Going viral – is social media an effective campaigning tool?

What are your views about the effectiveness of social media as a campaign tool? Read the final part of my three part interview with One in Four editor and Social Spider development director, Mark Brown, to get his take on where we’re at with social media and what the future holds.

Social media suicide reporting guidelines are a great example of influencing a live debate on Twitter.  I remember re-tweeting them when Gary Speed died but hadn’t realised you developed them. I’m interested in how this came about

When Alexander McQueen killed himself, Chris O’Sullivan () thought that it would be good to do some Twitter suicide reporting guidelines in the manner of the Samaritan’s excellent press ones.  We spent an hour knocking something up over email, got it online and then injected it into the various hashtagged conversations, asking people to read them and retweet them.

Given an event that people were discussing that couldn’t have been foreseen, we moved our arses quickly to do something useful and helpful.  There’s amazing scope for this kind of reactive agenda altering on Twitter.  You can directly affect how people think of something as it’s happening. 

Tell me a bit about campaigns using social media which have impressed you

I think one of the greatest examples of boundary fu**ing is the Broken of Britain campaign and its Responsible Reform #spartacusreport. Disabled people and supporters have come together entirely through social media and developed an effect way of responding to government plans.  I think this is the first truly social media age government and it’s been noticeable how susceptible they have been to disruption from citizen journalists and activists.  Basically people who have a voice where ten years ago there would have been no space for that voice to exist or to be amplified so effectively. 

A group of non-journalists have broken major news stories and got them into the mainstream of debate.  A group of non-professional campaigners with only crowdsourced funds have the ear of ‘the establishment’.  It’s social media that’s created that disruption of boundaries, that weight of unexpected voices and actions. 

It’s social media that’s allowed that transgression of the traditional order of things.

For me that’s where exciting things are happening and it’s a million miles from the communications team handling a single corporate Twitter account.  It’s also miles away from ‘service user consultation’ or meeting with your clients once every six months to discuss what you’re doing on their behalf.  I think medical professionals have to accept that to not engage with this shift is not preventing these changes, it’s just not taking part in them. Pandora’s box is opened and hope is still the prize.

The Time to Change campaign didn’t initially focused on social media but now has a massive Twitter following and likes on its Facebook page. I’d love to hear your views about this campaign and about the relative impact of social media compared to their other activities?

I don’t think it’s so much sites as the people or organisations using those sites.  I’m quite into the idea of social media ambassadors, a phrase that has been bandied about a bit but which hasn’t really stuck.  In the real world diplomatic terms an ambassador is someone who represents the interests of one country from a base within another country.  They ease and facilitate relations between their home country and the country they’re based in and also support their fellow foreign nationals in their dealings with the country they find themselves in.  They operate from an embassy, a literal bit of home on foreign soil.

I think the idea of situating an embassy and ambassadors for mental health in the ‘foreign’ countries of media platforms is an idea with mileage.  In many respects I see Time to Change as having moved into the role, representing the interests of people with mental health difficulties in social media spaces.  They’re pushing out positive mental health messages in the social media countries where people are, the equivalent of an ambassador representing the national interests of a country to the country in which they are placed. 

As such they are acting very much on a macro level – the equivalent level to matter of national interest.  They aren’t so much acting on a micro level, providing support, guidance and a sympathetic ear to their fellow ‘mental health’ nationals.  Time to Change is, after all, a campaign rather than an organisation and as such focuses on doing stuff on behalf of the whole body of people with mental health difficulties rather than for individual people with mental health difficulties.

I think mental health charities and social enterprises have woken up to the potential of social media to massively amplify messages far more quickly than NHS services have. 

The dominant model seems to be: get people with mental health difficulties to share their experience, package that into a shareable form, bang it out through social media to start conversations.  This is great, but I’m not sure if it really values people with mental health difficulties as anything other than stories that are ammunition in a war against stigma. 

