#MHmasks- What’s it all about
Notice: This content was originally located on the post ‘The ugly face of stigma within mental health services”, due to frequent updates I have given the #MHmasks its own page.
Mental Health is ‘everyone’s business’ and reducing stigma is ‘everyone’s’ responsibility
This post comes in on the ‘back end’ of the great British public ‘backlash’ against the stigma astride mental ill health. Directed at the Robert Gordon University for their use of ‘prosthetic masks’ within the training of their Mental Health Undergraduates. You can watch a BBC News reel on that here. Thousands of tweets were shared and exchanged, for the most part with complete outrage, confusion and disappointment.
Read the communications between Robert Gordon University, Professor Kerry Reid Searl and myself on our ‘News and Updates’ page.
I thank Sue from the twitter community for starting off the MHmasks hashtag and all of my fellow twitter friends and protestors for their contributions to the campaign. I would particularly like to thank Alison @allyc375, Chris @walkamileuk and Richard @ManamaCraven for their massive input.
I have found the use of the prosthetics and the ‘peripheral’ reactions from RGU representatives and staff distressing. I too found the concept of using such stigmatising masks triggering and very upsetting. Alison, Chris and Richard helped inject a little light humour into the campaign and pushed their own needs aside to put their views across in their own efforts to stamp out stigma…
The winner of ‘the most humorous tweeter in the face of adversity’ goes to…
Broadcasted and publicised by BBC News Online.
BBC News coverage on the use of ‘prosthetics’ in mental health training by the RGU, watch the BBC video here.
The ‘face’ of mental health difficulty?
Meet the characters:
‘Billy’ (Centre) is a north-east farmer with a strong Doric accent who suffers from depression. He is a carer for his wife who is being treated for cancer. He has considered suicide and is a problematic alcohol user
It is my opinion, as someone who has lived experience of longstanding mental health difficulties, that the Masks do not lend themselves well for training within a mental health care setting, they were originally designed for training within a physical healthcare setting. It appears that this is now being ‘rolled out’ across many areas of clinical practice, including ‘mental health’ training within the Robert Gordon University, RGU.
You can read my views on the masks, stereotypes and negative profiling toward the bottom of this post.
Inga Heyman, mental health nursing lecturer at RGU’s School of Nursing and Midwifery, championed the initiative, which is believed to be a mental health education first in Scotland, after learning about the use of masks in adult nursing education in Australia.
My colleagues and I have been working for some time to enhance our mental health simulation capability. We are very lucky to work with patient volunteers however, there are ethical issues in using them for particularly complex and sensitive issues and we were keen to find another way to engage the students.
On 15th February 2015 the Robert Gordon University apologised for the use of the prosthetic masks and announced their decision to ‘curtail’ them from use whilst reconsidering their position.
On 17th February 2015
Robert Gordon Universities Communications Officer Tweeted:
“Shame to see the #MHmasks bandwagon get to the point where speaking up in favour results in grief. Establish the facts first? #overreaction”
So which one is it Robert Gordon University?
There have also been accusations that undergraduates have been ‘bullied’ and ‘harassed’ by those protesting about the prosthetic masks. I have not yet seen any evidence of this, the opposite, in fact, appears to be true. I myself have received unhelpful, unprofessional tweets from RGU trainee nurses and senior staff.
I have referred to these accusations from individuals “as an attempt to deflect from what is important”, this has been put directly to Robert Gordon University.
You can see here the comments from fellow tweeters on Storify some sorrowful, some disappointed, some disgusted, some humorous, however I have yet to come across tweets evidencing the ‘alleged’ harassment. If there has been harassment, I do not condone that, what I will say is that I would hope the university consider it important to address the route of the concerns.
The #MHMasks campaign is covered by the national press
University slammed for using Hollywood-style horror masks to train students how to deal with the mentally ill
This morning I came across this article online, another prompting attention toward the alleged ‘harassment’ of the Robert Gordon University staff, RGU. Here is part of that article, you can read the full article here.
Staff and students “targeted” over controversial Hollywood masks
University staff and nursing students have been targeted over the controversial use of prosthetic facemasks during training. Robert Gordon University has complained to the Scottish Government over the issue. It comes after senior NHS staff in Scotland used social media to apparently criticise the use of the masks. Separate claims have been made that students were “harassed” online over their support of the training method with lecturers also receiving hostile messages, it is understood.
