Showing posts with label mental distress. Show all posts
Showing posts with label mental distress. Show all posts

Saturday, 27 September 2014

Interview with Mark Brown : One in Four magazine and beyond...

More views of - or before - Cambridge Film Festival 2014 (28 August to 7 September)
(Click here to go directly to the Festival web-site)


22 September

Mark, starting first with One in Four magazine, of which you were founder and editor, and which folded earlier this year, following a short statement made to subscribers...

Shortly afterwards, you elaborated on that statement in a piece in The Guardian, which was then commented on by Ruth McCambridge in Not For Profit Quarterly.


1. Is there anything more that, at this remove, you wish to say about the reasons why One in Four ceased publication ? (If appropriate, please point to accessible places where you have already said something more than in the sources above.)

After all, the announcement did come soon after the publication, in the editorial of the Summer 2013 issue, of the magazine’s five-year mission. On the other hand, in a statement when an issue had not appeared on time, you told readers that the depressive experience of having a diagnosis of Bipolar II had been responsible : ‘The autumn issue of One in Four eaten by the editor’s depression’. (McCambridge took the opening words of your statement as the title of her piece, So, what kind of a monster eats a mental health magazine ?.)

One of the things about running a magazine is that you always have to talk about it as if it is eternal and will continue forever. Projects like ours live hand to mouth and nothing is ever certain.

In the magazine business, publications begin and end all of the time. It's a ruthless area where the continuation of a magazine depends solely on its profitability.

With One in Four, the revenues available to continue it dropped as the effects of austerity became further and further ingrained. While the individual subscription rates were rising, the bulk subscription rates flatlined.

For the final few years of One in Four, the magazine was overwhelmingly me; and me in a way that wasn't contributing to the bottom line of our company. We cut the costs of the magazine, trimmed all wastage and made it cost neutral - as long as my time wasn't factored into the equation.

Where once I might have been able to continue the magazine, knowing that it was in some way contributing to the continuation of our company and indirectly towards my own wages, we ended up in a situation where One in Four was a great project as long as I and everyone else (apart from writers) gave our time to it for free. This coming at a time where the importance of doing activity that paid was becoming more and more important.

After six or so years, I ran out of energy and steam. When you have limited resources, you fill in for missing resources with your own time and effort. This is always a risky strategy as once you run out of yourself; that's it.


2. Supplementary question :



Whatever one thought of it, it seems hard to believe that we once had a Social Exclusion Unit (which then became, before its abolition in 2010, the Social Exclusion Task Force)… However, that fact makes this aim that you stated in The Guardian having had for One in Four seem even more relevant :

We wanted to alleviate some of the isolation people with mental health difficulties feel.


Politics apart, but just thinking of the increasing pressures on NHS Trusts to reduce budgets, by losing in-patient beds and cutting services, was it a more realistic expectation that a publication that editorially implied a psychosocial (or other non-medical model) of mental health, e.g. by using a term such as 'mental health difficulty', could be of interest to bodies in the third sector, rather than Trusts ? If so, what would that realization have had you do differently at the outset ?


3. As its issues appeared, one thing that one noticed about One in Four is that, compared with the first ones, they no longer exactly fitted this description (taken from the oneinfourmag.org web-site) :

One in Four is a glossy full colour quarterly 32-page quarterly magazine written by people with mental health difficulties who lived through it and found ways around it. It’s the perfect guide to getting stuff in your life sorted.


Therefore, in terms of how One in Four looked, and, in particular, thinking of that word ‘glossy’, how later issues no longer had the same paper or feel. And, without checking, it seems uncertain whether ‘full colour’ continued to be an apt description…

Were these early signs that what the magazine had hoped to be, i.e. sold ‘in bulk to NHS trusts’, had not happened, and thus that there was not the expected funding for it to be as described. And do you think, in turn, that factors to do with appearance and feel could have impacted on the saleability of One in Four, to potential subscribers as well as to contributors (or advertisers, though the impression that was that advertising revenue was not likely to be significant) ?