One of the challenges that the current generation of people with mental health difficulties who are involved in doing stuff around mental health are facing, is that having come to doing stuff as ‘service users’ or ‘people with mental health difficulties’ they find it very difficult to escape from that pigeon hole.  They, in other words, find it hard to move from being beneficiaries of mental health organisations to peers of mental health organisations.

This is noticeable when it comes to the large number of notable bloggers and writers on mental health, who still work mostly for free on writing jobs for major campaigns, providing excellent ammunition in the war against stigma.  They are in effect treated as an asset to the campaign, but as an asset that can’t realise value for itself in that they can’t get paid for doing what is, in effect, a professional job.

I think Time to Change in particular, realised very quickly that there is no narrow casting in social media space and that they couldn’t just address people without experience of mental health difficulty when the people most likely to amplify their messages were people with experience of mental health difficulty themselves.  They couldn’t say ‘well, that bit of material wasn’t aimed at you people with mental health difficulties’.  I think they learned very quickly that their campaign would be far more successful in social media space if its beneficiaries were also its partners. 

I think there is a natural next step, though, which is to realise that people with mental health difficulties do need to be able to realise the value of their assets and actually get paid for the level of support they provide to organisations who still, quite possibly by accident, regard them as beneficiaries or campaign assets rather than peers and partners.

A final note from me

I’d like to say a bit huge thank you to Mark for sharing his time and knowledge with me (and now you) – I’ve learnt a lot from our discussion and, whilst some of his comments about corporate NHS Twitter accounts have made me wince a bit, it’s only because I broadly agree with his take on them. I think the more people using and working in mental health services begin using and interacting with social media, the more interesting things will become, and the more traditional barriers will not be able to be maintained.

We’d both be very interested to hear your reaction to what Mark has to say and we’ll both respond to any comments you make. We’ve really enjoyed our conversation and would like to expand it further with you too. 

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Is the NHS rubbish with social media? Part II of a three part interview with

What do you think about how the NHS is responding to social media? Read part II of my three part interview with One in Four editor and Social Spider development director, Mark Brown, to get his take on where we’re at with social media and what the future holds.

Where do you think we are at with social media in mental health services?It amazes me how little the thinking has moved on in the area of social media and mental health.  It’s like a country, hidden away from progress, on a secret plateau.  There’s so much focus on how does mental health do social media or ‘how do we do social media at people with mental health difficulties?’. It’s unconnected to the experience of people actually doing and using social media.

The problem isn’t about access (there are computers in libraries, school, workplaces and an increasing number of homes) the problem is meaning.  Why would people want to go online?  Without a particular reason to do so and support to improve your competency, the tendency is to get there, turn the thing on, prod it a bit and then wonder why it isn’t bringing all of these amazing and life changing things into your life.

What are your views about how NHS Trusts are currently using social media? To an NHS press office doing social media, timely means putting out a scheduled tweet about it being a bank holiday, on a bank holiday.  This isn’t to say that there isn’t room for machines (or press offices) to pump content into social media space.  Indeed, if you’re going to see your role as an information provider then you should do it consistently, but that isn’t the same as having a social media presence.  It’s injecting information into a social media space, and I think there’s a big difference.

Twitter is news, and the ideas of people about news, all as one unified space.  Rather than public opinion being what happens outside the newsroom door, it’s now in the news room and is often difficult to separate from the news itself.

What would you say to mental health professionals who are concerned about the potential negative impact of social media for the mental health of people they support? I think it’s going down the wrong track to discuss social media as if it is something that is either good or bad for your mental wellbeing.  It all depends on both how you’re using it and what you’re using it for.  For some people social media is a kitten photograph or an inspirational aphorism collecting device.  For others it’s their place of work.  I think the issue is how you use it and what you’re hoping to get out of it.  I think the best way to look at it is a huge cloud of opinion, ideas, news, experiences and just stuff made by people.

There are huge advantages to living an online life ‘in the spotlight’ and also drawbacks.  It’s fantastic that when I go to Twitter there are people talking to me.  It’s also awful when I don’t feel like engaging in weighty discussions about the future of mental health.

