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Royal College of Psychiatrists - Celebrating 180 years
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  • Become a psychiatrist

    Become a psychiatrist

    • Choose Psychiatry

      Choose Psychiatry

      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • Career essentials
      • What next?
    • Sixth formers and school students
    • Medical students

      Medical students

      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
    • Foundation doctors

      Foundation doctors

      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry

      Help us promote psychiatry

      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • Our strategy
    • Choose Psychiatry: Guidance for Medical Schools
    • Choose Psychiatry
      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • Career essentials
      • What next?
    • Sixth formers and school students
    • Medical students
      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
    • Foundation doctors
      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry
      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • Our strategy
    • Choose Psychiatry: Guidance for Medical Schools
  • Training

    Training

    • Curricula and guidance

      Curricula and guidance

      • GMC approved curricula
      • Curricula review project
      • Specialty guides
      • Dual Training
    • Your training

      Your training

      • Psychiatric Trainees Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Leadership and management training
      • Training less than full time
      • Routes to Registration
      • Cost of Training
    • Exams

      Exams

      • Can I take an exam?
      • Contact the exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • MRCPsych examinations and COVID-19
      • Webinar: MRCPsych Exam - Changes to exam delivery this autumn
      • Capacity reached for September 2020 CASC
    • Neuroscience in training

      Neuroscience in training

      • About the project
      • Neuroscience events
      • Who is on the commission?
      • Latest news from the neuroscience project
      • Neuroscience history
      • Neuroscience videos
      • Neuroscience resources
    • Information for Local Education and Training Boards (LETBs)
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates

      International Medical Graduates

      • Shortage Occupation List
    • Quality Assurance in Training
    • Curricula and guidance
      • GMC approved curricula
      • Curricula review project
      • Specialty guides
      • Dual Training
    • Your training
      • Psychiatric Trainees Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Leadership and management training
      • Training less than full time
      • Routes to Registration
      • Cost of Training
    • Exams
      • Can I take an exam?
      • Contact the exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • MRCPsych examinations and COVID-19
      • Webinar: MRCPsych Exam - Changes to exam delivery this autumn
      • Capacity reached for September 2020 CASC
    • Neuroscience in training
      • About the project
      • Neuroscience events
      • Who is on the commission?
      • Latest news from the neuroscience project
      • Neuroscience history
      • Neuroscience videos
      • Neuroscience resources
    • Information for Local Education and Training Boards (LETBs)
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates
      • Shortage Occupation List
    • Quality Assurance in Training
  • Members

    Members

    • Supporting you

      Supporting you

      • Psychiatrists Support Service
      • New consultants (StartWell)
      • Mentoring and coaching
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • If a patient dies by suicide
      • Writing clinic letters
    • Submitting your CPD

      Submitting your CPD

      • CPD Submissions FAQs
      • Alterations to CPD during coronavirus pandemic
    • CPD Online
    • Membership

      Membership

      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Your Faculties

      Your Faculties

      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Devolved Nations

      Devolved Nations

      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions

      English Divisions

      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members

      International members

      • International strategy
    • Special Interest Groups

      Special Interest Groups

      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
      • Special Interest Group Job Descriptions
      • Digital psychiatry
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Your monthly eNewsletter

      Your monthly eNewsletter

      • Members' update 8 April 2021
      • RCPsych eNewsletter March 2021
      • Members' update 11 March 2021
      • RCPsych eNewsletter February 2021
      • Members' update 11 February 2021
      • RCPsych eNewsletter January 2021
      • Members' update 14 January 2021
      • RCPsych eNewsletter December 2020
      • RCPsych eNewsletter November 2020
      • Members' update 12 November 2020
      • RCPsych eNewsletter October 2020
      • Members' update 8 October 2020
      • RCPsych eNewsletter September 2020
      • Members' update 11 September 2020
      • Members' update 1 September 2020
      • Members' update 14 August 2020
      • RCPsych eNewsletter July 2020
      • Members' update 10 July 2020
      • RCPsych eNewsletter June 2020
      • Update 12 June 2020
      • COVID-19 Update 29 May 2020
      • RCPsych eNewsletter May 2020
      • COVID-19 Update 7 May 2020
      • COVID-19 Update 1 May 2020
      • RCPsych eNewsletter April 2020
      • COVID-19 Update April 2020
      • RCPsych eNewsletter February 2020
      • RCPsych eNewsletter January 2020
      • RCPsych eNewsletter December 2019
      • RCPsych eNewsletter November 2019
      • RCPsych eNewsletter October 2019
      • RCPsych eNewsletter September 2019
      • RCPsych eNewsletter July 2019
      • RCPsych eNewsletter June 2019
      • RCPsych eNewsletter May 2019
      • RCPsych eNewsletter April 2019
    • Posts for members
    • Public members list
    • Jobs board
    • Specialist and Associate Specialty Doctors