To be honest, I don't think that anyone who subscribed to the magazine was hugely fussed about the full colour and glossy bit. One of the reasons that we chose the idea of a glossy lifestyle magazine was to set it apart from either bland and ridiculous corporate brochures on one hand and photocopied ‘anything-you-fancy-putting-in-can-go-in’ photocopied newsletters.

We thought that there was a big gap where something well written and well produced could go. Bringing the idea of mental health out into the open; both in terms of making something that anyone could read, but also in terms of wrestling back the media power over mental health representation a bit. We wanted, as much as possible, to place mental health stories in professional standard settings to show that a) it was possible and b) it was better than the more traditional ways of covering mental health such as ‘the tragedy narrative’, ‘the overcomes adversity narrative’, ‘the everything’s going to be terrible forever narrative’ or the ‘jesus christ them mentals are coming’ narrative.

It was, and still is, an approach that should be taken.


Advertising revenue was never really on the table. There isn’t a notion of people with mental health difficulties as a market to be sold to. If you open a disability magazine, you’ll see adverts for a whole range of disability adaptations and services. There isn't the equivalent for mental health. We took on an ad sales executive for a bit, but I don't think we ever got any bite from an advertiser that we didn’t already know and who wasn’t already operating in the mental health field.

As I’ve written about elsewhere, it was always going to be a risk attempting to make One in Four stand on its own feet financially without any outside support. In some respects, our glossy approach was a double-edged sword. For everyone who was glad that there was a new, fresh way of looking at mental health that you could leave on your coffee table with your other organs of note, there was someone else lining up to have a pop at us for being slick profiteers, looking to turn a quick buck from the misery of others. People equated glossy with inauthentic, something that riled me then and riles me now. People always vastly over-estimate how expensive printing is, while vastly under-estimating how expensive actually getting what you’ve printed into people’s hands is. And the thing is, it doesn’t matter whether you run your magazine off on a photocopier or get it printed on glossy paper, it mostly costs the same to send it to people.

By the end of One in Four we had worked out the print costs so that every additional 1,000 copies of the magazine would cost about £160, as long as we were printing over 1,000. If we could have delivered the magazine in consignments of 1,000 to NHS trusts, we could have charged pennies for them. The problem was : without the bulk orders to make things work, posting individual copies to subscribers was, and is, extremely expensive.

In the first couple of years, we had people complaining that we charged £10 for a year-long subscription, claiming that it should be free. By the end of the magazine, we had put up the price of a subscription to a whopping £12. For the people who believed that the magazine should be free for ideological reasons, the fact that we were producing it at all was an affront, and that it was glossy sealed our fate as moustache-twirling top-hatted capitalists.

So, as I say, the glossy bit never proved to be the definitive you'd imagine.



4. I know of one countywide mental-health advocacy service that subscribed to benefit its clients. However, were such organizations doing so, too, not the norm, even in an area that is the territory of voluntary-sector organizations such as Turning Point, local Mind associations, or Speaking Up! ? Outside advocacy, was the purchase of copies by this sort of charity, to give free to those with whom they came in contact, as good, or even better ?


Yes, there were organizations that purchased the publication to give, free, to members or visitors, but there were never enough. The problem that many organizations had was that the magazine was an actual magazine, not a brochure or a bit of location-specific health promotional material. The thing with a magazine is that it's a thing that you read that’s full of lots of different stuff, like a buffet for your mind and eyes. The key is to having a variety of dishes that combine together well, but which can also stand on their own. This is not the model that organizational comms use to think of ‘mental health promotion'. It’s all about message, message, message.

The thing that we didn’t really grasp initially, but really grasped as the project went on, was that One in Four didn't provide any glory for the organization that bought it in. It didn’t come from them, it didn't have anything specific to them, it didn’t promote them. It was great that organizations thought ‘We’ll buy this in, because it’s good and something different to what we would produce’, but there weren’t enough that thought like that.



5. As mentioned, your colleague and you obviously had intentions and expectations for One in Four, and maybe some sense of what unexpected turns of events might be (to help you plan for What if…) : now, do you see it essentially in the unforeseen that the origins of the demise of the magazine lay – and how that then impacted on what you felt personally that you could achieve (or still desired to achieve) ?

