This site uses cookies: Find out more

Okay, thanks
User content image
Play
Royal College of Psychiatrists - Logo
SKIP NAVIGATION
  • SKIP NAVIGATION
  • About the College
  • News and features
  • International
Logout MY CONTENT 
Login
DONATE
Search
  • Become a psychiatrist

    Become a psychiatrist

    • Choose Psychiatry

      Choose Psychiatry

      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • What next?
      • On a break from training?
      • Choose Psychiatry 2021 video
      • Continuing to choose psychiatry
      • Hear more from the stars of our 2022 film
    • Sixth formers and school students
    • Medical students

      Medical students

      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National Student Psychiatry Conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
      • The Student Psychiatry Audit and Research Collaborative (SPARC)
    • 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
      • RCPsych Recruitment Strategy 2022-2027
    • Choose Psychiatry: Guidance for Medical Schools
    • Supporting Medical Students: Medical Schools
    • Careers past events
    • Choose Psychiatry
      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • What next?
      • On a break from training?
      • Choose Psychiatry 2021 video
      • Continuing to choose psychiatry
      • Hear more from the stars of our 2022 film
    • Sixth formers and school students
    • Medical students
      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National Student Psychiatry Conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
      • The Student Psychiatry Audit and Research Collaborative (SPARC)
    • 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
      • RCPsych Recruitment Strategy 2022-2027
    • Choose Psychiatry: Guidance for Medical Schools
    • Supporting Medical Students: Medical Schools
    • Careers past events
  • Training

    Training

    • Curricula and guidance

      Curricula and guidance

      • 2022 Curricula Implementation Hub
      • 2014 GMC approved curricula (ending July 2024)
      • 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
      • Training less than full time
      • Routes to Registration
      • Cost of Training
      • Leadership and Management Fellow Scheme
      • Understanding Career Choices in Psychiatry
    • 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
      • Examiners and exam panels recruitment
      • FAQs about applying for exams
      • FAQs about preparing for exams
      • FAQs about the day of the exam
      • FAQs about assessment and results
      • Exams news and updates
    • Neuroscience in training

      Neuroscience in training

      • About the project
      • Neuroscience events
      • Who was on the commission?
      • Neuroscience history
      • Neuroscience resources
      • Multimedia learning
    • Deanery/LETB Hub
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates

      International Medical Graduates

      • Shortage Occupation List
    • Quality Assurance in Training
    • Credentialing
    • CPD eLearning
    • Building Capacity in Perinatal Psychiatry

      Building Capacity in Perinatal Psychiatry

      • Perinatal 2023 Masterclass Programme application and process details
      • Perinatal Psychiatry Masterclass for New consultants resources
      • About the Building Capacity Project
      • Perinatal Psychiatry Masterclass for Senior Trainees resources
      • Perinatal Psychiatry Top - up masterclass for consultants resources
      • Perinatal Psychiatry Masterclass for Senior Trainees Jan 2023 resources
    • Dean's annual update
    • Curricula and guidance
      • 2022 Curricula Implementation Hub
      • 2014 GMC approved curricula (ending July 2024)
      • 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
      • Training less than full time
      • Routes to Registration
      • Cost of Training
      • Leadership and Management Fellow Scheme
      • Understanding Career Choices in Psychiatry
    • 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
      • Examiners and exam panels recruitment
      • FAQs about applying for exams
      • FAQs about preparing for exams
      • FAQs about the day of the exam
      • FAQs about assessment and results
      • Exams news and updates
    • Neuroscience in training
      • About the project
      • Neuroscience events
      • Who was on the commission?
      • Neuroscience history
      • Neuroscience resources
      • Multimedia learning
    • Deanery/LETB Hub
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates
      • Shortage Occupation List
    • Quality Assurance in Training
    • Credentialing
    • CPD eLearning
    • Building Capacity in Perinatal Psychiatry
      • Perinatal 2023 Masterclass Programme application and process details
      • Perinatal Psychiatry Masterclass for New consultants resources
      • About the Building Capacity Project
      • Perinatal Psychiatry Masterclass for Senior Trainees resources
      • Perinatal Psychiatry Top - up masterclass for consultants resources
      • Perinatal Psychiatry Masterclass for Senior Trainees Jan 2023 resources
    • Dean's annual update
  • Members

