Freeman

Stoddart

English

Freeman, Mona

Stoddart, James

Tavistock and Portman E-Prints Online

Psychiatr ic Bul let in (2008 ), 32, 149-150. doi: 10.1192/pb.bp.107.017319MONA F R EEMAN AND JAME S S TODDA R TBack to basics - getting involved in public educationBeing a doctor nowadays is not a role which automati-cally raises one’s status and brings one respect. Ourtreatment plans and advice are no longer acceptedwithout discussion and/or often compromise. Ourpatients are now familiar with technical jargon and oftencome to appointments armed with the ‘latest research’ orup-to-date National Institute of Health and ClinicalExcellence (NICE) guidance, which can make such consul-tations feel more like flashbacks to the Part 2 clinicalexam.With an increasingly informed and sometimescritical public regarding all aspects of health and medi-cine, it is imperative that we, as psychiatrists, are at theforefront of providing information about the illnesses andconditions we treat. Essentially, such information for thepublic must be easy to understand, accurate andunbiased.With this in mind, we enthusiastically applied to jointhe Public Education Editorial Board of the Royal Collegeof Psychiatrists. This is a subcommittee of the PublicEducation Committee of the College which since the mid-1990s has been producing high-quality, evidence-based,award-winning public education leaflets about all aspectsof mental health.We were hoping to find an interestingand productive use to our research time that did notinvolve filling in yet more ethical approval forms, and wewere not disappointed.The role of the Public Education EditorialBoardThe Public Education Editorial Board was formed in 2002with the task of developing and reviewing the publiceducation leaflets, some of which had a traditionalprescriptive approach rather than providing somethingmore empowering for patients that would enable themto make better-informed choices for themselves. TheCollege also wished to seek independence from thepharmaceutical companies which until then had spon-sored the leaflets and covered printing costs (Timms et al,2005).The board is thus involved with all aspects of theplanning and distribution of information about mentalillness to the public: from deciding which topics to coverand seeking the involvement of partner organisations, tocritically appraising the information (once written orcommissioned) and seeking the views of service usersprior to the launch of a new leaflet. Each new leafletusually commences as an idea of a College member, oroccasionally a member of the public, who has identified a‘gap’ in the available mental health information. Lesscommonly, a fully formed leaflet already in circulationlocally is sent to us in the hope of wider dissemination.The board would then ask an expert in the field to writeor comment on the leaflet as appropriate.We would thenedit, appraise and launch the leaflet. New leaflets areadvertised to College members on the College websiteand they are freely available there. In addition, themajority exist in print and they are distributed on requestto a wide range of organisations - from general practi-tioners’ surgeries and hospital trusts to health shops andeven the forestry commission. They are regularlyreviewed, ensuring feedback from the public is usedconstructively and that the information remains up-to-date.Our rolesAs specialist registrars on the board, our main task was toeach produce a new leaflet on a topic of our choice,under the supervision of one of the board members. Thisinvolved planning, researching, writing, appraising andediting the leaflet. Apart from this, we were also able toget involved in the editorial process of other leafletsalready in the pipeline. The editorial board is a small team,a mix of jobbing consultant psychiatrists and members ofthe External Affairs department of the College.We werewarmly absorbed into the group and were given a goodinsight into what it is to be an editor: deciding on what istopical and pertinent, thinking of whom one couldcommission to write the leaflet, and then once written,appraising and editing the work. To aid appraisal, we wereintroduced to DISCERN - a brief questionnaire developedat the University of Oxford (www.discern.org.uk). This isthe first standardised index of quality of consumer healthinformation and it provides a valid and reliable way ofassessing the quality of written information on treatmentchoices for health problems. It can also be used byauthors and publishers of information on treatmentchoices as a guide to the standard which users areentitled to expect.Sullivan & Thompson Bridging the gap between the university and the NHSeducation &trainingimplementation of research findings.BMJ, 317, 465-468.GRIMSHAW, J. M.,THOMAS, R. E.,MACLENNAN, G., et al (2005)Effectiveness and efficiency ofguideline dissemination andimplementation strategies.International Journal ofTechnologyAssessment in Health Care, 21,144-150.THOMPSON, A., BARLEY, M.,SULLIVAN, S., et al (2007) The DEBITtrial: an intervention to reduceantipsychotic polypharmacyprescribing in adult psychiatrywards - cluster randomisedcontrolled trial. Psychological Medicine,38,1-11.