And, with the end of One in Four, is there scope to keep any content available to read through what remains of Social Spider (whatever that may be) ?


In the final two years of One in Four, One in Four became less and less of Social Spider’s overall activity. It went from having one full-time member of staff, one part-time staff writer and me spending a lot of time each week on it, plus a designer and an on-commission ad sales manager, to being just me and a voluntary designer. We always paid our writers, though. Maybe not as quickly as we, or they, would have liked. But we always paid.

In an effort to make One in Four sustainable, we essentially diversified our work around mental health and the other kinds of projects that we do. Since we brought One in Four to an end, Social Spider - as a small social enterprise - has never been in ruder health.



6. Turning away from what has happened with the magazine, what, at its best (as we mentioned above a time when depression swallowed an issue), has it meant to you to be its editor – both as a person, and in what it has enabled in your life outside work ? In particular, I gather that you worked from an office, so what did going there to work on One in Four give you ?


Social Spider has always tended towards the lowest possible overheads. It’s been based in other people’s offices, in the basement of the offices of an upmarket sex-shop, and currently lives in a three-desk office above The Mill, a community run space in Walthamstow. For me, I tend to work wherever I am, via the wonders of plugging in laptops and being on a mobile. I actually moved to Social Spider from another social enterprise that Social Spider was getting free office space from originally. At the point I moved to Social Spider in 2006, I had been editing a creative-writing web-site for three years, and doing creative-writing projects.

One in Four was amazing. A pain in the arse. But amazing. It’s given me the perfect excuse to spend my days talking to people with mental health difficulties, exploring what life is like and thinking about how it might be possible to make the way we deal with mental health as a society less shitty.

And, make no mistake, it is shitty. And shitty for lots of reasons we haven’t even begun to address yet.

Outside of work ? There’s an outside of work ?

In some respects, the whole experience of launching a national project that I made up, and then becoming the reluctant front person for it, has been the making of me.


7. Then, as now, you could be seen Tweeting content from conferences in the UK, and perhaps you are still running some of the training courses in topics, such as effective use of social media, that you did before. Are you in a position to say yet what else you may be doing ‘behind the scenes’, or is too early ?


8. Some will know your comments quite well on Twitter, but, for others, can you place what the magazine was about in relation to what often gets abbreviated in Tweets (maybe unhelpfully ?) to #socent – can you say what it is about a magazine as a social enterprises that makes it distinctive, and what are its strengths and advantages, as well as its likely drawbacks ?


When we were doing One in Four, I always tried to stay on the side of impartial journalism over committed journalism. This meant that we got some flak for covering the facts of the introduction of ESA [Employment and Support Allowance], rather than advancing opinion that it was wrong.

Looking back, one of the things that I wish that we could have had with One in Four was more investigative journalism. But that was out of our reach, I think. I still think we need more journos covering mental health, and that more of them should be people with direct experience...

I really do think there's a huge space that a strong press should occupy in mental health, but that's a very different project to One in Four. I don't ultimately think that there's a commercial model that could sustain both news reporting and investigative journalism in mental health in the UK. At the minute, even with the bloom of mental-health-related stories in UK media, we're only getting the surface of stories, not their core :

A lot of the time in this country, we (me included) have thought we've been doing journalism, when we've been doing comment. Good, but the thing is that I don't see anyone anywhere who can put up the cash for the journalism needed to capture, and hold to account, events in mental health.

I wonder whether we'd see more attempted legal take-downs of mental-health bloggers if we could find a bit of money to finance journalism. At the minute, bloggers who do proper journalistic work, digging and covering stories, are vulnerable to the more powerful taking legal action, and there are a lot of mental-health-related stories that need exploring, but very few homes for them ‘to land in’ and that pay for the work.

Journalism is expensive, because it requires people to go to places, talk to people, find things out… It is out of reach for mental health in the UK at present, because we're blighted by a lack of historical context in the way in which we present current events, because, again, we have no press. And, if you're lucky enough to get the email 'Would you like to write about mental-health issue X ?', no one will stump up the cash for research.