I think it’s a pointless quest to try to make social media space ‘safe’.  We would be far better off concentrating on looking at ways that people can elect to keep themselves safe.

Social media used properly accelerates your thinking.  Follow the right people and you suddenly have access to the latest research, the most up to date news stories, the fastest opinion.  Whereas catching up with the world used to be a paper on the train and then a few monthly or weekly magazines for longer reads, now I read huge amounts of stuff across a wide range of topics.

 How do you think mental health professionals should be engaging with apps and social media in their day-to-day clinical work? I think it’s useful to detach ideas for apps from thoughts about social media. Apps might interact with social media, they may even be based within social media platforms, but they aren’t social media.  Thinking of the two in the same breath makes people think of ‘doing a Facebook for mental health’ or ‘let’s set up a closed discussion forum’.

I’ve been to a few innovation events recently and it’s confirmed to me that apps work only when they do specific things, in a specific context for specific people and they don’t work if those people don’t want to use them.  Check out this blog post that I wrote about a #mindtech event I attended recently.

What social media can be incredibly effective at is liberating knowledge assets from institutional silos.  The NHS building blocks for this exist but we’re in a transitional phase. Lots of NHS stuff exists online but not so many NHS folk exist in the social media sphere.

At the minute there are a number of people doing smash and grab raids on these info piles using search engines rather than crowbars; finding relevant information or data and launching it out to a lay audience on Twitter.  This has pre-empted policy to do so. These diggers are actually doing what big orgs should be doing, moving their assets into public spaces where their value may be realised in ways that no-one planned.  has been tweeting the NICE guidelines for minimum standards in mental health care and suggesting people keep a copy with them for reference when accessing services. This does the potentially transformative job of making people who access services aware of the actual standards to which those services should subscribe.  This turns an asset created for one purpose into an asset with value to a completely different audience to that for which it was intended.

I think the NHS is massively behind the game in understanding this.

The role of peer support workers are becoming more common in many mental health services. Do you think there’s room for a similar social media version? There’s a proper term for the practice of making sense of information and guiding people towards the most useful and relevant apomediation. I see one of my roles as an apomediary – being a trusted voice to guide people to the good and relevant knowledge assets and away from the bad or awful ones.  This is an active process based on having a good idea of what my followers might find useful and being able to translate a raw asset into something with a realisable value to people.  Signposting has an established professional role, but is often seen as something that happens within a particular pathway and forgets that people exist for 24 hours a day and not just at points of contact with services.

I think the NHS as a whole hasn’t been great at seeing the potential of apomediaries as partners in making mental health systems work better.  The NHS tends to see information from their side of the desk and to forget that what they want to tell people isn’t necessarily what they want or need to know.  I think there’s incredible scope for the NHS to work more closely with apomediaries as partners and peers.  The NHS is a system.  It’s great at providing for people.  It’s often awful at knowing people as people rather than patients.

People working in and using services are beginning to get their heads around personal and professional identities and boundaries. What are your views about this? I think that social media represents in practice the equivalent of 18th Century coffee houses, a far more widespread and democratic version of the ‘public sphere’.  There are less barriers to entry, anyone can dive in.  We’re seeing the establishment of a notional place of discussion where public opinion is formed, fought over, modified and manipulated.

Whereas the real coffee houses were where the newly arrived middle class formed coherent ideas about how they would struggle against autocratic decision makers and rulers, this social media coffee house is a repository and trigger of far more forms of ideas, expressions and actions, as the people entering it are far more diverse.

In mental health, I think social media is actually serving exactly the same function: creating a discursive space where a ‘new’ mental health is being hashed out collectively as the kind of sum of millions of tweets, blogs, videos, discussions and podcasts.

The NHS is the place of the fading autocratic rulers and in the mental health public sphere you have a huge number of different voices all, whether they realise it or not, asking the same question: ‘How can we make life better for people with mental health difficulties, or in many cases, ourselves?’