    Members

    • Workforce Wellbeing Hub

      Workforce Wellbeing Hub

      • Psychiatrists' Support Service
      • How the College supports workforce wellbeing
      • Top 10 tips for wellbeing
      • Mentoring and coaching
      • If a patient dies by suicide
      • If a patient commits homicide
    • Supporting your professional development

      Supporting your professional development

      • New consultants (StartWell)
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • Writing clinic letters
    • CPD eLearning
    • Submitting your CPD

      Submitting your CPD

      • Alterations to CPD during coronavirus pandemic
    • 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
    • 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
      • Startwell and Staywell
    • 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
    • Special Interest Groups

      Special Interest Groups

      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Digital psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality and Psychiatry 
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Members' eNewsletters
    • Posts for members
    • Public members list
    • Jobs board
    • 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
    • 2021 membership survey
    • Mindmasters quiz

      Mindmasters quiz

      • About the quiz
      • Who won in 2022?
      • The rules of the quiz
      • Sample quiz questions 
    • eLearning Hub
    • Workforce Wellbeing Hub
      • Psychiatrists' Support Service
      • How the College supports workforce wellbeing
      • Top 10 tips for wellbeing
      • Mentoring and coaching
      • If a patient dies by suicide
      • If a patient commits homicide
    • Supporting your professional development
      • New consultants (StartWell)
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • Writing clinic letters
    • CPD eLearning
    • Submitting your CPD
      • Alterations to CPD during coronavirus pandemic
    • 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
    • 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
      • Startwell and Staywell
    • 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
    • Special Interest Groups
      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Digital psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality and Psychiatry 
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Members' eNewsletters
    • Posts for members
    • Public members list
    • Jobs board
    • 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
    • 2021 membership survey
    • Mindmasters quiz
      • About the quiz
      • Who won in 2022?
      • The rules of the quiz
      • Sample quiz questions 
    • eLearning Hub
  • Events

    Events

    • Conferences and training events

      Conferences and training events

      • Register your interest - CESR in Psychiatry Training
      • MHA Section 12 and Approved Clinician Training
      • Register your interest - Present State Examination Course 2022
      • Subscribe to receive the Events eNews
      • Register your interest - ICD-11 events
      • RCPsych Certificated Courses
      • Grand Rounds
    • International Congress 2022

      International Congress 2022

      • Congress 2022 FAQs
      • Congress Webinar Package
      • Poster Presentations 2022
      • Exhibition Opportunities 2022
      • Your guide to Congress
      • IC22 Keynote speakers
      • Programme
      • Speaker information
      • Travel and accommodation guidance 
      • Social and Fringe Events
      • #RCPsychIC
      • Rapid Fire and Poster Prize Winners
    • International Congress 2023

      International Congress 2023

      • Register your interest - Congress 2023 exhibitors
      • Travel and accommodation guidance 
      • Registration
      • Congress 2023 FAQs
      • Poster Presentations 2023
      • Programme
      • Social Media
    • In-house training

      In-house training

      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Events held by other organisations
    • Free webinars

