Between 4 and 15% of the population are estimated to hear voices – despite this, in many Western countries, hearing voices is a highly stigmatised experience.1 People who hear voices are often considered psychotic and treated with fear and suspicion. Ando et al2 suggested that hearing distressing voices is one of the most stigmatised experiences in psychiatry.
A number of studies have shown that qualified and student health professionals are influenced by commonly held stereotypes about hearing voices. For example, Llerena et al3 found that in a sample of medical and nursing students, 78% thought people with a diagnosis of schizophrenia were likely to be violent or dangerous, and 50% thought people with that diagnosis would not recover or live a ‘normal’ life.
I have been part of a project team, based at the University of Chester, developing the Hearing Voices App, which is aimed at health and social care professionals to enhance their understanding of the experience of hearing voices. The App may also be of interest and help to people who hear voices and their family members, friends and colleagues. The App can be downloaded for free from itunes and Googleplay. An introductory video about the App is available here.
The Hearing Voices App project team consisted of people with lived experience of voice hearing, academics, and health professionals from various backgrounds – nursing, clinical psychology and public health. A unique feature of the App derives from the collaborative approach taken which ensured that it is not predominated by the medical model but rather represents the wider spectrum of understanding, interpretations and approaches to managing hearing voices.
Podcasts of people who hear voices are incorporated into the text of the App, allowing a number of stories to be heard. Simulation of hearing voices is a central feature of the App – this aims to provide a deeper insight into the experience and to promote empathy and understanding. When using the simulation feature, users of the App can engage in a number of social and cognitive tasks while listening to recordings created by people who hear voices. This approach builds on previous research suggesting that simulation of hearing voices can develop understanding and empathy4 and that simulations must be sufficiently realistic to enable people to suspend disbelief.5
The Hearing Voices App was launched in April 2015 and is free to download. Evaluation of the App is still in its preliminary stages, but anecdotal evidence suggests that it has, and will continue to be, widely used by educators and clinicians regionally and beyond. A pilot study of the App involved student nurses who provided feedback in a focus group. This offered early indications as to the App’s efficacy – students appeared to have an enhanced understanding of hearing voices, and they expressed the view that using the App would positively impact upon their communication and attitude.
As the evaluation is still underway, it is too early to come to firm conclusions. However, the initial results suggest that the App can enhance learners understanding and attitudes towards hearing voices. Another, somewhat unexpected, finding is the breadth of the appeal of the App, as early indications suggest that it has proved beneficial in enhancing the understanding of hearing voices for relatives of people who hear voices as well as a wide range of professionals (e.g. police, service industry) beyond the health and social care arena.
I believe the App can be of value to people who hear voices, family members and friends of voices hearers, along anyone who works with people who hear voices. Please share the links to the App to help spread understanding about hearing voices!
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- Longden E, Madill A, Waterman ME. Dissociation, trauma and the role of lived experience: toward a new conceptualisation of hearing voices. Psychol Bull. 2012 Jan; 138 (1):28-76
- Ando S, Clement S, Barley E, Thornicroft G. The simulation of hallucinations to reduce the stigma of schizophrenia: A systematic review. Schizophr Res.2011; 133:8-16
- Llerena A, Cáceres M, Peñas-lledó EM. Schizophrenia stigma among medical and nursing undergraduates. Eur Psychiatry. 2002 Sept; 17(5):298-299.
- Chaffin A. Creating empathy through use of a hearing voices simulation. Clinical Simulation in Nursing. 2013; 9:e293-e304
- McNaughton R, Ravitz P, Wadell A, Hodges B. Psychiatric education and simulation: a review of the literature. Can J Psychiatry. 2008 Feb; 53(2):85-93
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.