Stigma: the representation of anorexia nervosa in UK newspaper Twitter feeds.

BACKGROUND: There is evidence that the representation of mental health in newspapers has an influence on readers' attitudes, however, relatively little is known about how the industry presents accounts of anorexia nervosa. Further, the industry increasingly uses Twitter as a medium for reaching readers and this remains an under-examined area of research. AIMS: To explore the representation of anorexia nervosa in the UK national press' Twitter feeds. METHOD: Frame analysis was used to examine the manner in which anorexia nervosa was represented in the Twitter feeds of all national UK newspapers between 2009 and 2019 (n = 332). This qualitative approach used Braun and Clarke's stages of thematic analysis, while drawing on Van Gorp's use of a frame matrix to support the definition of the news frames. RESULTS: The analysis identified four news frames: social model, illness model, stress-recovery model and clickbait model. CONCLUSIONS: The newspapers drew on a range of perspectives in their representation of anorexia nervosa, which typically were not stigmatising in their accounts. However, there was a pattern of using sensationalistic images in some of the tweets, which may encourage readers to view people with anorexia nervosa as Other, and as a consequence contribute to stigmatisation.

Stigma: the representation of mental health in UK newspaper Twitter feeds.

BACKGROUND: The press' representation of mental illness often includes images of people as dangerous, and there is evidence that this contributes to stigmatising understandings about mental illness. Little is known about how newspapers portray mental health on their Twitter feeds. AIM: To explore the representation of mental health in the UK national press' Twitter feeds. METHOD: Content analysis was used to code the Tweets produced by UK national press in two time periods, 2014 and 2017. Chi-square analysis was used to identify trends. RESULTS: The analysis identified a significant reduction in the proportion of tweets that were characterised as Bad News between 2014 and 2017 (χ2 = 14.476, d.f.=1, p < 0.001) and a significant increase in the tweets characterised as Understanding (χ2 = 9.398, d.f.=1, p = 0.002). However, in 2017, 24% of the tweets were still characterised as Bad News. Readers did not retweet Bad News stories significantly more frequently than they were produced. CONCLUSIONS: There is a positive direction of travel in the representations of mental health in the Twitter feeds of the UK press, but the level of Bad News stories remains a concern.

Crisis resolution home treatment team Clinicians' perceptions of using a recovery approach with people with a diagnosis of borderline personality disorder.

WHAT IS KNOWN ON THE SUBJECT?: It is known that people with a diagnosis of borderline personality disorder often experience crises in their mental wellbeing. There is little evidence about the approaches of mental health nurses in community-based crisis teams when working with people with a diagnosis of BPD. WHAT THE PAPER ADDS TO THE EXISTING KNOWLEDGE?: This paper highlights that limited resources, work-patterns and issues of stigma present challenges to delivering recovery-oriented care. The paper highlights that nurses typically try to navigate the challenges to continue to provide individualized care, though their self-assessment is that this is with mixed success. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest that support is needed to develop brief interventions specific to teams working with people with a diagnosis of BPD who are at a point of crisis. ABSTRACT: Introduction People with a diagnosis of borderline personality disorder (BPD) are often in contact with mental health services at a point of crisis, and in the UK, this includes Crisis Resolution Home Treatment teams (CRHTT). There is a drive for services to be recovery orientated; however, there is little evidence about the degree to which community services achieve this for people with a diagnosis of BPD when in crisis. Research Aim To understand the perceptions held by CRHTT clinicians about their provision of recovery-orientated acute care, for people with a diagnosis of BPD. Method From a purposive sample of a single CRHTT, seven registered mental health nurses were interviewed and Braun and Clarke's thematic analysis framework was used to interpret the data. Results Five themes emerged: person-centred care; the timing is wrong; inconsistent staffing; the risks are too great; and BPD as a label. Discussion The results demonstrate tensions between a drive to deliver person-centred care and a range of challenges that inhibit this, with the possibility of reframing a recovery approach as "recovery-ready". Implications for Practice A whole-system approach is required to enable a consistent recovery-oriented approach, but research is also needed for brief interventions specific to this context.

Forensic and non-forensic psychiatric nursing skills and competencies for psychopathic and personality disordered patients.

