Presentation from the International Congress of the Royal College of Psychiatrists 24-27 June 2014, London

1. Twitter and Your Career
DR JENNY HOLMES MBBS MFFLM MRCPSYCH
SPECIALITY DOCTOR PSYCHIATRY OF INTELLECTUAL DISABILITY CHESHIRE AND WIRRAL PARTNERSHIP NHS TRUST
LEAD FORENSIC PHYSICIAN MERSEYSIDE POLICE

2. About Me
Late to Psychiatry
5 session Speciality Doctor job in Learning Disability
Lead the Healthcare Team serving Merseyside Police
Work with detainees in Police Custody, Adult and Child Complainants of
Sexual Assault and Domestic Violence
High proportion of work is mental health based
Work with Merseycare NHS who are implementing extended Liaison and
Diversion Services
Little known Faculty of Forensic and Legal Medicine (www.fflm.ac.uk) within
Royal College of Physicians

3. What Do I Believe In?
Independent Forensic Physicians provide part of the checks and balances on
the Power of the State
Strong Human Rights element to the work
The interface between Policing and Psychiatry poorly understood
The mentally ill and learning disabled are highly vulnerable in the CJS as
victims and offenders and require highly skilled professionals
Multi agency working is the key

4. FME@northwestdoc
Dr Holmes. Forensic Medical Examiner (Custody &
SARC)/Psychiatrist . Interested in interface policing
and mental health. All views my own. RT not
endorsement.

5. Why Twitter?
A way to interact with professionals of many disciplines:
Police/AMHPs/Psychiatrists/Probation/Lawyers/Emergency Medicine/Nurses
A way to understand policy and influence debate
A way to keep up with newsworthy items in field of interest

6. Press Release 6 01 2014
 Extra funding for mental health nurses to be based at police stations and courts
across the country
 Organisations: Department of Health and Home Office
 Care and Support Minister, Norman Lamb, announces £25 million of funding to
join up police and courts with mental health services
 Policing Minister Damian Green said:
 Police officers should be focused on fighting crimes and people with mental
health conditions should get the care they need as early as possible.
 These pilots will not only ensure that happens but in the longer term will help
drive down reoffending by individuals who, with the right kind of treatment,
can recover fully.

7. Service Users
Strong network of service users
A way to learn about what it is like to live with a mental illness
Understand what works in professional interactions
A teaching resource
(see Jonny Benjamin #findmike and ‘Sometimes’)

8. But
Those who are acutely mentally unwell are often drawn to MH professionals
seeking advice and to communicate hostility
Fine line between supportive interaction and doctoring
Suicidality
Foxtrot Oscar
When to end an interaction?

9. Career Development
Education of other professionals
Raising of profile (service and personal)
Invitations to speak at conferences
Contribution to national debate

10. Tweet on Topics of Interest
 Let's be clear #blurredlines is a song that condones sexual violence against
women. I have 14 years experience of looking after rape victims
 Pharrell Williams making a very poor but brazen defence of #blurredlines but
good attempt @krishgm : @jonsnowC4 you should have tried!!

11. Comment on the News
 Hope the latest USA shooting doesn't demonise people with Aspergers. Gun laws
not autism/mental illness is the issue. When will USA wake up?
 I feel there’s also an increase in requests for MH Act Assessments because there
is no prospect of a voluntary bed. And long delays in >
 < starting MHAA as AMHPs etc stretched. And new concept of ‘we cant assess as
there’s no bed’ all pretty awful for a person in a Police Cell.
(in response to @rcpsych survery by PTC ‘Sectioned to Get a Bed’ 02 06 2014)

12. Tweet About What I’m Doing
 Off to a meeting on how we develop better pathways to prevent people
with learning disabilities entering the criminal justice system
 Delighted to be invited to @MerseysidePCC Youth Advisory Panel
tomorrow to seek their views on how to reduce first time entrants to the YJS

13. Join in Conversations on Important
Topics
@NathanConstable
New restraint guidelines for NHS staff .Did anyone in ACPO or CoP know this
was happening? The implicationarehugehttp://tinyurl.com/nhga3tx
FME @northwestdoc May 19
@NathanConstable can't argue with @MentalHealthCop mantra -
weapons/hostages/barricades to support Police decision on when to
intervene

14. Network
 @ProfLAppleby
 Probation, now child protection: aren't there services that state should
provide as matter of principle? http://m.bbc.co.uk/news/education-
27452457 …

15. Join Campaigns and Consultations
@TheBMA
If you believe that equal value should be placed on both mental and physical health PLS RT
http://bit.ly/RbsuX9 #healthparity
Great debate #s136. We all need to send input to the Government inquiries on s136/5 and
Policing/Mental Health. Lots of valid points made
@rcpsych
New CQC map shows "worrying restrictions" in "places of safety" for young people experiencing
mental health crisis
http://www.cqc.org.uk/media/new-map-health-based-places-safety-people-experiencing-
mental-health-crisis-reveals-restrictio …

16. Seek Help
 FME
 @northwestdoc
 Struggling over writing a presentation on restraint for a mixed
Police/mental health professionals audience. Its a minefield. Suggestions?

17. The Perils
Protect the Personal
Twitter likes a bit of personal to keep it interesting but keep it anonymous
Patient Confidentiality
Very easy to inadvertently breach

18. Other People’s Agendas

19. I wrote a Blog in Response
Mrs May’s Speech: Thoughts From a Police Outsider
Irene Curtis @barrackslass · May 27
Excellent balanced blog from @northwestdoc covering the 'no blame' culture
we need: Thoughts from a Police Outsider http://wp.me/p4FgY03

20. Enquiry from Journalists
Positive?
A chance to put my message across?
Or all together more sinister?
Led to me taking the blog down

21. Lessons Learned
Stick to what you know
Don’t be tempted to over personalise it
Make sure any organisation you can be identified as working with is happy for
you to tweet and what the parameters are
Exercise extreme caution with service users
Remember you represent the medical profession
But it can lead to learning, reflection and significant career development –
particularly in a niche field