Ad description
A cinema ad for Frontline19, a support service for NHS and frontline workers, seen April 2024, featured scenes of NHS workers in various states of distress, including a doctor delivering bad news to a patient and consequently being attacked and a paramedic with bloodied gloves.
The ad then showed an individual entering a house as a voice said, “Attempted suicide, 17 St Edwards.” A police officer stated, “It says she works at the hospital”, as they handed a lanyard with “Nurse” printed on it to the individual.
On-screen text at the end stated, “With over half suffering from poor mental health many NHS workers are sicker than the patients. Not that they’d ever let you see it”, and “Donate now so we can provide the therapy they urgently need. Frontline19. Emotional support for the frontline”.
Issue
Five complainants, one of whom was a doctor and believed that the scenes, including the one that depicted the aftermath of an attempted suicide, were overly graphic and upsetting, challenged whether the ad was irresponsible and distressing.Response
FL19 CIC t/a Frontline19 said they were a non-profit organisation that offered a free, independent, confidential service to help frontline NHS workers seek the psychological support they needed. They said their advertising was a medium through which they could address sensitive topics in an impactful way to support the key goals of their organisation. They provided statistics to show the level of mental health concerns impacting NHS workers and frontline staff.
Frontline19 acknowledged the content of the ad could be upsetting to some viewers. They believed there was a balance between depicting a difficult reality and ensuring the ad did not cause undue levels of distress, but they felt they had handled the matter with the sensitivity it warranted. They said they intentionally avoided imagery which could be particularly distressing, such as ill children, grieving families or physical injuries, and that the scenes depicted were the everyday reality NHS workers faced when they went to work.
They said the reference to suicide was also potentially unsettling and the subject of suicide was undoubtedly distressing. However, they had taken great care to ensure the scene was not unduly graphic. Their intention was to raise awareness and to signpost support and they felt this outweighed any discomfort that may have been felt by viewers. They said that omitting the reference to suicide would have meant the most important example of the impact of poor mental health support would not have been relayed. They said they regretted the ad had caused distress amongst even a small number of viewers. However, they considered their reasoning – to direct NHS frontline workers towards mental health resources and to encourage donations – was justifiable.
The Cinema Advertising Association (CAA) explained their panel believed the ad did not breach the Code.
They said that since the Covid pandemic, the pressure NHS and frontline workers could be under in the healthcare service had become clear. They felt the concept of NHS and other frontline workers needing additional support due to the nature of their jobs would not be shocking to the public and had been widely reported on. As the statistic in the ad indicated, more than half of NHS staff were suffering from poor mental health. They deemed the ad had a clear social message – to promote an organisation that focused on providing what could potentially be crucial psychological support for those in need of help in the healthcare service.
They said that, due to the distressing content, the ad had an advertising age-restriction for 15-rated films and above. By the British Board of Film Classification’s (BBFC) own age-rating guidelines there was the potential for audience members in a 15-rated film to see visuals that depicted graphic violence and strong threat, as well as scenes of suicide and self-harm and sexual violence. They noted there was only one instance of blood shown in the ad ? on a healthcare worker’s gloves - and there was no focus on graphic injuries.
While there was a brief mention of suicide, the scene was not detailed in its description, prolonged or endorsed and also showed no blood or injury.
However, they still deemed the ad was likely to elicit strong emotional responses from audience members and took the potential for emotional distress seriously, particularly with younger people. They had therefore restricted the advertisement accordingly.
Assessment
Not upheld
The CAP Code required that advertisements must be prepared with a sense of responsibility to the audience and to society and must not cause fear or distress without justifiable reason.
The ad featured scenes of NHS workers in various states of distress, including a paramedic washing blood from their gloves and then the aftermath of an NHS worker’s attempted suicide. The end of the ad showed the NHS workers recomposing themselves before returning to assist their patients.
The ASA recognised that some viewers could find the content of the ad distressing, in particular the depiction of the aftermath of an attempted suicide. We understood the topic of suicide, by its very nature, was one that would cause a level of distress to some viewers. We noted, however, the scene which depicted the aftermath of an attempted suicide was brief and not the focus of the ad. In addition, it was not unduly graphic and focused on the impact on members of the emergency services attending the property, not details of the attempted suicide.
Further to that, other scenes in the ad such as NHS workers visibly expressing emotions, interacting with grieving parents, including one instance of resulting aggression, and having blood on their hands, while impactful, were depicted as context for their mental health challenges. We also noted that the end of the ad included the text, “With over half suffering from poor mental health many NHS workers are sicker than the patients” and “Donate now so we can provide the therapy they urgently need. Frontline19. Emotional support for the frontline”. We considered it was clear that the overall aim of the ad was to inform viewers about the mental health crisis, to make NHS workers aware of the service offered by Frontline19 and to ask for donations so that the organisation could continue to provide its service. In addition, the ad had been given an age-restriction that meant it would only be shown with 15-rated films and above. We understood that the content of the ad was in keeping with material that would be expected in 15-rated films.
We considered, therefore, that while the ad was likely to be distressing to some viewers, especially those with lived experience working in the NHS, the ad’s hard-hitting nature was generally likely to be seen in the context of raising awareness and funding for an important cause. The overall message of the ad meant that any distress caused was justified.
We therefore concluded that the ad was not irresponsible and did not cause unjustifiable distress.We investigated the ad under CAP Code (Edition 12) rules 1.3 (Social responsibility) and 4.2 (Harm and offence), but did not find it in breach.
Action
No further action necessary.