      Free webinars

      • Free webinars for members
    • Recruitment events
    • Claiming Expenses
    • Terms and conditions
    • Speaker guidance for online events
    • Conferences and training events
      • Register your interest - CESR in Psychiatry Training
      • MHA Section 12 and Approved Clinician Training
      • Register your interest - Present State Examination Course 2022
      • Subscribe to receive the Events eNews
      • Register your interest - ICD-11 events
      • RCPsych Certificated Courses
      • Grand Rounds
    • International Congress 2022
      • Congress 2022 FAQs
      • Congress Webinar Package
      • Poster Presentations 2022
      • Exhibition Opportunities 2022
      • Your guide to Congress
      • IC22 Keynote speakers
      • Programme
      • Speaker information
      • Travel and accommodation guidance 
      • Social and Fringe Events
      • #RCPsychIC
      • Rapid Fire and Poster Prize Winners
    • International Congress 2023
      • Register your interest - Congress 2023 exhibitors
      • Travel and accommodation guidance 
      • Registration
      • Congress 2023 FAQs
      • Poster Presentations 2023
      • Programme
      • Social Media
    • In-house training
      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Events held by other organisations
    • Free webinars
      • Free webinars for members
    • Recruitment events
    • Claiming Expenses
    • Terms and conditions
    • 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
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
      • CCQI news
    • Campaigning for better mental health policy

      Campaigning for better mental health policy

      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • Cross-government mental health and wellbeing plan 
      • 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
      • Reforming The Mental Health Act
      • Don't overlook mental health campaign
      • The Mental Health Policy Group (MHPG)
    • Planning the psychiatric workforce

      Planning the psychiatric workforce

      • About workforce
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
      • Job description approval process
    • Public Mental Health Implementation Centre

      Public Mental Health Implementation Centre

      • Our partners and first partnership activity 
      • How to work with the Public Mental Health Implementation Centre
      • Who's involved in the Public Mental Health Implementation Centre?
      • Aims and objectives
      • Reports
      • About public mental health
      • PMHIC Parliamentary Launch 
    • National Collaborating Centre for Mental Health

      National Collaborating Centre for Mental Health

      • About NCCMH and our work
      • Clinical guideline development
      • Competence frameworks
      • Quality improvement programmes
      • Reports and research
      • Service design and development
      • Work with us
    • Physician Associates

      Physician Associates

      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
      • The Competence Framework for Physician Associates in Mental Health
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and mental health

      Sustainability and mental health

      • In your community
      • In your practice
      • In your trust
      • Nature matters
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • College position on sustainability
      • Attending COP26
    • Using quality improvement
    • Net Zero Mental Health Care Research, Resources and Education
    • College Centre for Quality Improvement (CCQI)
      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
      • CCQI news
    • Campaigning for better mental health policy
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • Cross-government mental health and wellbeing plan 
      • 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
      • Reforming The Mental Health Act
      • Don't overlook mental health campaign
      • The Mental Health Policy Group (MHPG)
    • Planning the psychiatric workforce
      • About workforce
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
      • Job description approval process
    • Public Mental Health Implementation Centre
      • Our partners and first partnership activity 
      • How to work with the Public Mental Health Implementation Centre
      • Who's involved in the Public Mental Health Implementation Centre?
      • Aims and objectives
      • Reports
      • About public mental health
      • PMHIC Parliamentary Launch 
    • National Collaborating Centre for Mental Health
      • About NCCMH and our work
      • Clinical guideline development
      • Competence frameworks
      • Quality improvement programmes
      • Reports and research
      • Service design and development
      • Work with us
    • Physician Associates
      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
      • The Competence Framework for Physician Associates in Mental Health
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and mental health
      • In your community
      • In your practice
      • In your trust
      • Nature matters
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • College position on sustainability
      • Attending COP26
    • Using quality improvement
    • Net Zero Mental Health Care Research, Resources and Education
  • Mental health

    Mental health

    • Problems and disorders

      Problems and disorders

      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety and generalised anxiety disorder (GAD)
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Catatonia
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Feeling overwhelmed
      • Gambling disorder
      • Heroin dependence
      • 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) 
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self-harm
      • Shyness and social phobia
      • Sleeping well
      • Avoidant/restrictive food intake disorder (ARFID)
      • Cocaine dependence
    • Support, care and treatment

