Does it count as facing west if the head of the bed is against the west wall?

Depends on the specific situation:

Bedroom Feng Shui believes that it is not good for the head of the bed to be against the west wall. Because the West is the Paradise, the place you yearn for after death. People will only go to the West Paradise after death. Therefore, it is taboo in Feng Shui to place the head of the bed against the Western wall. In addition, according to the direction of the rotation of the earth, it is from east to west, so if the head of the bed is to the west, it will often cause blood to rush to the ears, which will lead to a decrease in sleep quality and a great impact on health. Therefore, the bed head is not suitable to be placed against the west wall, as it will affect the health of the occupants.