Taking part in Channel 4's Bedlam, episode 4: Breakdown

Dr Tony RaoDoctors who chose a career in psychiatry will tell you that there is often a look of disapproval from other doctors when you tell them that you want to specialise in mental health.

I remember the puzzled expressions on the faces of doctor colleagues when working on a medical ward and informing them of my chosen career path. It was almost as if they thought that I wasting my time.

Little did they know that I had chosen my career well before medical school, influenced heavily by my mother who was a psychiatrist looking after a 200 bedded community hospital for people with learning disabilities.

Having grown up accompanying her on ward visits during my school holidays, I cannot pretend that witnessing behaviour and social interactions from some of the people living there did not make me feel frightened and uncertain about how to respond. Little wonder then that public opinion is shaped by a poor understanding of mental illness, much of which fuels stigma and the discrimination that follows.

At first, I was extremely sceptical about the ethics of filming potentially vulnerable older people

One of the main duties of a doctor is to protect patients who are at risk of exploitation. People with mental illness are even more vulnerable in that a life event such as being seen by millions on television can risk a relapse in their illnesses. In fact, I had previously been involved in another documentary where one of my patients was filmed and the stress of this ordeal led to a relapse and a hospital admission.

The whole process by which Bedlam was thought out and carried out proved to be a completely different story. Here was an opportunity to show the public that older people do get better from their mental illnesses and can live their lives to the full, independently and in their own homes.

As Professor Howard says in the episode Breakdown, older people suffer a 'double whammy' of stigma, related to both age and mental illness. Here was a chance to open our doors to the public, but this needed to be handled with care, compassion and dignity.

Lights, Camera, Action!

The whole process of introduction, preliminary enquiries and filming took place over an 8 month period, from January to August 2013.

Even after the first meeting with the production team, I still needed convincing. Although my patient had given consent to be filmed on the ward, I needed to be re-assured that filming was done in a way that was not intrusive and that reflected the real life encounter of an outpatient interaction.

It did not take long for me to change my mind. The first and all other filming sessions were done in different segments, so that it did not give me or my patient the feeling that there was a camera constantly on us. I was also particularly impressed by the 'pastoral' support provided the production team, who showed sensitivity and genuine concern for the welfare of my patient, extending to the time spent in the community, where he was also filmed at regular intervals.

What was the big idea in filming older people with mental illness?

Both the popular press and contemporary literature is permeated by a deep seated ignorance of what mental illness is and how devastating it can be to those who mostly suffer in silence for fear of being victimised or having to suffer from some form of abuse or exploitation. By opening the door to a whole new understanding of mental illness and showing the positive effects that treatment and care can offer our older people, Bedlam pulled off a truly remarkable feat.

Even after filming had finished, the production team remained in contact with my patient, showed him the episode in advance and asked if he had any concerns about any of the footage that involved him. Even at the outpatient appointments and home visits where has was not filmed, he spoke about the production team in glowing terms and waxed lyrical about their kindness and open line of communication with him whenever he had any concerns.

In a way, Bedlam has also been part of the recovery process

By feeling that 'someone out there is listening to me', the awareness that others may have a better understanding of what it is like to live with mental illness was a critical part of the process of improving mental health and wellbeing. This was far cry from my own fears and prejudices of what might happen with filming older people with mental illness, all those months ago.

I am excited by the prospect that Bedlam will represent a landmark documentary for the 21st Century. Not least because it has immense potential to change public attitudes towards mental illness, putting us further along the road to tackling stigma and ending discrimination for good.

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Comments

Bedlam

These programs make me want to cry. I would be very interested in seeing programming that followed the lives of people who lead 'normal' lives after diagnosis as I believe this would go much further in reducing stigma. Next month will be 10 years since I was diagnosed with bipolar disorder. My stay in hospital was very brief and I have never been admitted again despite being a carer myself. However, I took control of my own recovery and did not leave it to my mental health team who I felt were useless. This may not be the case everywhere but it is my experience. I now work in a psychiatric hospital and have to say I have very little faith in them really helping the majority of people who end up in them.

The lady having lost the sense of self and the use of ECT

I really appreciated the way psychiatrists and other members of the staff handled the case of that lady having severe depression and treated using ECT treatment.The results showed an impressive change in the person`s life and she was able t have a dialogue and to recognize herself ,so where antidepressants are not working in some cases ECT seems a very powerful answer.Thanks for sharing some insightful experiences.

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