Plus, there are very few people in the UK who know the mental-health ‘beat’ as journos to the level needed to link across stories : I mean, when was the last time that you saw a mental-health-related story that came from a top, high-level source, and was built on research ? Although I know a fair bit these days about mental health in this country, because I used our own money to find stuff out when doing One in Four, writing about mental health for public consumption has only ever been a small bit of what I do to pay the rent.

Money = time to get stories right, whereas, a lot of the time during the life of One in Four, our company and I very nearly couldn't pay the rent. I sometimes wonder who has contacts close to where decisions are made in mental health, and what it would take to turn those contacts into stories…


9. At the time of our previous interview (which has had more than 700 page-views), we looked at what you called The New Mental Health, which tied in with a first-ever trip outside the UK to Australia. I think that it was to a destination in the Republic of Ireland that you recently made another return-flight to give a talk.

How can you tie in these book-ends of speaking engagements both to what has been happening to your experience of life, and as you have seen it affecting the lives of those being told, for example, that they are ‘under-occupying’ property, even if ‘the spare bedroom’ is needed, say, to house dialysis equipment ? And how, if at all, have your ideas about The New Mental Health changed in the intervening time ?


10. Thank you for your time, Mark. Is there anything else that you would like to say in conclusion ?




Unless stated otherwise, all films reviewed were screened at Festival Central (Arts Picturehouse, Cambridge)

Tuesday, 29 January 2013

The Language of Mental Health

More views of - or before - Cambridge Film Festival 2012
(Click here to go directly to the Festival web-site)


29 January




I hope that I may be excused for using this Tweet to illustrate a point or two*...

First, for good or ill (and from such things as having mental health services and a Mental Health Act), the words ‘health’ and ‘mental’ are linked, but it is typical that, when we mean mental ill-health we might write mental health, and vice versa.

It might be personal to me, but I hate – I almost cringe – this idea that mental distress should be linked with suffering. Not that people do not sometimes have a very painful, tortured time with voices or with depression, but just that one of the things that people believe, because they are inclined to say (or think) Bloody pull yourself together !, and why make it easier for them to say that those who have mental-health issues are suffering self-indulgent martyrs ?

Interlude : I was at the One in Four conference four years ago, where the topic was that of this posting, and I just wonder how far we have come on, because it is my belief that even the mental-health world is not united in its use of language. You may not have spotted, but I have already used Mind’s preferred term, of mental distress, and one that those who have had contact with services sometimes use, of mental-health issues - Mind’s misses out the emphasis, still so prevalent, on health, whereas the other phrase focuses on the issues. Then again, the preferred words in One in Four magazine are mental health difficulty

So, there is no common language, which does not make communication any more straightforward, and the word depressed can mean, at one end, someone willing to undergo ECT not to be so numb and to feel something, and, at the other, someone a bit weepy because cooking dinner did not turn out right.
Back at our Tweet, the final thing that I wanted to say is that, when we wish that a friend with measles gets better soon, we do not look for – though it might be needed – some moral improvement.

However, I am not so sure that this sense is not imported into the language of mental health, because, on the sly, there is a belief that there is some sort of malignancy or turpitude in having a stay in a psychiatric unit, even if it is at the level of It’s all right for some ! from disgruntled colleagues or the like. (Talking, instead, about recovery does not make things any more palatable, for me, but creates more difficulties.)
We are urged to talk about mental health, by campaigns such as Time to Change, but do we have the words in which to do it that are not already laden with cynicism, connotation and criticism… ?


End-notes

* Not to pick at the writer of this Tweet, but at what the instinctive choice of language tells us all about this subject



Tuesday, 24 July 2012

What does the word 'stigma' tell anyone ?

More views of - or before - Cambridge Film Festival 2012
(Click here to go directly to the Festival web-site)


25 July

These are some further thoughts about what meaningful message, if any, is given to the public by talking about the stigma of mental ill-health*.


I suspect little more (and who judges a book by its cover - don't we all?) than titles of texts such as, being quite random, The Tao of Pooh, The Road to Wigan Pier, The Dancing Wu Li Masters or Lady Windermere's Fan.

Yes, they identify something, and not always exclusively: for example, film convention is to write Psycho (1960), not least as it was re-made**.

