Friday, 2 June 2017

What is Big White Wall?

What is Big White Wall?

1. Big White Wall is an online early intervention service for people in psychological distress. Big White Wall combines social networking principles with a choice of clinically informed interventions to improve mental wellbeing. It can be accessed 24/7 and has staff (Wall Guides) who ensure the full engagement, safety and anonymity of all members.
Big White Wall is a community of people who are experiencing common mental health problems who are supported to self-manage their own mental health. According to members, one of the most important elements of the service is the ability to talk freely, whilst remaining completely anonymous.
Big White Wall has won multiple awards for its services, and its LiveTherapy service is CQC registered.
2. What can people do on Big White Wall?
Big White Wall offers a range of therapeutic interventions including highly creative self-expression. For example, members use powerful images, drawings and words to make vibrant and expressive ‘bricks’ that are posted to The Wall where they can choose to share and discuss the underlying ‘story’ of their pictures and words.
Other therapeutic interventions include:
  • Talk therapy in community, groups and on a one-to-one basis.
  • Guided Groups informed by recognised therapies such as cognitive behaviour and interpersonal therapies.
  • Extensive Useful Stuff section on the website to help people self-manage psychological distress.
  • Networking based on peer support including the ability to make friends and follow their moods and activities
  • LiveTherapy - One to one online therapy with experienced counsellors and therapists, via webcam, audio or instant messaging. 

Who is Big White Wall for?

1. Who can access Big White Wall and how much does it cost?
Anyone who is aged 16 or over, and who is experiencing emotional or psychological distress can log on to and either join via their local NHS provider, if available in their area, or choose to join by paying a subscription of £24 per month.
2. What are the common issues that bring people to Big White Wall?
Anything that is causing people emotional or psychological distress: This can include anxiety, stress, feeling low and depressed, feeling out of control, trauma; all of which may be triggered by life events such as the loss of a loved one, relationship breakdowns, employment related issues, financial crisis, sexuality, isolation, alcohol or drug related problems.
3. Why is anonymity important?
Research has demonstrated that people shy away from sharing their troubles with friends, family or healthcare professionals. For example, 50% never go to a GP for fear of stigma. Men in particular are afraid to reveal how they feel or what’s troubling them. Big White Wall provides an environment in which members feel safe and supported whilst remaining anonymous. 

What impact does Big White Wall have?

1. Is there any evidence to support claims that BWW makes a difference to its members?
A survey of BWW's members found that:
  • 46% report sharing an issue or feelings on BWW for the first time
  • 70% report that using BWW improved their wellbeing in at least one way
  • Of people who were not referred to Big White Wall by a health professional, 48% had not received any treatment for their mental health in the month before joining 

How safe is BWW?

1. Surely it's an easy target for people to prey on vulnerable people?
No, it's not. Jane Chapman, independent risk adviser to the Tavistock and Portman NHS Trust, conducted a comprehensive governance and risk assessment of Big White Wall. The assessment showed BWW carries an overall low risk for users given the safeguards in place.
House Rules, Privacy Rules and specific guidance are provided to members, particularly on how to keep themselves safe on Big White Wall. BWW advocates a policy of non-exchange of personal information or private contacts.
All new content generated by members on the site, including Talkabouts and bricks are monitored and reviewed 24/7. Specific behaviours on the website will trigger a response by BWW staff (Wall Guides) and an escalation process will be implemented.
Big White Wall can remove any content from the website and bar members who are not working within the House and Privacy Rules.
2. How does Big White Wall respond to people who are in danger of harming themselves or others?
Almost a quarter of BWW members have experienced suicidal thoughts and/or thoughts of self-harming. Wall Guides respond immediately when alerted to members who are at danger of self-harm by:
  • Checking whether they have already acted in a way that is harmful and strongly encourage them to contact emergency services of go to A&E if they have
  • Encouraging the member to talk about what they are feeling and what they think is causing the feelings
  • Listening empathetically and being present for the member – making it clear they are not going away
  • Checking whether they have anyone with them or close by that they can call to be with them
  • Explore whether the member has had self-harming thoughts or behaviours previously and what did they do that helped
  • Exploring the type of things they find soothing i.e. music, hot non-alcoholic drinks, reading etc.
  • Encouraging them to draw on the support of their peers/friends on BWW
  • Exploring whether they have sought or would like to see professional help in their local area
  • Encouraging the member to keep in touch
  • Keeping regular contact with the member to see how they are doing
3. How does abuse of the system get reported i.e. people making inappropriate comments?
There is a simple process where a member can click on a Report button on pages of the website to report abuse of the system, this is then escalated to a team member of BWW.
There is also a system of watchwords that signal inappropriate behaviour or language use, which are immediately flagged to a Wall Guide.
4. Who are Wall Guides and what do they do?
Wall Guides are required to be proactive in responding to BWW members who are in crisis and engage with them to provide support, seek local assistance from their GP or therapist. The community is the main source of support as individuals share their stories and experiences and engage in conversations with those who are struggling or troubled.
The functionality on the web site is highly developed and assists the Wall Guides in their work by identifying an exhaustive list of watchwords that trigger alerts for attention. In addition, all members have access to “Report” buttons to alert Wall Guides to any content that they find troubling or concerning.
A key requirement of Wall Guides work is to ensure that anonymity of members is maintained and to report any incidence of posts that may assist to reveal the real identity of a member. This requires that all comments, and all images are read to ensure that it conforms to BWW House Rules
Wall Guides are required to model the behaviour that Big White Wall wants members to adopt within the community. This includes, being welcoming of new members, exchanging comments that are non judgemental and respectful as well as encouraging others to express their troubles and provide assurance of a safe space.
For more information on any of these topics, contact