What’s interesting to me is the extent to which mental health professionals are keeping out of this discussion.  They have huge knowledge assets which they currently aren’t contributing to this grand conversation (apart from notable exceptions).  It seems, tied up in rules and guidance that the NHS collectively has moved to try to keep the barbarians from the gates.

Social media is a boundary fucker.  We talk so much about confidentiality and protecting patients then you look and find people tweeting from inside inpatient wards while ill.  We find people who a trust will see as patients writing blogs that many more readers than the chief executive of the trust that provides them services.  Social media, by its nature, puts together people who would never have met.  It creates strong public voices which didn’t get there through traditional routes.  It creates stories that appear from odd angles and at unexpected times.  It makes public issues of things that might once have remained behind closed doors.  It doesn’t let things stay where policy makers have traditionally put them.

It also creates a situation for mental health where it is less ‘them and us’ and more ‘just us’.    There is something hugely satisfying in seeing someone who offline would be seen as a ‘patient’ discussing online with someone who would be seen as an ‘expert’ and both learning from that experience.

This does create huge boundary issues which are being played out across all professional sectors at the moment.  There are similar debates going on across local government, the media industries, the NHS as a whole about professional boundaries.

The challenge is moving from being a closed organisation to an open one, from a series of monolithic structures to a series of groups of individuals working together with the communities that they serve.  That is not well governed by heavy handed rules usually written by people who see social media only as a challenge or a danger – social media as scandal waiting to happen.  They need a clear and developing debate for guidance that is based on flexibility not regimentation.

Can it be a choice for mental health professionals or do they need to understand social media? I think mental health professionals have to keep up with the aspirations, ideas, hopes and ideals of the people they work on behalf of anyway.

It’s absurd that spending time in front of a computer is seen as de facto more harmful than reading a book – it depends what book you’re reading versus what you were doing online.

I’ve heard awful things like people being told to stop blogging ‘for their own good’ or being forbidden from tweeting while in hospital.  I’ve also heard of professionals using information from people’s blogs in their professional practice of treating that person (now there’s a two way boundary shifter!)

One of the things that I did find out very early online in social media was that there is not a uniform level of digital competency across people and that is often in no way related to their academic or social status.  Some people don’t realise that information that they put online can be seen by people other than those they intend.  Some don’t understand the difference between debate and bullying.  Others still can’t understand that a blog post by someone is not the same as an article published in a major newspaper.  This creates a wide disparity of expectation and also a wide differing of understanding as to what actions in that social media space mean.

If my local NHS mental health trust follows me I think: “Cool! the person running their account must be vaguely interested in what I say”.  Someone else might think:  “Shit!  They’re checking up on me and want to read all my personal business!”

I think that’s why mental health practitioners need to develop or co-produce not rules for social media use but an ethics of social media use as, at heart, you’re dealing with people through a technology not just a technology itself.

Should we be worried about anti-social networking? I think in social media you have to roll with the nature of the space that you’re in.  People contact you at odd hours and discuss things that you weren’t expecting to discuss.  I think a personal or professional based ethics approach is the way to go.  It’s almost the same as being mindful: know what you’re doing and why you’re doing it, be authentic, behave with kindness and compassion for others but also for yourself.

I think we all grow our social media tool kit.  I keep to hand lots of different links that are useful when people bring certain questions to me on Twitter.  I think it’s always worth remembering that most of the time, people have come to directly address you on social media for one of four reasons: (1) they really want to talk with you (2) they really want you to tell other people something they’ve told you (RT/share) (3) they’re talking to you because they can’t get to talk to the people they really want to talk to (4) they really want you to listen.

The first rule of any social media space is always to put in more than you take out.  I think if you stick with that you’re usually fine.

 A final note from me

So do you think the NHS is rubbish with social media? and if so, what should we be doing to change things for the better? My view (as someone who works for an NHS Trust) is that we’re learning fast but still have a long way to go. We’d both be very interested to hear your reaction to what Mark has to say and we’ll both respond to any comments you make. We’ve really enjoyed our conversation and would like to expand it further with you too.