      Specialist and Associate Specialty Doctors

      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
    • President's lectures

      President's lectures

      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • New Members Ceremonies
    • Obituaries

      Obituaries

      • Submit an obituary
      • Remembering Dame Fiona Caldicott
    • About CPD Online - elearning
    • Supporting you
      • Psychiatrists Support Service
      • New consultants (StartWell)
      • Mentoring and coaching
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • If a patient dies by suicide
      • Writing clinic letters
    • Submitting your CPD
      • CPD Submissions FAQs
      • Alterations to CPD during coronavirus pandemic
    • CPD Online
    • Membership
      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Your Faculties
      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Devolved Nations
      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions
      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
      • International strategy
    • Special Interest Groups
      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
      • Special Interest Group Job Descriptions
      • Digital psychiatry
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Your monthly eNewsletter
      • Members' update 8 April 2021
      • RCPsych eNewsletter March 2021
      • Members' update 11 March 2021
      • RCPsych eNewsletter February 2021
      • Members' update 11 February 2021
      • RCPsych eNewsletter January 2021
      • Members' update 14 January 2021
      • RCPsych eNewsletter December 2020
      • RCPsych eNewsletter November 2020
      • Members' update 12 November 2020
      • RCPsych eNewsletter October 2020
      • Members' update 8 October 2020
      • RCPsych eNewsletter September 2020
      • Members' update 11 September 2020
      • Members' update 1 September 2020
      • Members' update 14 August 2020
      • RCPsych eNewsletter July 2020
      • Members' update 10 July 2020
      • RCPsych eNewsletter June 2020
      • Update 12 June 2020
      • COVID-19 Update 29 May 2020
      • RCPsych eNewsletter May 2020
      • COVID-19 Update 7 May 2020
      • COVID-19 Update 1 May 2020
      • RCPsych eNewsletter April 2020
      • COVID-19 Update April 2020
      • RCPsych eNewsletter February 2020
      • RCPsych eNewsletter January 2020
      • RCPsych eNewsletter December 2019
      • RCPsych eNewsletter November 2019
      • RCPsych eNewsletter October 2019
      • RCPsych eNewsletter September 2019
      • RCPsych eNewsletter July 2019
      • RCPsych eNewsletter June 2019
      • RCPsych eNewsletter May 2019
      • RCPsych eNewsletter April 2019
    • Posts for members
    • Public members list
    • Jobs board
    • Specialist and Associate Specialty Doctors
      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
    • President's lectures
      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • New Members Ceremonies
    • Obituaries
      • Submit an obituary
      • Remembering Dame Fiona Caldicott
    • About CPD Online - elearning
  • Events

    Events

    • Conferences and training events

      Conferences and training events

      • Faculty of intellectual Disability Spring Conference 2019
      • Faculty of Forensic Psychiatry Annual Conference 2020 - Register your interest
      • Section 12 and AC – Update for Trainers - Training Day Course Resources
      • Resilience & Wellbeing Course for SAS Doctors
      • Present State Examination Course 17 April - Register your interest
      • Present State Examination Course 1 September - Register your interest
      • Section 12 and Approved Clinician Training
      • Perinatal Psychiatry Masterclasses
      • Women and Mental Health Special Interest Group Annual Conference
      • Faculty of Medical Psychotherapy Annual Conference 2021 - Register your interest
      • Register your interest - Clinical and Educational Supervisor Training future dates
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trainee)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
    • Events held by other organisations
    • Terms and conditions
    • In house training

      In house training

      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Highlights from International Congress 2020 - Webinar Series

      Highlights from International Congress 2020 - Webinar Series

      • Registration
      • Programme
      • FAQs
    • Accommodation List
    • Recruitment events
    • Claiming Expenses
    • International Congress 2021

      International Congress 2021

      • Congress FAQs
      • Exhibition Opportunities 2021
      • Registration
      • IC21 Keynote speakers
      • Programme
      • Presenter information
      • Your guide to Congress
    • Free webinars