      Support, care and treatment

      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Antipsychotics in pregnancy
      • Being sectioned
      • Benzodiazepines
      • Children's social services and safeguarding
      • 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)
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Lithium in pregnancy and breastfeeding
      • Mental capacity and the law
      • Mental health in pregnancy
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Mother and baby units (MBUs)
      • Neuromodulation
      • Perinatal mental health services: what are they?
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Social prescribing
      • Spirituality and mental health
      • Stopping antidepressants
      • Valproate in women and girls who could get pregnant
      • What to expect of your psychiatrist in the UK
      • COVID-19: Medication for mental health
      • COVID-19: Remote consultations
      • COVID-19: Going to hospital for a physical illness or injury
      • COVID-19: Eating disorders
      • COVID-19: Perinatal care
      • Hypnosis and hypnotherapy
      • Benefits, financial support and debt advice
      • Caring for someone with a mental illness
    • Young people's mental health
    • Translations

      Translations

      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German 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
      • Sindhi سنڌي
      • Ukrainian украї́нська
      • Swahili Kiswahili
    • Mental health and psychiatry FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd – free mental health eLearning
    • Order mental health packs for schools

      Order mental health packs for schools

      • Order form for mental health factsheets for young people
    • Audio resources
    • Veterans' mental health
    • Suicide resources
    • Problems and disorders
      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety and generalised anxiety disorder (GAD)
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Catatonia
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Feeling overwhelmed
      • Gambling disorder
      • Heroin dependence
      • 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) 
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self-harm
      • Shyness and social phobia
      • Sleeping well
      • Avoidant/restrictive food intake disorder (ARFID)
      • Cocaine dependence
    • Support, care and treatment
      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Antipsychotics in pregnancy
      • Being sectioned
      • Benzodiazepines
      • Children's social services and safeguarding
      • 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)
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Lithium in pregnancy and breastfeeding
      • Mental capacity and the law
      • Mental health in pregnancy
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Mother and baby units (MBUs)
      • Neuromodulation
      • Perinatal mental health services: what are they?
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Social prescribing
      • Spirituality and mental health
      • Stopping antidepressants
      • Valproate in women and girls who could get pregnant
      • What to expect of your psychiatrist in the UK
      • COVID-19: Medication for mental health
      • COVID-19: Remote consultations
      • COVID-19: Going to hospital for a physical illness or injury
      • COVID-19: Eating disorders
      • COVID-19: Perinatal care
      • Hypnosis and hypnotherapy
      • Benefits, financial support and debt advice
      • Caring for someone with a mental illness
    • Young people's mental health
    • Translations
      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German 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
      • Sindhi سنڌي
      • Ukrainian украї́нська
      • Swahili Kiswahili
    • Mental health and psychiatry FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd – free mental health eLearning
    • Order mental health packs for schools
      • Order form for mental health factsheets for young people
    • Audio resources
    • Veterans' mental health
    • Suicide resources
Menu   
  • Home
  • News and features
  • Blogs
Back to Blog

Dr Christina Fawcett on the Batman: Arkham series and incarceration of people with mental illness

Cultural blog, Gaming the mind

15 January, 2020

  • Print this page
  • Share this page
    • facebook
    • twitter
    • linkedin
  • Email this page

The game Batman: Arkham Asylum​ (2009) and its sequel, ​Batman: Arkham City (2011),​ both give the player thrilling experiences as the iconic superhero Batman. With both games placing the action within a supposed forensic psychiatric care setting, they portray villainisation, incarceration, and brutalisation of people with mental illness. These depictions of mental illness are clichéd and highly stigmatising, but there is more on these issues a player could appreciate through the games beyond what they are shown superficially. I was pleased to speak to Dr Christina Fawcett, a video game theorist, for a better understanding of the depth of messaging regarding mental illness within these games.