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Social media is my rocket fuel – part I of a three-part interview with

Do online networks enhance offline relationships? How can you make the most of Twitter? Read part I of my interview with One in Four editor and Social Spider development director, Mark Brown, to get his take on where we’re at with social media and what the future holds.

So tell me a bit about you… I’m Mark Brown. Real world age 34. Twitter age 3 as of 23rd April 2012.

I edit One in Four, the mental health magazine written by and for people with mental health difficulties. It grew from my own experiences in my early twenties when I was unemployed, unwell and wondering just what I was meant to do with my life; or more correctly, wondering what sort of life someone with a mental health difficulty was meant to have.  At the time I felt a huge sense of being on the outside of things, not knowing what I was meant to do to have a ‘proper’ life.

When did you first start using social media? In 2001 someone I was sharing a flat with won a computer and brought it with him when he moved in.  I didn’t own one of my own until 2006. I’d been writing while I was unwell and it seemed to be the natural step to try to find places to share my writing.  I’m old enough to not be a digital native and grew up in a world where what I had access to intellectually and culturally depended on what was physically there.

In what ways did you use social media in the early days? I did what a lot of people did in those days before Facebook and Friendster and Youtube.  I spent lots of times on message boards and in chat rooms for various topics, all early manifestations of what we’d recognise as social media.

The first website I came across for sharing writing was ABCtales.com.  I put some pieces up.  People liked them.  I put some more up.  People liked them.   I got to know the voluntary editors of the site and was asked to become one.  ABCtales ran and still runs informal get together events where people read or perform their work.  It was at one of those events that I met the owner of the site.  I was unemployed, was stuck at job club and as being sent for wildly inappropriate jobs.  I wrote to the owner of the site and said ‘take me on, as long as it replaces my dole I’ll work for next to nothing!’ And he did.

How did these early experiences inform your understanding of social media? I see social media as a means of meeting and interacting with strangers around a common aim and also a means of putting bits of myself and my thinking ‘out there’ to public comment as well as making things happen offline too.

As the editor of the site I got to see all of the things that have now passed into common collective experience – the online spats, the trolling, the relationships made and broken.  I also got to have that experience of people I had never met ‘in real life’ knowing more about me than I did about them.

It gave me a grounding in the idea of the web as a ‘people made’ space.  I went from reading people’s contributions to creative writing websites and forums to reading blogs and similar.  It gave me the sense of the internet not as a series of publications to read, but a series of places to be, where things happened.; the internet not so much as a series of finished and polished bits of media, but a series of inter-related sprawling unfinished texts where your involvement could change the way they turned out.

So how do you use Twitter now? I suppose I got the open nature of Twitter quickly and the fact that Twitter makes it very easy to talk to and share ideas with people you’ve never met.

I’m naturally an enthuser and a reader and don’t work so well in isolation.  In my own personal writing, I actually spent a year writing 200 word short stories and posting them  online which turned out to be amazingly good training for Twitter.  Part of the impetus for that was that I couldn’t bare the long silent absence that ‘working on something big and long’ requires. I want to have an idea, bang it out and then get it out in the world so I can talk about it.  I don’t want to wait until something is ‘finished’ before it’s open for discussion.

What do you get personally from using Twitter? I love that feeling of being inside that field of opinion, information and ideas when suddenly something happens and it all lights up and that in a tiny way I might be able to contribute something to how it’s understood or even what happens.

One of the great joys of Twitter is that it’s something you can do on the move and it’s an incredible tool for capturing things ‘as they happen’.  Quite early I saw that ‘live blogging’ from events could add substantial value both to the event itself and to you value in attending it.  Being an on-the-spot reporter gives you a different relationship to anything you witness or are party to.  The ability to throw the response to a conference open to the world while it’s taking place, allows a kind of democratisation of networks.  I’ve been at events where people on Twitter have asked me to feed in ideas or questions.  I’ve also been at events where the discussions on Twitter between people in the audience have been far more valuable than the actual stuff that was being said from the lectern or microphone.