      Free webinars

      • Free webinars for members
    • Speaker guidance for online events
    • Conferences and training events
      • Faculty of intellectual Disability Spring Conference 2019
      • Faculty of Forensic Psychiatry Annual Conference 2020 - Register your interest
      • Section 12 and AC – Update for Trainers - Training Day Course Resources
      • Resilience & Wellbeing Course for SAS Doctors
      • Present State Examination Course 17 April - Register your interest
      • Present State Examination Course 1 September - Register your interest
      • Section 12 and Approved Clinician Training
      • Perinatal Psychiatry Masterclasses
      • Women and Mental Health Special Interest Group Annual Conference
      • Faculty of Medical Psychotherapy Annual Conference 2021 - Register your interest
      • Register your interest - Clinical and Educational Supervisor Training future dates
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trainee)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
    • Events held by other organisations
    • Terms and conditions
    • In house training
      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Highlights from International Congress 2020 - Webinar Series
      • Registration
      • Programme
      • FAQs
    • Accommodation List
    • Recruitment events
    • Claiming Expenses
    • International Congress 2021
      • Congress FAQs
      • Exhibition Opportunities 2021
      • Registration
      • IC21 Keynote speakers
      • Programme
      • Presenter information
      • Your guide to Congress
    • Free webinars
      • Free webinars for members
    • Speaker guidance for online events
  • Improving care

    Improving care

    • College Centre for Quality Improvement (CCQI)

      College Centre for Quality Improvement (CCQI)

      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • Using quality improvement
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
    • Campaigning for better mental health policy

      Campaigning for better mental health policy

      • The Mental Health Act (MHA)
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • The Mental Health Act White Paper 2021
    • Planning the psychiatric workforce

      Planning the psychiatric workforce

      • What we do
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
    • Physician Associates

      Physician Associates

      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
    • National Collaborating Centre for Mental Health

      National Collaborating Centre for Mental Health

      • About the NCCMH
      • Mental health care pathways
      • Mental health quality improvement programmes
      • Other programmes
      • Reducing restrictive practice
      • National suicide prevention programme
      • Sexual Safety Collaborative
      • COVID-19 Mental Health Improvement Network
      • RCPsych Enjoying Work Collaborative
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and working sustainably

      Sustainability and working sustainably

      • In your community
      • In your practice
      • In your trust
      • Green care
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • Working sustainably (old)
    • RCPsych Course Accreditation

      RCPsych Course Accreditation

      • Apply for accreditation
    • College Centre for Quality Improvement (CCQI)
      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • Using quality improvement
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
    • Campaigning for better mental health policy
      • The Mental Health Act (MHA)
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • The Mental Health Act White Paper 2021
    • Planning the psychiatric workforce
      • What we do
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
    • Physician Associates
      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
    • National Collaborating Centre for Mental Health
      • About the NCCMH
      • Mental health care pathways
      • Mental health quality improvement programmes
      • Other programmes
      • Reducing restrictive practice
      • National suicide prevention programme
      • Sexual Safety Collaborative
      • COVID-19 Mental Health Improvement Network
      • RCPsych Enjoying Work Collaborative
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and working sustainably
      • In your community
      • In your practice
      • In your trust
      • Green care
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • Working sustainably (old)
    • RCPsych Course Accreditation
      • Apply for accreditation
  • Mental health

    Mental health

    • Problems and disorders

      Problems and disorders

      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Depression and men
      • Eating well and mental health
      • Feeling on the edge
      • Feeling overwhelmed
      • Feeling stressed
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post Traumatic Stress Disorder (PTSD)
      • Problem gambling
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self harm
      • Shyness and social phobia
      • Sleeping well
    • Support, care and treatment

      Support, care and treatment

      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Being sectioned
      • Benzodiazepines
      • Bipolar medications
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Electronic health records in mental health services in England
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Mental capacity and the law
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Spirituality and mental health
      • Stopping antidepressants
      • Talking to your GP
      • What to expect of your psychiatrist in the UK
      • Antipsychotics in Pregnancy
      • Lithium in Pregnancy and Breastfeeding
      • Mother and Baby Units (MBUs)
      • Children's Social Services and Safeguarding
      • Valproate in women and girls who could get pregnant
      • What are Perinatal Mental Health Services?
      • Mental health in pregnancy
      • Medication for mental health and COVID-19
      • Remote consultations and COVID-19
      • Attending hospital and COVID-19
      • Monitoring health at home and COVID-19
      • Alcohol and COVID-19
      • Eating disorders and COVID-19
      • Perinatal care and COVID-19
      • COVID-19: Self-harm in young people 
      • COVID-19: Self-harm and suicide 
      • COVID-19: Looking after your mental health – for young people and their parents and carers 
      • COVID-19: Using drugs
      • COVID-19: ASD
    • Young people's mental health
    • Translations