Do titles / names do any more than identify***? Only, I feel, if they are apt, rather than arbitrary (remember the times when no one knew what counselling was, and everyone had to explain that they weren't seeing a counsellor to get advice?): as my footnote says, the titles that Breton gave to Gorky's paintings seem apt, as does The Canterbury Tales.


Contrast that with The Merchant of Venice, because many people (we have probably all still heard of Shylock) would be pressed to say who the person is to whom the title relates. Do we want that sort of confusion, if we are talking about the very real effects that other people's attitudes (not always conscious) have on almost every detail of the lives of people with an experience of mental ill-health?

For those attitudes get translated into a behaviour with as many points on it as most spectra, from which, maybe:

* funny looks

* crossing the road to avoid

* suddenly halting a lively conversation

* name-calling

* telling stories to councils, the Department for Work and Pensions, social services, TV Licensing, the RSPCA, etc.

* excrement on the car / through the door / over the fence

* damage to property, pets, plants, etc.

* putting burning paper through the door

* personal physical attack

* arson (burning paper through the door that 'works')

* murder (where death is not the result of the arson)


That's for the home-life of that person - home, or feeling that one has one, being much of what is left. Since the chances are that, if he or she had a job, an enforced hospital stay led to another spectrum of behaviours, ending in dismissal or resignation. (Home, that is, if an arsonist - or a violent partner - left any home remaining, other than the streets.)


A grim picture? Not an exaggerated one, though, because all of these things do happen, and one thing can lead to another - after all, who is an expert in responding non-provocatively to that sort of attack on who one is and what one has?

No worse considering it than the fact that the mental-health community shudders every time some violent or fatal crime is associated with the perpetrator's mental ill-health, because a backlash is feared. I come back to that phrase:

Who one is and what one has


That is what we want to protect****:

Who one is can so easily and so subtly be under attack, a stealthy attrition that is upon one before one is aware of it, just as is what one has, mentally or, in physical / emotional terms, the little that one calls a home, family, or friends, all of which have a tendency to slip away, if they did not already at whatever breakdown is (the Peer Support Workers call it psychiatric challenge).

Stopping a world continuing to exist where these things happen and are casually - or callously - taken for granted is what combating stigma should work for:

The verbs to traumatize and to stigmatize (both from Greek, so they have a similar ring) are closer than we realize, and using the word 'stigma' - to me - says not nearly as much.


We are stigmatizing people for things that they did not choose to happen. They are not weak, they do not deserve it - if it meant anything to our society any more to say it, we would know that There (but for the grace of God) go I.

This is the significance of talking about one in four people - not that one gets into a four where there already 'a mad person', so that one is magically safe, but that the former slogan of The National Lottery applies: it's not you yet, but how do you know that it won't be?

We must not traumatize people further for what has already left them traumatized - if we were human beings in any real sense, we would stay with them while they seek to tell their stories, weep with them over what has happened already, and help them to heal, and to feel healed, not judged, criticized, abused, spat out and scapegoated.


And, above all, we would burn that stupid slogan out of our hearts, Sticks and stones may break my bones, but words will never hurt me.




End-notes

* Or whatever one's preferred term, as, sadly (in a way), there is no agreement even on that: e.g. mental distress (Mind), mental health difficulty (One in Four magazine), mental illness (NHS), etc., etc.

** Re-made, apparently, unhelpfully faithfully, according to one person who could not see the point of re-enacting the old screenplay.

*** Hesitating to dilate on what is added (or lost) when a visual artist calls every work Untitled, although I will recount how a symbiosis occurred between a painter and a poet:

André Breton, spokesman for the Surrealist movement and a poet and novelist, came to know Arshile Gorky and his works. The two men had a good relationship, such that Breton wrote about and gave rise to titles of many of Gorky's later works

With a good (i.e. apt) title (like The Canterbury Tales), can it be separated from the work, because it is now part of it (and of its meaning)?


**** Even if the dismissive (and damning) ways of some consultant psychiatrists can make the job harder, right at the outset, of that person believing that he or she will not always be like this, always need medication, never get back to work, because it is too stressful.