It’s been instructive watching our old staff writer and her in some ways pioneering use of Twitter as a tool for on-the-spot reporting and aggregating of experience.    It was hugely unnerving seeing her tweet from the fees demos in November 2010 the later in the evening hearing her speak from inside the kettles on rolling news because it was obviously ‘on the spot’.

I see a lot of people with mental health difficulties using social media to do the same thing and report from the front line of their own life, with similar amazingly immediate and sometimes unnerving results.

The things that really brought alive the reality of Twitter for me were things like the general election in May 2010, live tweeting corrections to ideas about benefits during the emergency budget in October of that year and the growth of things like #brokenofbritain and spontaneous hashtags like #whatstigma.

What are your tips for using Twitter? The perfect way to use Twitter is to create bite-sized things often, maintain a presence, get involved with conversations, don’t work in seclusion.  It’s being an open worker rather than a closed one.

What I clocked quite early on was that the most useful and interesting people to follow on Twitter were people where you got a real sense of who they are behind their tweets and who also understood that they were choosing to have a series of conversations in public, on purpose and that when they tweeted they also had an idea of why they were doing it and who they hoped was reading.

I also clocked that Twitter has a rubbish-in, rubbish-out effect.  How interesting the people that you follow are directly effects how interesting you are as a tweeter.  Following people who are good news sources makes you in turn a good news source for others when you share their tweets.  Following exciting conversational tweeters and talking to them about their interests and activities enriches your understanding and broadens your horizons.

I also got quite quickly that you don’t have to follow people unless you’re interested in them and that hashtags make Twitter a million times more rewarding.

I’m very conscious of Twitter as a near infinite number of unfolding streams of information and opinion.  I tweet to specific hashtags consciously to try to enhance them, make a point or to change their direction slightly.  There’s no way of automating that or scheduling it.  you have to be a person reading other people’s tweets and keeping abreast of that huge cloud of opinion, ideas, hopes, fears and hatred to be able to contribute anything of value in an effective manner.

How do your online and offline networks connect? I think that in some senses it’s a false opposition to draw a distinction between online and offline social networks, without discussing the quality or purpose of those networks.

It’s based on the idea that online networks replace offline networks and are somehow a poor shadow imitation.  It forgets that people are active agents in the online world they make for themselves rather than passive recipients.  It also tends to see online relationships as only being imperfect impressions of the perfect ideal of lovely, harmonious, nurturing real life relationships rather than seeing online networks as something with different qualities and possibilities.

Professionally, intellectually and personally, deft uses of social media have added rocket fuel to my real-life networks.  I’ve gotten work as a result of being ‘that off Twitter’.  This interview is a result of me being a person on social media.  My intellectual life and experience has broadened as a result of what I’ve encountered as a result of social media.  It’s brought me together with other people in ways that I never would have expected.  Social media are a the space where you can pitch beyond the people you know and get to the people you’d love to know.  Without pitching into that social media world I would never have ‘jumped the rails’ of how my life was looking like it was going to turn out and found a place in the world doing stuff that I care about and which I hope makes a difference.

I’m honoured to have been touched by the lives of so many others via social media.  I routinely meet or run into people I know from social media in real life and the interesting thing about that is that they more often than not are exactly as their online persona suggests they would be.

If you look at social media not as some shadow space that sucks up lonely people but as a series of portals to the opportunity to network, find solidarity, make friends, discover affinities and explore without high barriers to entry then I think you’re closer to the reality.

I can’t see any way that you can remove the potential negatives of social media without also removing the positives.

A final note from me… My interview with Mark took place through a series of emails and a follow up telephone conversation. We’d both be very interested to hear your reaction to what Mark has to say and we’ll both respond to any comments you make. We’ve really enjoyed our conversation and would like to expand it further with you too.

Watch out for part II next week for Mark’s views for the how the NHS is engaging with social media.

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