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Thursday, October 03, 2013

Bedlam - the story behind the name of our C4 series

We've had lots of positive feedback about news of the forthcoming Channel 4 documentary about South London and Maudsley.

There's also been concern and criticism about the fact that the series is called 'Bedlam'.

In response to this reaction, we thought we should provide more information about the thinking behind the name.

First off, it's worth saying that our main reason for wanting to be involved in the series was to try and help promote better public awareness and understanding of mental health. It's also true that we wanted to promote our services - not least because so much of the work our staff do is poorly understood by the public.

We thought long and hard and spent more than a year discussing the ethics and practicalities of how filming could take place safely and sensitively. All credit to Channel 4 for allowing The Garden Productions – the team who made the series - sufficient time to plan things properly.

The filming itself was guided by a very carefully thought out set of guidelines that we agreed with Channel 4 and The Garden. We'll be publishing more on that shortly.

But, jumping forward to the issue of the name, it was felt that the working title of 'The Maudsley' or 'Inside the Maudsley' didn't really cut it. The practical problem was that most of the filming didn’t actually take place in the Maudsley Hospital, it was filmed across our other sites and in the community. Deliberately, we had sought from the outset to try and show some of the areas of our work that don’t often get attention, a good example being the work of our adult mental health community services.

Another important factor was that Channel 4 wanted a title that would create interest and attract viewers. So did we. We took part because we wanted to try and help shift public attitudes about mental health. You can't do that if nobody is watching.

By their own admission, the channel has a liking for edgy titles which get people talking and encourage them to watch. But they were very clear they would only go with a title that we signed up to and we were clear from the start that we would only accept a title our staff and patients would be comfortable with. The Garden also said it would need to be a title that they could feel at ease with when discussing with the patients who had given their consent to be filmed.

It was, of course a really tough decision to make as no title is going to be universally acceptable, especially in the field of mental health. More comfortable language like 'recovery' which we are familiar with from an NHS and mental health perspective doesn't lend itself to a snappy TV title.

We also had discussions with executives from C4 about the use of the word “mad” in the title. It has been used on previous television projects and by some mental health charities but we were not happy for any of our patients who had agreed to be filmed to be referred to using language they may find derogatory, demeaning or which may make them question their decision to appear in a documentary like this in the first place.

Talking it through with Channel 4 and The Garden, we hit upon the idea of going ‘back to our roots’. The logic of the name being that South London and Maudsley can trace its origins back to the founding of 'Bedlam' in 1247. For the television producers and commissioners, it's a word that resonates with people who aren't familiar with the world of mental health. And for those who are familiar they will know the significance of the word and how treatment of mentally ill people has evolved since the ‘Bedlam’ years.  

And, yes, it is provocative. The history of treating mental illness is far from having always been a proud one. 'Bedlam' is a name which is often associated with the incarceration of the mentally ill within the walls of the asylum and charging people money to view the 'lunatics'.

For us as an organisation, there's something to be said for making the contrast between the history of 'Bedlam' and the way in which mental health services are provided today (not perfect, by any means, but more focused on trying to help keep people well and out of hospital, and on providing care and treatment that helps people recover).

We were mindful that not everyone would see it that way. We did discuss the idea of canvassing opinion more widely. But, to be honest, we felt it would be nigh on impossible to come up with a title which everyone would be happy with (we can at times be guilty in the NHS of avoiding decisive action by trying to build consensus; whereas this was felt to be a call we should make and stand by).

The Garden asked the patients who had been filmed - they have kept in touch with all of them to make sure they remain happy to be included in the series - and nobody objected. On that basis, we gave the name our vote. It wasn't imposed upon us and we weren't strong armed into agreeing.

From the feedback we've had to date, it's clear that not everyone agrees. Far from it in fact - some people clearly feel, very strongly and very genuinely, that we've made a poor decision that reinforces stigma. We respect this perspective and we are genuinely interested in discussing it. This is why we thought we should try and explain our thinking in a bit more detail.

We hope you agree when the series comes to Channel 4 soon that it provides a much needed, measured and powerful look at an issue which remains shrouded in too much mystery and misunderstanding. And we hope plenty of people will end up watching who may not ordinarily tune in to a documentary about mental health.

Above all, we hope the series continues to generate debate and discussion - too much, too often is left unsaid when it comes to mental health.


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