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. Aims 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 < .001) and a significant increase in the tweets characterised as Understanding (χ2 = 9.398, d.f. = 1, p = .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.

It is not only women who experience shame and stigma because of their circumstances, it can affect midwives too. Shame and stigma can have a significant impact on both parents and midwife. Expectant parents who are experiencing difficulties with childbirth may become self absorbed. Critical ruminations are likely to ensue and this can lead to these parents failing to care for themselves appropriately. Meanwhile, midwives’ professional practice may also become compromised because of shameful ruminations.

The first part of this series (JCN, 28(5): 30–32) provided the background to the study, which used semi-structured interviews with 18 nurses based in Afghanistan during 2013 to focus on factors affecting the delivery of mental health care in the field. This, the second part of the series, details the results of the study in the form of analysis of the interviewees’ verbatim transcripts. The study offers an insight into the role of deployed mental health nurses and examines some of the challenges they face. The findings demonstrate that managing the mental health of armed forces personnel on an operational deployment requires the ability to develop trusting relationships, identify factors leading to stress, and help staff to feel supported.

The mental health (MH) of soldiers remains extremely newsworthy and is regularly featured in high profile media forums that focus on post-traumatic stress disorder. However, the authors feel that there are distinct benefits to serving within the Army, and that it provides effective occupational medical, MH and welfare support. This research study explores potential benefits and stressors of being in the Army and provides an overview of Army mental health services (AMHS) through the perspectives of AMHS personnel, 84% of which were nurses. The study indicated that the Army can provide a protective community, sharing a bond based on common values and experiences. The Army can provide soldiers with career opportunities that are not available in civilian life, and there are opportunities to develop an employment profile, enhanced by internal and external educational training, and encapsulated within a progressive career pathway. The Army can also be seen to offer an escape route, preventing soldiers entering a life of crime, and supplying the stable family these soldiers had never experienced. The provision of leadership, within an environment where soldiers are valued and stigma is not tolerated can potentially shield against MH problems.

For some vulnerable women, a major life event such as becoming pregnant can bring out a predisposition to mental illness. Receiving mental health care can invoke stigma and shame in varied and complex ways causing a sense of entrapment.

Although becoming and being a parent are considered happy life events, parents can suffer from varying degrees of anxiety and variable mood. Anxiety and mood changes can be missed and this can lead to mental health problems if not recognised at an early stage. An insecure attachment in a parent's early infanthood can contribute to increased levels of anxiety and emotional problems when becoming and being a parent themselves, which can influence mother and child bonding as well as wider difficulties within family relationships. In many instances, attachment styles can be passed on to the infant causing a range of emotional and intellectual difficulties. In certain circumstances, these parents may benefit from psychotherapy. Psychotherapy is a method of addressing troubling emotions along with life difficulties and relationship struggles. Using psychological methods, a psychotherapist can help a person change his or her life for the better by becoming more effective in work or personal relationships. Local community support and befriending approaches have been shown to be beneficial in alleviating anxiety and depression. This article briefly describes what psychotherapy is and demonstrates ways in which interpersonal attachment styles established early on in life can bring difficulties to adult relationships. Two disguised scenarios referring to actual psychotherapy consultations are included to illustrate how plans can be put in place to address interpersonal difficulties related to attachment styles.

Mental health is an integral part of health and a state of wellbeing. The concept of ‘parity of esteem’ increases awareness that mental health needs to be treated as seriously as physical health. During the childbirth continuum, women and their partners can be at increased risk of mental health problems; therefore it is important to embrace the ‘parity of esteem’ concept. This article highlights links between mental and physical health problems and discusses the vital role that midwives can play in promoting better maternal mental health. It considers the challenges this can present to midwives and maternity services.

Aims. Media representations of mental health problems may influence readers’ understanding of, and attitude towards, people who have received psychiatric diagnoses. Negative beliefs and attitudes may then lead to discriminatory behaviour, which is understood as stigma. This study explored the language used in popular national newspapers when writing about schizophrenia and considered how this may have contributed to the processes of stigmatisation towards people with this diagnosis. Methods. Using corpus linguistic methods, a sample of newspaper articles over a 24 month period that mentioned the word ‘schizophrenia’ was compared with a similar sample of articles about diabetes. This enabled a theory-driven exploration of linguistic characteristics to explore stigmatising messages, whilst supported by statistical tests (Log-Likelihood) to compare the data sets and identify words with a high relative frequency. Results. Analysis of the ‘schizophrenia’ data set identified that overtly stigmatising language (e.g. “schizo”) was relatively infrequent, but that there was frequent use of linguistic signatures of violence. Articles frequently used graphic language referring to: acts of violence, descriptions of violent acts, implements used in violence, identity labels and exemplars of well-known individuals who had committed violent acts. The word ‘schizophrenic’ was used with a high frequency (n=108) and most commonly to name individuals who had committed acts of violence. Discussion. The study suggests that whilst the press have largely avoided the use of words that press guidance has steered them away from (e.g. “schizo” and “psycho”) that they still use a range of graphic language to present people with a diagnosis of schizophrenia as frighteningly ‘other’ and as prone to violence. This repetition of negative stereotypical messages may well contribute to the processes of stigmatisation many people who experience psychosis have to contend.

The study aims to assess the feasibility of using a computer assisted diagnostic interview by GPs and to examine the level of agreement between the Spanish version GMHAT/PC diagnosis and psychiatrists' ICD-10 based clinical diagnosis. Participants in the study ranged from those who were in remission to others who had different mental illnesses. They were recruited from inpatient and outpatient mental health settings. All consecutive patients were interviewed using Spanish version of GMHAT/PC and they were assessed independently by psychiatrists to in order to get their ICD-10 based diagnosis. Two hundred ninety-nine patients participated in the study. The mean duration of interview was 12.5 minutes. There is an acceptable to good level of agreement between the GP’s (GMHAT/PC) diagnoses and the psychiatrists’ (clinical) diagnoses of any mental illness, Kappa 0.58 95% C.I (0.46, 0.72). There is good level of sensitivity (81%) and specificity (92%), with GPs correctly identifying 242 out of the 250 participants diagnosed with mental illness and 27 out of 35 of those without. The finding of the study suggest that GMHAT/PC Spanish version used by GPs detected mental disorders accurately and it was feasible to use GMHAT/PC (Spanish version) in Latin America settings.

To help the British armed forces minimise mental health problems while undertaking military duties, operational psychological support is provided by military mental health nurses. This series of two articles is part of the first qualitative research completed in Afghanistan by British armed forces into the effectiveness of the military mental health nursing role. The authors aim to increase understanding of the factors that affect the delivery of nursing care during an operational deployment, including educational and clinical competency, multiprofessional and multinational boundaries, and the challenges of providing nursing care for both military personnel and local nationals. This article, the first of the two-part series, looks at the set up of the study, while the second article (featured in the next issue of JCN) will look at the study findings