Fawcett’s academic background is in monster theory, where she dealt with cultural and moral elements of the monsters in Tolkien’s legendarium. She teaches courses in science fiction, fantasy, fairy tales, and horror at the University of Winnipeg. She described villainy as one of the more human forms of monstrosity, which led her academic interest to the Batman franchise, with its eclectic rogues’ gallery. With her colleague Steven Kohlm, Professor in the Department of Criminal Justice at the University of Winnipeg, Fawcett analysed Batman: Arkham Asylum and Batman: Arkham City through the framework of popular criminology (Fawcett, 2019). Fawcett was already a fan of the games, but she noted, “I was finding myself uncomfortable with the way the asylum space is set up and the way you are forced to physically engage with the inmates.”

Into the asylum

Arkham Asylum has been part of the Batman franchise since 1974, described as an institution for the “criminally insane” and housing a variety of Batman’s infamous foes. The game Batman: Arkham Asylum sees Batman enter the institution in order to confront his nemesis Joker, who has allowed himself to be detained in order to seize control of Arkham from within.

As part of Joker’s scheme, a fire at Blackgate Penitentiary leads to prisoners being transferred to the asylum, resulting in what Fawcett describes as “a collapse of penal institution and mental institution.” This collapse is further advanced in Batman: Arkham City, in which both Arkham Asylum and Blackgate Penitentiary are shut down, in favour of a single immense detention complex named Arkham City. “We have the carceral space becoming home to both individuals found guilty of a crime and individuals who are dubbed ‘criminally insane’,” said Fawcett. “That suggests an equivalence of treatment; that the patients aren’t really getting treated as patients; they’re just seen as prisoners. The game gets us to think about how the mental institution operates within the carceral system.”

Fawcett’s background in monster academia gives her a unique window to interpret the inhuman ways in which the patients of Arkham are depicted. She describes two layers of representation of mental illness within the first game. First are the supervillains. “They all get bio statements which highlight their mental illness and psychopathy,” she said. “Those are just naturalised traits; they’re just constantly present.”

Among the villain biographies, Joker is described as a “homicidal maniac”; Harley Quinn as a “homicidal psychotic”; Two-Face as a “schizoid criminal mastermind, obsessed with duality”; Professor Hugo Strange as “plagued by schizophrenic episodes”; and The Riddler as having an “obsessive-compulsive need for attention”. Fawcett explained why mental illness is so common to Batman’s rogues’ gallery: “The complicated psychology of Batman himself invites more of a psychological foil. As much as you can frame Batman as being this incredibly powerful human, he’s still human, and so we have him facing human opponents. And what’s the scariest kind of human opponent? Somebody who we can’t reason with. A complete lack of reason, sense, or logic is terrifying, and it’s something we’re not comfortable with. That then gets framed as mental illness.”

The second layer of mental illness representation exists in the unnamed patients of Arkham, broadly labeled ‘lunatics’. “The ’lunatics’ are sub-verbal,” Fawcett explained. “They make feral noises. There’s a lot of screaming, growling and hissing: entirely animal.” The ’lunatic’ characters thrash around in long straightjackets and try to chew on Batman. “So you have the supervillains who are intelligent and insane, and the purely insane who are just animalistically violent.” The ’lunatic’ characters are dated in design, wearing restrictive apparatus like wirecages and constrictive leather straps, evoking barbaric torture devices. “It is an amplification and sensationalisation of mental illness,” said Fawcett, “with all humanity stripped away.”

Joker frees the ‘lunatics’ from their cells, to pose a hindrance to Batman

Joker frees the ‘lunatics’ from their cells, to pose a hindrance to Batman

The games have an exaggerated, stigmatising view of villainy’s rooting in mental illness, but they also offer little other reason for why criminal activity occurs, as though mental illness is the only explanation. “It doesn’t address circumstance, desperation and economic disparity,” said Fawcett. “All of those things just get erased. The drivers of crime; greed, or desperation, those things don’t come into play.”

