsley Foundation Trust