      Translations

      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Auf Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
      • Tamil தமிழ்
      • Urdu اردو
      • Welsh Cymraeg
    • Mental health FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd: web tools for those working with young people
    • Order mental health packs for schools
    • Audio resources
    • Problems and disorders
      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Depression and men
      • Eating well and mental health
      • Feeling on the edge
      • Feeling overwhelmed
      • Feeling stressed
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post Traumatic Stress Disorder (PTSD)
      • Problem gambling
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self harm
      • Shyness and social phobia
      • Sleeping well
    • Support, care and treatment
      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Being sectioned
      • Benzodiazepines
      • Bipolar medications
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Electronic health records in mental health services in England
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Mental capacity and the law
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Spirituality and mental health
      • Stopping antidepressants
      • Talking to your GP
      • What to expect of your psychiatrist in the UK
      • Antipsychotics in Pregnancy
      • Lithium in Pregnancy and Breastfeeding
      • Mother and Baby Units (MBUs)
      • Children's Social Services and Safeguarding
      • Valproate in women and girls who could get pregnant
      • What are Perinatal Mental Health Services?
      • Mental health in pregnancy
      • Medication for mental health and COVID-19
      • Remote consultations and COVID-19
      • Attending hospital and COVID-19
      • Monitoring health at home and COVID-19
      • Alcohol and COVID-19
      • Eating disorders and COVID-19
      • Perinatal care and COVID-19
      • COVID-19: Self-harm in young people 
      • COVID-19: Self-harm and suicide 
      • COVID-19: Looking after your mental health – for young people and their parents and carers 
      • COVID-19: Using drugs
      • COVID-19: ASD
    • Young people's mental health
    • Translations
      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Auf Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
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Mark Saville on how SpecialEffect 'levels the playing field' for people with physical disabilities

Cultural blog, Gaming the mind blog

26 April, 2017

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No man is an island,
entire of itself;
every man is a piece of the continent,

a part of the main.

John Donne

However for some children, this may not often feel the case. Children with physical disabilities may face limitations in their interactions with peers (Stevens et al, 1996). Reduced access to participation is often not only due to differences in functional skills, but may also be due to limitations imposed by the physical and social environment (Law et al, 2007).

SpecialEffect is a charity which looks to address this issue when it comes to participation in gaming. Mark Saville, who acts as communication support for the team, was kind enough to offer his time for an interview, so I could find out more about the charity's work.

Levelling the playing field

Mark set out the aim of SpecialEffect: 'To help people of all ages with physical disabilities enjoy videogames. To play video games on a level playing field with everyone else. So, for those with a physical disability to join in with their family and friends as effectively as possible.'

I was curious about the origin of this service. Mark told me about SpecialEffect's founder and CEO, Dr Mick Donegan (an Associate Senior Research Fellow at SMARTlab, University College, Dublin, and Adjunct Professor in the Department of Assistive Design at OCAD University, Ontario), who ten years ago was working for another charity in which he was helping severely disabled children with their communication.

'The parents would come and say their children can communicate at school, but what happens when they leave? What quality of life do they have on the weekends on evenings? This was a time when video games were on the rise. Games provided a perfect platform for people with disabilities to join in.'

Mark returned to the concept of levelling the playing field. 'I think we are looking at children who don't have the ability to run around and play like other children do. And, you know, the online version of football – FIFA, for example – comes along and they can't play that either. They are missing out twice with their friends.

The aim of the charity is to at least pull back one of those and make it possible. And by doing that, the impact is incredible. The inclusion, the raising of quality of life, is just astonishing.'

The way SpecialEffect 'pulls back' is by modifying the hardware required to play computers games, in order to increase their accessibility. I was fortunate enough to trial some of their technology at Rezzed, a gaming convention in London, and was able to see the different modifications to gaming controllers which help people with disabilities engage with games.

However, the question remained whether it would allow somebody with a physical disability to play on the aforementioned 'level playing field'.

Mark acknowledged that there are a lot of variables influencing whether the charity is able to help somebody. 'For example, a parent or a child might come to us, and the young person is saying 'Look, I have muscular dystrophy and I have weakness in my fingers but I really want to play Call of Duty.' And so we say 'Okay, we will go along and look at your specific abilities even down to the millimetre of movement you have and we will see whether there is some way, be it through joysticks, switches or eye gaze, and we will try and find some way for you to play Call of Duty.' So that is the primary aim. And that is what I mean by levelling the playing field. We will do our utmost to make that happen.'

Mark recognises that sometimes it is a case of managing expectations. 'Especially sometimes we find we are working with people who may have a condition which may be advancing. We will try to keep them playing as long as we can but we may have to progress to other games as time goes on.'