Brutal retribution

Being action games, Batman must fight on his path to thwarting Joker’s plans, and this does mean fighting the residents of the institution. All mentally ill people within the game are framed as a threat, to justify your retaliation. “You don’t really get a choice in the matter,” said Fawcett. “The game makes that kind of violence mandatory.” In the first game, Batman fights both the Blackgate prisoners and Arkham ’lunatics’, though his brutality differs between the two groups. Defeating ‘lunatics’ requires Batman to use subduing actions, though still violent, such as slamming them to the ground. “It’s framed as you putting them down for their own good, to use that animal language,” said Fawcett.

Some players may try to engage less aggressively, however futile the attempt, pointing towards critical thought on the part of the player. “We are aware of our own individual identities outside of the protagonist,” Fawcett said. “As long as we’re aware of that separation, that my identity is not lost when I play this game, and who I am is still important, then, yes, the game is making you do this, but you can consider: narratively, why? Also emotionally or politically or socially, what is the game doing and why is it making me have that uncomfortable moment?”

Fawcett is interested in how this mandated violence makes players feel and how players engage with such framing. She also hopes that players remain questioning of their actions, even if they are forced: “You’re choosing to participate in the game space. These games can challenge us on what we’re willing to do, even if it’s only in a digital space.”

The player can discover aspects of Arkham’s history throughout the game. For example, they learn how the asylum’s founder, Amadeus Arkham, had hoped for the asylum to be a rehabilitative institution. However the first patient Amadeus treated immediately attacked Amadeus’s secretary upon discharge. “That gets highlighted as a warning that this is what happens when you try to cure people,” Fawcett said. “We have an attempt at cure being thwarted by the patient’s manipulation of the system. The system becomes retributive in response.”

The games portray Amadeus’s legacy as the need to enact violence against mental health patients as a means of controlling and subduing them. The asylum’s modern custodian, Warden Sharp, is the inheritor of this legacy. Sharp is documented as being openly abusive of Arkham patients. “He frames it as retributive; that they deserve it,” said Fawcett. “He’s not enacting any form of rehabilitation or treatment. It is absolutely abuse for the sake of abuse.”

By the second game, the asylum and prison are fully combined into a massive carceral institution, and Batman’s growing unease with the situation catches up with the player’s own discomfort. Even at this point, said Fawcett, there is some hypocrisy to Batman’s stance: “We see Batman showing frustration with the way the private guards are treating prisoners and then he goes and beats people just as violently.”

Bruce Wayne (Batman) is critical of Arkham City - but his concern is not for the patients

Bruce Wayne (Batman) is critical of Arkham City - but his concern is not for the patients

Batman, though traditionally described as a vigilante, is a firm part of the oppressive law enforcement system. Even as supposed civilian, he is allowed to take weapons into Arkham. He is a useful cog, carrying out the brutal acts the justice system openly cannot. How is the player expected to react to Batman’s brutality? Fawcett described that the games “allow a space of tremendous player discomfort with Batman’s vigilante actions.” However, the game is open to different readings: “The game offers the opportunity to think ‘wow I get to be Batman, this is awesome’ – and there’s also a simultaneous narrative of ‘should I really be punching these people?’ The narrative is one of tension between you and your protagonist.”

This tension is enhanced by the third-person perspective used in the games, where the player controls Batman but views him from the outside. “It gives us more of that filmic distance, that disassociation from the body,” said Fawcett. “Yes, we are the ones who pushed the button, but that looked aggressive. That creates a potential for tension.” In addition, the player can see Batman’s face when he enacts violence, and note the discordance between his emotions and their own. “You realize he’s totally fine with it. How can he be comfortable with that?”

What works?