It was disappointing to read yet another piece focusing on the ‘wrong’ issue. I have referred to this as ‘deflection’. I had already mentioned in my article on February 18th that I had not seen any of the alleged harassment towards the RGU staff, what I had experienced was unprofessional, stoking responses from nurses and senior staff of the university.
What I will say, and I know that my fellow campaigners feel the same, is that we need to focus on what is right for everyone, that includes prospective nurses, service users and the wider audience. There needs to be open and transparent discussion about the MASK-ED system and its use within mental health training.
I wrote an email to the inventor of the MASK-ED system, Kerry Reid-Searl, here’s what I wrote:
Sent: 20th February 2015 13:20:24
CQ University Australia
FAO Kerry Reid-Searl
Re MASK-ED/ KRS System: use within Mental Health Training
I am contacting you from London, UK. My name is Rosalind I have written an article within which both you and the ‘MASK-ED’ system have been mentioned, please see link below.
The ‘Robert Gordon University’ in Scotland had used the MASK-ED innovation within their training of mental health undergraduates and staff. Thousands took to social media protesting the use of prosthetic masks being used within the training of mental health staff.
Here is my article:
The universities response:
The university released a prompt and respectful statement noting that they had decided to ‘curtail’ use for further consideration and discussion, however not 24 hours later senior staff from the said University began ‘re-stoking’ the issue by tweeting and ‘re-tweeting’ negating comments on twitter.
The University appear to have been deflecting from further looking at the depth of stigma attached to the use within mental health training by accusing protestors of ‘harassment’.
I am one of the objectors of use [use within the training of mental health staff] and a key contributor and had not come across any such harassment. I personally was accosted by Robert Gordon University nurses and was disappointed by the Universities communications officer ‘stoking’ the situation when a pacifying statement had already been released. In a nutshell, much negative attention is being drawn to the MASK-ED system.
I have politely asked the Robert Gordon University that the investigation and discussion regarding this innovation being used within their mental health training is transparent and made available to all who have shown great concern.
Here is an article about the accusation of ‘harassment’:
It is my opinion that the ‘MASK-ED’ system is innovative, I congratulate you for that, however I firmly believe alongside thousands of others that there is no place for these masks within ‘mental health’ training. I would like to point out that I have lived experience of mental health difficulty and have seen first hand the pre-existing stigma that sits within the mental healthcare system already, I also work hard to reduce the stigma attached to mental health difficulty. Alongside myself, clinical professionals, managers, nurses, former CEO’s of NHS institutions and individuals from all backgrounds have shown disapproval and great concern about their use within mental health training.
I note that this innovation has been used effectively within the training of nurses and is being rolled out across various settings and modalities however this clearly is not a system to be brought into mental health training.
I wonder if you would be kind enough to share your views on using the MASK-ED system within mental health training. I note you are trained in Paediatrics, Reproductive Medicine and Midwifery. I would be particularly interested to learn if any research or discussion has been had with mental health experts on this matter, both experts by ‘lived experience’ and experts by ‘academic training’.
Thank you for reading.
Read more communications between Robert Gordon University, Professor Kerry Reid Searl and myself on our ‘News and Updates’ page.
MASK-ED™ (KRS simulation) is a simulation technique created by Associate Professor Kerry Reid-Searl at CQUniversity Australia in 2010. The technique is informed by a teaching process and involves realistic body silicone props including masks, torsos, arms and legs worn over the informed educator to mask them. The hidden educator then transforms into another identity, as a character/person with a history/story that is relevant to the learning experience. The character and their history becomes a platform for teaching. The technique involves a three way interplay involving the educator, the character and the learner.
The interplay allows the hidden educator to direct the learning process as they create a spontaneous and realistic simulation experience, informed by their knowledge as the expert, to the learner. The KRS component stands for knowledgeable, realistic and spontaneous simulation. The technique is about constructing realities for learners and provides them with practical experience in the realities of their discipline. It enables learners to make sense through reality, it promotes reflection on practice and serves as a strategy that caters for different learning styles. Whilst initially designed for undergraduate nursing students in the teaching of nursing skills, the technique has application in multiple disciplines.