*Sarah Sullivan Research Associate, University of Bristol, Academic Unit ofPsychiatry, CothamHouse, CothamHill, Bristol BS6 6JL, UK, email: sarah.sullivan@bristol.ac.uk, AndyThompson Honorary Clinical Lecturer, University of Bristol149The DISCERN questionnaire focuses in particular onwhether the information is clear, complete, unbiased, andwhether it discusses all treatment options including therisks and benefits. Leaflets should encourage shareddecision-making, include references and provide sourcesof further information to score highly on the scale.Usually two board members appraise the leaflet sepa-rately against the DISCERN criteria, and authors areencouraged to revise their texts accordingly, aiming foran overall DISCERN score of 4-5/5. The questionnaire is astraightforward tool to use and relatively quick to imple-ment. Although some leaflets lend themselves morereadily to this type of assessment than others, the boardfind it an invaluable help in assessing the quality of thedraft leaflets.Our leaflets are now completed - one on person-ality disorder (Stoddart, 2007) and the other on resiliencefor children and young people (Freeman, 2007), bothavailable on the College website. In our work on theleaflets, we each faced unique challenges, but the lessonslearnt were the same for all: learning to avoid jargon andconvey a message that is readily understandable, scienti-fically accurate and evidence-based. It was equallyimportant to ensure that in using lay language, one didnot ‘dumb down’ the information or patronise thereaders. We may, as psychiatrists, believe ourselves tohave communication skills that are better than most onthe social scale, and we may pride ourselves on our abil-ities to convey information and understanding to ourclients, but it is a very different skill to be able to use inthis regard the written, rather than spoken, word. Ourtime on the board has certainly given us an insight intothese complexities and we hope to continue to honethese new skills in the future.Spin offsIn most cases, to have a piece of one’s work publishedneeds a spot of luck and being in the right place at theright time. Being involved with committees like this onehelps one to get recognition in the field and as a resultone may find oneself contributing to various projects,which may prove to be an exciting and rewarding experi-ence. As members of the Public Education Editorial Board,we have contributed to three publications (in addition toleaflets) directly or indirectly linked to public education inpsychiatry (Freeman & Khalifeh, 2006; Stoddart, 2006;Freeman & Khalifeh, 2007).How to get involved in public educationWe hope that this article will inspire trainees to apply tojoin the Public Education Editorial Board, and that asmembers they will design and produce their own publiceducation leaflets for the College. However, this is notthe only way to get involved in public education. Youcould think locally and produce something for your wardpatients or your trust, on anything relevant to your sub-specialty and knowledge base. Have a look at the sort ofinformation that is given out already; some of it may bevery good, but a lot of it is probably out of date or inneed of a significant ‘facelift’. Be opportunistic - if asystematic review has recently been published relating toyour field of expertise, how about translating it intosomething helpful and informative for your patients?Final thoughtsOur message is simple: get involved. If the informationthe public has access to is unbiased and evidence-based,unlike what they may read in the popular press, it is notonly empowering for them, but it will ultimately make ourjobs easier.Declaration of interestM.F. and J.S. are currently members of the Public Educa-tion Editorial Board.ReferencesFREEMAN, M. (2007) When bad thingshappen. Royal College of Psychiatrists.FREEMAN, M. & KHALIFEH, H. (2006)The brain. InThe Brain Manual (ed. I.Banks), p. 2-10. Haynes.FREEMAN, M. & KHALIFEH, H. (2007)Your brain and how it works. InTheMind - AUsersGuide (ed. R. Persaud),p. 9-17.Transworld Publications.STODDART, J.W. A. (2007) PersonalityDisorder. Royal College of Psychiatrists.STODDART, J.W. A. (2006) An SpR’sexperience serving on the College’sPublic Education Editorial Board. Pre-Membership PsychiatricTraineeHandbook. Royal College ofPsychiatrists.TIMMS, P., HART, D., COHEN, A., et al(2005) ‘Help is at Hand’on the web -what do our readers think? PsychiatricBulletin, 29, 24-27.*Mona Freeman Specialist Registrar in Child and Adolescent Psychiatry,Tavistock and Portman NHS FoundationTrust, London, email: mona.freeman@nhs.net, James Stoddart LocumConsultant in Forensic Psychiatry, BamburghClinic, St Nicholas Hospital, Newcastle-Upon-Tyneeducation &trainingFreeman & Stoddart Back to basics - getting involved in public education150

An SpR’s experience servingonthe College’s Public Education Editorial Board. PreMembership PsychiatricTrainee Handbook. Royal College of Psychiatrists.

Personality Disorder.RoyalCollegeof Psychiatrists.

Whenbadthings happen. Royal College of Psychiatrists.

Your brainandhow it works. InThe Mind- AUsersGuide(ed.R.Persaud),

Back to basics.  Getting involved in public education

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