The games paint a dilemma of rehabilitation versus punitive incarceration, where neither option works for the management of the mental health patients. Medical records the player finds throughout Arkham demonstrate the futility of mental health treatment for supervillains who have never shown recovery. Meanwhile, the justice system is so ineffective it requires the likes of Batman to support it. Fawcett recognizes an element of hopelessness to the game. She brings it back to the first appearance of Arkham Asylum within the comics, which was in the same year sociologist Robert Martinson published what would come to be known as the ‘Nothing Works’ report (Martinson, 1974). The report highlighted the shortcomings of prison rehabilitation programs at the time. Fawcett explained: “The report was taken up by conservative lawmakers as: ‘nothing we’re doing is helping, let’s forget rehabilitation, let’s warehouse people and let them suffer for their crimes.’” Martinson’s report had, in fact, called for improvements to rehabilitation. “But the report and its message got twisted into: ‘why are we bothering?’”

The Arkham games continue this nihilistic view. “We’re never given an optimistic solution of how to deal with carcerality,” said Fawcett, “or how to deal with the violent and mentally ill.” However, the games open a space to critique existing systems, or at least fictionalized, sensational versions of them. The problems of Arkham City reflect those of the real world: we really do have warehousing prisons, and we really do have people with mental illnesses and substance use disorders who end up in prison instead of in treatment.

Arkham is depicted in a manner that already presumes its failure as a space for rehabilitation. “By positioning it in Victorian buildings with old fashioned torture-style devices,” Fawcett said, “it makes all the treatment feel outdated and ineffective because it’s the brutality of the past.” There is no representation of modern psychiatric settings within the game. “We don’t get a counter to that. We very much see the dangers and threats of the system, in a way that justifies Batman’s violent interventions. It justifies the way he engages with the space as brutal. Because nothing else works… so you may as well send in a guy with a big bat cowl to punch people.”

Of all the game’s supervillians, Joker’s mental illness is perhaps the most overt in its depiction. Joker has been part of Batman history ever since the debut issue of Batman in 1940. Fawcett noted Joker was introduced to audiences “well before the idea of the serial killer was popularised.” Though initially a remorseless killer, Joker was soon developed into a prankster character, more interested in stealing jewels and spreading fear. While the original Joker was threatening, “there was nothing about his behavior that was highlighted as manic, or mentally abhorrent, other than the fact he likes his costuming and has his clown makeup."

arkham3

Joker taunts Batman as he is escorted into Arkham Asylum, with a suggestive comment about Batman’s own mental health

In 1973, Joker returned to the comics as a serial killer driven by mental illness, along with the new concept of Joker being ‘criminally insane’. This evolution of the character took place on the backdrop of changing social theories of criminality, as Fawcett described: “The idea of the serial killer or the super-predator, arising in the 70’s and 80’s, described figures who are beyond logic. The justification for their crime was portrayed as something darker or more frightening, because it came from within their own mind and was something we could not understand so easily.”

Almost as the existence of Joker demands the existence of Batman, so too the existence of serial killers demanded the expansion of federal police powers in America. “The framing of crime in this way, I don’t think it was necessarily trying to pull psychology and psychiatry into the realm of the criminologist, so much as it was justifying extra-legal near-vigilante or brutal responses on the part of law enforcement. This is just after 'Nothing Works', and we started to see more focus on the serial killer and super-predator, which justified that these aren’t people we can treat with the normal kind of incarceration; we needed more extreme forms of control. These were literally the poster children for retribution within a penal system.”

As emerging social theories inspired the ‘psychopathic’ framing of Joker, media depictions of Joker in turn galvanised this framing within public consciousness. “When you have something as iconic as Batman," said Fawcett, "that feeds into other narratives and spaces and media - the show, the films, the games - the image keeps filtering through until it becomes the norm, and pretty soon, 'How do you deal with a problem like Joker?' Well, with vigilante apocalyptic violence. That’s the only form of justice you can find: brutal, physical retribution.”

We now have more of an understanding of mental illness and treatment. However, fictional psychopathic serial killers have persisted as a holdover from this prior era. "Once Joker took on that lens of psychopathy, for lack of a better term, he’s never going to drop that,” said Fawcett. “Particularly for the Batman world, Arkham is such a ripe space for interesting and dark narratives and examinations of psychological complexity. We’re never going to get away from that.”

