Social media in the NHS - worries about Chaos and Control

It's interesting to see the line of what is ‘permitted’ by NHS trusts around social media shifting. Here’s the Chaos and Control blog – beautifully written by Little Feet – about how her un-named mental health trust prevented her from blogging during a recent stay as an in-patient. But what exactly was the problem that so bothered the mental health trust?

'Given that I wasn’t blogging about other patients and when specific staff were mentioned, they were anonymised, I felt this approach a bit heavy-handed. However, their argument was that patients who were more unwell than me could blog anything, regardless of the truth'

Yes, well that’s true. In a world where everyone has a public voice – i.e. can blog or tweet or post on Facebook – all sorts of people are now able to say all sorts of things about all kinds of institutions. And so? Does that make the sky fall in? No. Is it a good thing or a bad thing? Well I guess that depends on your perspective. But the one thing that is absolutely clear is that public voice shifts power to the citizen. This kind of heavy handed approach by the trust will inevitably back fire. Just ask Mubarak.

Of course some blogs and Facebook entries will be offensive, untrue or malicious (none of which is in anyway true of Chaos and Control). But on the other hand as Claire an OT who is one of our favourite NHS bloggers (@ClaireOT)  cogently argues  self expression is part of getting better, of moving up Maslow’s hierarchy. From a therapeutic point of view, all other things being equal, blogging and using social media should welcomed by mental health teams.And surely it’s all useful data – either about the staff, the service, or occasionally about the person who posts

So a blanket rule of ‘Don’t blog!’ is in our view both misplaced and impractical. What is happening here is that the NHS is (slowly!) learning the realities of the new world of social media. Most of the time social media comments should be welcomed. Sometimes they should be ignored. Occasionally something needs rebutting. For a good guide on all this take a look at the useful  US Air Force process chart on how to respond to blogs which we found on Jeremiah Owyang's great blog 

From our experience of moderating thousands of stories about mental health services we know that occasionally postings will raise issues of clinical governance – for example people expressing suicidal thoughts or threatening harm to staff. But in principle this has always happened and trusts should have procedures to deal with this.The fact that it is now happening in public on-line may be uncomfortable but does not change anything much. At root trusts need to think about whether they are exercising a legitimate duty of care - or protecting themselves.

And if Little Feet would like to use Patient Opinion as a platform to talk about her experience of services we would welcome her story.