AIM AND OBJECTIVE: To understand better the skills and competencies for forensic and non-forensic nursing of psychopathic and personality disordered patients. BACKGROUND: In the UK, there has been growing interest in service provision for this client group, but with little research to support the nursing skills required. DESIGN: A non-experimental design, using a postal survey to 990 forensic and 500 non-forensic nurses. METHOD: An information gathering schedule was used to generate data about the most desirable skills and competencies and least desirable weaknesses and nursing attributes to nurse this group. RESULTS: The results for the forensic nurses. Main strengths and skills: being firm, setting limits and defining boundaries. Main weaknesses: inability to engage, inability to resolve conflict and impatience. Main skills and competencies: being non-threatening, non-judgemental and able to expect anything. Least desirable qualities: over-reacting, being judgemental and over-confrontational. The results for the non-forensic nurses. Main strengths and skills: being non-judgemental, listening skills and good risk assessment. Main weaknesses: frustration with the system, a fear of aggression and no skills to engage. Main skills and competencies: being open-minded, non-judgemental and forming relationships. Least desirable qualities: a supercilious attitude, cynicism and being judgemental. CONCLUSION: The results highlight the importance of forming therapeutic relationships as the bedrock of both forensic and non-forensic nursing, and they also highlight the important differences with regard to the significance of therapeutic action and therapeutic verbal interaction. RELEVANCE TO CLINICAL PRACTICE: The provision of better care for this client group will rely on appropriate training for nurses. This research highlights the need for training that supports the development of engagement skills, communication skills and an ability to use reflection in action as a means of providing therapeutic care. It also highlights the different emphasis on the use of these skills by forensic and non-forensic nurses.

Stigma: A linguistic analysis of personality disorder in the UK popular press, 2008-2017.

WHAT IS KNOWN ON THE SUBJECT?: People with a diagnosis of personality disorder often experience stigma both outside of, and within, mental health services. The media contribute to people's understanding of mental health issues, and negative portrayals appear to lead to increased negative attitudes in readers. Relatively little is known about how the press represent personality disorder, and the types of messages that people with this disorder may be receiving, which may impact on their understanding of themselves and emotional well-being. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The key findings indicate that in a 10-year period, the representation of personality disorder in the popular tabloid press in the UK was characterized by the frequent use of language of violence. The research approach enabled the study to identify significant patterns in the language used, rather than only using a checklist of words that the press are directed to avoid. This adds to our understanding about the images repeatedly presented that may affect how readers treat people with a diagnosis of personality disorder and affect the self-esteem of those with the diagnosis. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses are well placed to address issues of stigma both in terms of the general public's beliefs and the impact it has on those who use mental health services. A greater understanding of the messages in the press can help nurses to support service users who are vulnerable to believing that their lives will start to reflect the negative messages they have read. ABSTRACT: Introduction Many people with a diagnosis of personality disorder experience stigma, and the press' representations may contribute to those processes. To date, little is known about how the press write about people with personality disorder and analysis of language used is often limited to checklists of words to avoid. Aim The aim of the study was to explore the linguistic characteristics of press articles about personality disorder in popular tabloids in the UK and consider the implications for stigmatization. Method Corpus linguistics was used to examine a 50% sample of all articles published by the popular press in the UK, from 2008 to 2017, that referred to personality disorder (n = 260). Results The findings identified a range of words that constructed narratives of violence. Discussion The method enabled the findings to expand the current level of knowledge in the field, identifying patterns in the use of the language of violence, which may contribute to the processes of self-stigma. Implications for practice Greater understanding of the messages in the press can sensitize nurses to common misconceptions about the disorder, how these may have become internalised and the need for psycho-social interventions to address the impact of self-stigma on self-esteem.

Stigma: Content analysis of the representation of people with personality disorder in the UK popular press, 2001-2012.

There is evidence that people with personality disorder are stigmatized within healthcare settings; however, little is known about the role that the media has played in the wider processes of stigmatization. This research examines the degree to which the popular press in the UK have established a link between personality disorder and homicide, and the impact this may have had on the processes of stigmatization. Using a content analysis approach, it was identified that there were 552 articles in the popular press, between 2001 and 2012, that made reference to personality disorder and 42% of those articles established a link with homicide. Comparison between two time periods, 2001-2006 and 2007-2012, identified that there was a significant reduction in the proportion of homicide articles (Pearson χ2 (5, n = 552) = 5.64, P > .05), however, the effect size of this change was only small. These findings suggest that the press may have contributed to the processes of stigmatization, and may have encouraged the general public to hold prejudicial attitudes towards people with a diagnosis of personality disorder.