Beneath the surface

While, superficially, these games easily could, and arguably should, be criticised for their portrayals of mental illness, the story does not end at surface impressions. “You can play it absolutely flat, and enjoy that you get to be Batman,” said Fawcett. “The game design presents the opportunity for a countervisual that the player can either engage with a simple relationship of player-to-Batman, or with a relationship of player-to-world. And if we start looking at the larger world, if we start looking at the other characters, the other perspectives, and we’re not simply being Batman, we have the opportunity to look beyond what he sees and consider the faults and the violence that is inherent in a carceral system that brutalises the mentally ill. And so, by having a space of potential discomfort, players are invited to think critically about how these systems work and what these systems do to people.”

At least, that is perhaps the ideal. It is possible that many players do play only on a flat reading, enjoying the experience and not paying mind to the difficult questions the games raise about justice and rehabilitation. We must also accept that some players may enjoy playing around with mental illness and the mentally unwell in a way that perpetuates stigmatisation, echoing the real asylum tourism that persisted well into the mid-nineteenth century. It may be the case that the creators of the games did not intend to explore these issues at all, and that deeper readings are solely bound to the interpretations of players who wish to seek that meaning from the material available to them.

But these games do hold tensions to them: between the role of player and the role of Batman; between the role of hero and role of law enforcement; between being a protector and being a brutaliser; between the perceived safety of incarceration and the horror of punitive justice; between the popular narrative of crime and the more complicated truth. The player may find discomfort in these tensions and a space to begin questioning themselves.

No tension seems more key to the games than what Fawcett describes as “contradictory carcerality”. Fawcett explained the term: “It is very much the same way that we trust in the carceral system as necessary, but we also have to be perpetually critical of the problems of carcerality and the problems of incarcerating individuals who need treatment instead of being locked up. We have to be perpetually aware of the contradiction of something that we think is necessary for the safety of society that is simultaneously a threat to individuals and people. So the game offers an ability to play within and be aware of that tension.”

The Arkham games are well celebrated, and raising their more disturbing content is not an argument that the games should be disregarded or avoided. Most art that attempts to represent and critique human society will fail to break free of the ideological prejudices of the time in which it is made. Great art is able to transcend such boundaries, but whether the Arkham games achieve this is open to debate. We can still engage with and enjoy these games, but it is important to play with a critical eye, locating the discomfort within the games, and challenging ourselves to find deeper meaning in the message. If the Arkham games can make us reflect on the issues of incarceration of people with mental illness, they play an important role.

Authored by Sachin Shah

Fawcett, C., & Kohm, S. (2019). Carceral violence at the intersection of madness and crime in Batman: Arkham Asylum and Batman: Arkham City. ​Crime, Media, Culture​, 1741659019865298.

Martinson, R. (1974). What works?-Questions and answers about prison reform. The public interest, 35, 22.

 

Blog Author
Gaming the mind team

Previous post Next post
  • Mental health
  • Members
  • Improving care
  • About the College
  • News and features
  • Contact the College
  • Work for us
  • Jobs Board for Members
  • Data protection
  • Disclaimer
  • Permissions
  • Web accessibility
SEE MAP

London Office
21 Prescot Street London E1 8BB
0208 618 4000

stonewall-silver-logo-small

disability-confident-logo-small

european-diversity-awards-winner-charity-of-the-year-badge-small

memcom-best-edi-campaign-winner-2022-small

Royal College of Psychiatrists

© 2023 Royal College of Psychiatrists.

Registered charity no. 228636 (England and Wales)

Charity registration no. SC038369 (Scotland)

  • Become a psychiatrist
  • Training
  • Events
  • Facebook
  • Twitter
  • YouTube
  • LinkedIn
  • Instagram