Practicalities

He also highlighted the difficulties in the practicalities in creating bespoke controllers for video games. 'Making a general controller for accessibility for all games isn't possible, even within a particular disability. If you look at cerebral palsy for example, every single person has different difficulties: their muscle spasm might mean they spasm inwards or outwards. There are various levels. It is therefore impossible to create a generic controller and say, 'there you go.''

This means that each controller made via SpecialEffect is customised for the child requesting it. This is, as Mark puts it, 'the one-to-one approach.' This in turn requires a multidisciplinary team being involved, such as technologists and occupational therapists going out to visit people. 'They are amazing to watch,' Mark said, 'to see them working with people to produce something custom.

It could be something as simple as an adapted one-handed joystick for some people who may have a problem with one hand. If it is somebody with a spinal injury, we might be thinking of a chin joystick combined with a voice control in combination with a couple of head switches on the head rest.

There is a huge range of technology which includes pulse switches and eye blink switches. So we are kind of mixing and matching and creating. Sometimes we have to pull a controller apart and put holes into it and modify it in a way which makes it easier for somebody. It really is horses for courses.'

Mark described the benefit the work has had not only for the children involved, but also for the carers as well. 'The impact we are finding is not just obviously fun: we are finding that especially with people with severe disabilities, if we enable them to gain three or four hours in a stretch, we are giving a lot of respite time to their carers.

We are also giving those people a chance to be anonymous online and interact at the same level with the people they are playing. They may well be beating people online and those people have no idea this person has got a disability. It is a big thing.'

This impact is seen through the positive feedback the charity receives. 'I was talking to a parent the other day, a parent we had helped, who said, 'Thank you, as a father, for making me feel so much better that my daughter is enjoying herself.' And it had never struck me, before.'

These accessibility modifications can also have a role in physical rehabilitation. 'We may find an occupational therapist is referring someone who needs some kind of hand exercises, and for us, operating a joystick to play a game is a good repetitive hand exercise for a young child. It is a win-win. We are finding new positive impacts every day. But mainly it is still about inclusion.'

Looking to the future

Discussion turned to the future of SpecialEffect. 'First and foremost, we want to still be doing what we are doing now because the nature of disability is never going to change. There is always going to be a huge range of disabilities displaying in different ways and we will always need to produce custom controls. But what we are also doing is working with game developers as well, to look at ways in which they want to make their games more accessible to people. 10 years, who knows? But I can assure you we will still be helping people.'

The referral pathway for SpecialEffect is completely open. Anybody with a physical disability or their parents/carers can contact the team directly (a contact form is available). 'We don't charge,' said Mark, 'because we are dealing with young people and families who are facing enough pressures financially, or otherwise. The last thing we want to do is say 'Would you like to play games? I'm sorry that is going to cost you a few hundred pounds.''

To me, the charity seems a worthwhile cause, increasing social inclusion within an often overlooked group in society. In most fields of psychiatry, in particular in liaison and CAMHS, we often see individuals with physical disabilities which may limit their ability to engage in what is viewed as 'normal' activity among their peers.

This increases their sense of isolation and distress as they feel more disconnected from those around them. This loneliness is associated with increase rates of depression and suicidal feelings (Schinka et al, 2012), while strong social networks play important protective roles against depression (Santini et al, 2015).

With The Pew Internet Study (Lenhart et al, 2008) previously recognising that video games are becoming an almost universal pastime in society and that they are part of normal social engagement, reducing the barriers for people with disabilities to engage may be beneficial not only for their social interaction, but their mental health as well.

SpecialEffect is a registered UK-based charity. Coverage of this charity on this blog does not constitute its endorsement or recommendation by the College.

Authored by Sin Fai Lam

References

Law M, Petrenchik T, King G, et al (2007) Perceived environmental barriers to recreational, community, and school participation for children and youth with physical disabilities. Archives of Physical Medicine and Rehabilitation, 88: 1636–1642. [abstract]

Lenhart A, Kahne J, Middaugh E, et al. (2008) Teens, Video Games and Civics. Pew Internet & American Life Project. [website]

Santini Z, Koyanagi A, Tyrovolas S, et al (2015) The association between social relationships and depression: a systematic review. Journal of Affective Disorders, 175: 53–65. [abstract]

Schinka K, Van Dulmen M, Bossarte R, et al (2012) Association between loneliness and suicidality during middle childhood and adolescence: longitudinal effects and the role of demographic characteristics. The Journal of Psychology, 146: 105–118. [abstract]

Stevens S, Steele C, Jutai J, et al (1996) Adolescents with physical disabilities: some psychosocial aspects of health. Journal of Adolescent Health, 19: 157–164. [abstract]

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