So many shades of wrong, ‘Fifty shades’ is nowhere near!
For me there are many concerns that I have about the use of these masks within the mental health education system. The main issues are:
‘Apparent Competence’-Looking beyond ‘what you think you can see’
I personally have found that the only way to ‘survive’ whilst trying to live through mental health difficulty is to ‘wear a mask’, ‘put on a costume’ that enables me to engage in what most would consider to be normal ‘every day’ activities. You can read more about that in this post.
On the surface I will ‘for the most part’ appear relatively ‘stable’, within which, much of that time is spent deeply unhappy, unsettled and very ‘unstable’. ‘Masking’ is a ‘survival skill’ that many use, it is when there is an underlying deep rooted mental health problem that is being ‘masked’ that this learnt ‘survival skill’ proves to be unhelpful. It is important for clinicians, mental health nurses and healthcare staff to learn their own skills in ‘reading’ the human being that is in front of them. Body language, facial expression and gesturing give vital clues and indicators as to what might ‘really’ be going on. You can not learn that skill through a prosthetic mask, there is an immediate ‘barrier’ or wall that is formed between the ‘educator’ and the ‘trainee’.
Stereotyping, negative profiling and reinforcing pre-existing stigmatising views
There is so much pre-existing stigma, do we really want to reinforce any negative stereotyping? My experience has been that I am often not ‘heard’ because healthcare professionals have not ‘seen’ me to be unwell. That is a very scary place to be, torturous in fact because the truth is people ‘generally’ do not give ‘credence’ to mental illness because it is ‘invisible’.
Fitting the ‘profile’: Caught between a rock and a hard place
On the other hand, there lies the view that if you are mentally ‘unwell’ or experiencing mental health difficulty you’ll be dribbling or behaving in an obviously inappropriate way. I have often wondered if it would be better for me to allow myself to ‘deteriorate outwardly’ (even more so than the first things to go when I am finding life particularly tough like showering, cooking, getting out of bed, getting dressed, eating, thinking). I have found myself actually feeling a sense of heightened ‘insanity’ as I have questioned my own difficulties because of the ‘pre-existing’ stigma within services, are ‘my’ difficulties ‘real’.
Feeling ‘unseen’ by healthcare professionals is so very difficult to experience, after all, these individuals are like life buoys being thrown out to you when you feel like you are drowning (or not, as the case may be).
Do those of us experiencing mental health difficulties want to look ‘ill’, ‘un-kept’ or like ‘perceived thugs’ as per the prosthetics used by the Robert Gordon University? I think not, and for the most part, we do not. We do not all look the same, we differ, of course we do and thank goodness too. It is my sincere hope that healthcare professionals and trainees will be gifted enough to look beyond what they ‘think they can see’.
I came across this video and thought I would post it in dedication to all of the young people out there experiencing mental health difficulties
I found it very disappointing that the Robert Gordon University were so ‘proud’ of the prosthetics being used within their training of mental health nurse undergraduates and staff. What I have found particularly ‘interesting’ is that they hold a massive responsibility in their hands and have failed to note without wide intervention and prompting, that these ‘character portrayals’ are wrong on so many levels. I also found the defensive approach from Robert Gordon University staff (after the RGU statement and apology) disturbing. These individuals have a huge responsibility in their hands, there is no room for a defensive stance when it comes to the eradication of stigma generally, let alone ‘mental health’ stigma.
I have politely asked the Robert Gordon University to provide a transparent, detailed outcome review. The masks have been curtailed for mental health training (for now), I would certainly appreciate an expanded statement sharing their own views after further consultation.
“No health without mental health” World Health Organisation
Watch our video ‘wouldn’t it be good’– ‘Looking beyond what you think you can see’
View the background of the #MHmasks campaign in a story format:
or here for a full summary of all of the tweets from fellow outraged tweeters in twitterland (chronological order).
Here are some very insightful posts in response to the use of prosthetic masks within a mental healthcare setting:
find @nurse_w_glasses on twitter
Chris Young @walkamileuk
find @walkamileuk on twitter
find @bdogrunner on twitter