Monthly Archives: December 2008

Mental Health Nursing & e-learning at Birmingham City University

In common with most higher education institutions Birmingham City University courses use elements of e-learning to support the face to face taught sessions. We use a system called Moodle, which is considered  to be the most popular learning management system in the world being used in 199 countries by 25,477 people (As at 17.12.2008 see link for latest figures) . Students studying Mental Health Nursing at the Faculty of Health are no exception.

BCU Mental Health Nursing Students
BCU Mental Health Nursing Students

Individual course modules each have their own Moodle site, these are also grouped together into a single site called ‘The Mental Health Learning Community’. We have really tried to develop a good range of resources to support student learning such as filmed scenarios, quizzes and interactive resources. The intention was to try and make the online component of the course as accessible and interesting as possible. As part of this project an informal evaluation was carried out.

Over 200 students completed an evaluation survey which asked about their experience of using the online resources. The first sample of 142 students was taken between February and September 2007 and this was repeated with 60 students between October and November 2008. The survey suggests an interesting shift in the way students are using these resources.

Amongst the 2007 group, 12% stated that they rarely or never used the Moodle resources provided. There is quite a significant change over the course of a year as 100% of students surveyed accessed Moodle to some extent.

There are still some problems regarding ease of access. In response to the question ‘How easy did you find it to access the resources at University’ 30% found it ‘very easy’ in 2007 as compared with 32% a year later. Although no-one said they did not access it now (5% last year) there clearly remain some difficulties to look at.

Generally we were delighted with evidence suggesting that a large majority of students (98%) agreed that Moodle resources enhanced learning on the course to a ‘large extent’ or ‘some extent’. Again, this represents a positive shift towards acceptance of this resource.

These are just a few examples of the informal evaluation undertaken. This process is being used as part of a pilot study to be developed into a wider and more detailed research study to be completed over the course of 2009. Hopefully it should be possible to give information about this at a later date.

Laughing at the Lunatics : Hogarth’s the Rake in Bedlam

I have always found William Hogarth’s engravings fascinating – detailing both the trivia and the drama of ordinary lives in 18thCentury England. Many of them offer commentary on the problems of the day and perhaps also our own times?

In 1735 Hogarth completed a popular series of engravings entitled the “Rakes Progress”. These depicted a young mans debauched journey from a privileged start in life to his death in the infamous London Asylum called Bedlam. This name of this institution has passed into our speech as a term for a fearful and chaotic place. 

The Rake in Bedlam
Hogarth: The Rake in Bedlam

In the foreground of this picture we see the attendants removing the Rake’s chains (although I have read some saying that the chains are just being put on?). In death he is mourned only by the sweetheart he abandoned to pursue a life of drinking, gambling and womanising. As is typical of Hogarth’s work the rest of the picture is full of incident.

The cell on the left shows a “religious maniac”. His face contorts as he sees the shafts of sunlight coming through the bars which he sees as a spiritual visitation. In another cell a man who believes himself to be a king adopts a regal pose – harder to see is the pot he is pissing into. If you remember Dava Sobells book Longitude you will know about the struggle to figure out how to navigate around the world, the man with the telescope has lost his mind in the attempt. Other figures depict depression, a man who thinks he is the Pope and a mad tailor, a reminder of the tailor who measures him for a suit at the start of his progress. Two fashionably dressed women stand out from amongst the inmates.

These ladies have paid to tour Bedlam, this was a popular diversion of the day and a practice that was allowed until 1770 ( See thiswebsite for more details) . One of them is holding a fan to her face and is thought to be either trying to waft the stench from her face or possibly trying to hide the fact that she is laughing at the inmates. It is thought likely that Hogarth himself had toured this institution as it is said that architectural details (such as the bars which divide the “curables” from the “incurables”) are correct. Hogarth was closely involved in the foundation a few years later of the Foundling hospital – which cared for abandoned children. It seems reasonable to me to assume that he would have had a good reason to visit other institutions and didn’t go to Bedlam just to laugh? Whatever his reason to visit though we can be grateful that ideas have changed since Hogarth’s day – or have they?

Everyone is familiar with the experience of meeting a stranger at a party and going through the “what do you for a living” routine. Nowadays I can say I am a University Lecturer, but previously the revelation that I was a mental health nurse would often prompt a response such as “gosh you must be brave” or a request to talk about the sights I must have seen. If you are a mental health nurse -reflect on this yourself, do people have much idea of what mental health care is like or would their ideas more accurately fit Hogarths image?

Partly this may be due to media portrayals – try entering “schizophrenia” and “murder” into Google or recall the treatment Frank Bruno got from the Sun newspaper in the now infamous “Bonkers Bruno” headline. It is easy to question the press over some of this coverage, especially when the truth is that people with mental health problems are much more likely to be the victims than the perpetrators of violent crime (See MIND information for more details). It would be too easy (if not a little lazy?) to simply blame the press. Perhaps we all enjoy laughing at people who are perceived as different?

For example, I have laughed at some of the X factor auditions – there is an element of slapstick humour when things go horribly wrong but at the same time, being asked to join the laughter at films like this makes me uncomfortable. I have also come across this a few times as well – (whether this film is a fake or not) it is interesting to read the comments underneath.


What do you think? – I think we need to ask ourselves some questions: 

  What do we communicate to people about our work?

  •  What responsibility do we have in promoting understanding about mental health issues?
  •  Are we part of the solution?

…or sometimes part of the problem?