I was driven to the brink by the poor care my friend received. I finally left over pointless tasks
The first time I thought I should leave the NHS and never return was at my friend’s inquest. After struggling with mental health issues for many years he had taken his own life. At his inquest, I learnt that in the period leading up to his suicide his mental health appointments had all been with support workers and he had not once seen a qualified mental health nurse. I also discovered that his last five appointments had been with four different members of staff. The coroner asked about the level of the service he had received. The manager of the service cited difficulties with a large geographical patch and described the service he received as usual practice. As an NHS manager myself, I could see it may have been usual practice, but it was far from good enough.
As I drove home from the inquest my head was spinning with dissonant thoughts and questions. I was angry and upset. I was concerned for the service manager. I was furious with government cuts. I was worrying about the service I managed. I needed the noise in my head to stop. I found myself contemplating killing myself. I did not sleep that night. I knew I was unwell and so the next day I saw my GP. I needed three months off work for severe depression and anxiety. I had excellent talking therapy via my GP surgery and my counsellor continued to support me through and beyond my return to work.
Related: The NHS sets leaders up to fail – and then recruits more in the same mould
I was struck by their terrible experiences – the doctor who kept seeing a dead child and the person with an alcohol problem
When I began working as a psychologist at a large London teaching hospital I was fascinated and – a little overwhelmed – by the challenge of developing a new psychology service. I was employed solely for the 5,000 staff working in the hospital. Absolutely anyone could come and see me for psychological support, from the porters to the medical consultants. And they did. Over a 12-year period I saw many NHS staff.
Sometimes they were sent by managers who were worried about them. About their behaviour or their distress or the impact of a very traumatic event they had witnessed, for example. Others referred themselves in secret and hoped that no one would know they were coming. When they left they were always polite and thanked me but usually said that they hoped they would never see me again.
It sometimes felt like there was hope that staff could disappear for a bit and emerge intact and ready to work
It took ages to earn Sandra’s trust – she showed me how people’s lives can be consumed by the cruel fate of mental health problems
In medicine, psychiatry isn’t seen as glamorous. As a student and while training, you fight with your colleagues for the sexy jobs in cardiology, intensive care or on the frontline. When the crash call goes off, it’s dramatic; chest compressions, ventilation, trying to be the hero you see depicted on television. A job in psychiatry wasn’t my first choice, if there was a crisis, what would I do? Come running with my pen and notebook? Not exactly Oscar-winning stuff.
I had my reservations as I was about to embark on 91 days as a doctor in an adult inpatient psychiatric unit.
Related: The patient who showed me how to be a better doctor and person
I can refer people to mental health services and social care but they are overloaded and don’t provide much help
Recently a patient brought home to me how inadequate the help I can provide my elderly patients as a GP can be. Among more than 50 phone calls I fielded one day as one of the GPs dealing with urgent requests, there were two from a patient in her 80s who is the main carer for her husband who has dementia. She also has health issues and he is unaware of the problems they face. The receptionist learned far more about the difficulties they were having from the woman’s phone calls to the surgery and from observing them in the waiting room, than I did from my snatched telephone conversations and the scrawled note left for me. I found out later that the only way she could get to the surgery to bring the sample I requested was by locking her husband in the car outside. I knew that things were difficult, but this was a new low.
Over the last year I have been increasingly involved in the care of a man who is in his 80s and moved into my practice area to be nearer to his family. He enjoys telling me about his past when he gets the opportunity and I recall how his eyes sparkled as he told me that adopting his daughter was the best decision he and his late wife ever made. He knows his dementia is worsening and was the one who recognised the initial symptoms, well before these signs were noticed by others around him. He looks crestfallen as he recounts to me how he sees the frustration and sorrow in his daughter’s eyes when he asks the same question another time. He is annoyed by his failing health and memory and feels he is a burden to those around him. At times he is too proud to ask for help.
Most patients with an eating disorder are adults. The lack of specialist services could prove fatal
Sophie* developed an eating disorder when she was 11 years old. With the help of child eating disorder services, she got better and by the age of 16 had achieved a stable weight. But her A-levels proved tough and she relapsed. This time, she had to face the challenge of navigating adult eating disorder services as a vulnerable teenager. When she was finally referred to me nearly eight months after her relapse, she was 19 years old with a BMI of nine.
I worked as a consultant psychiatrist in child eating disorders before moving to adult services in Oxford. When the government announced in the Five Year Forward View a £30m investment for eating disorders in child and adolescent mental health services (Camhs) each year until 2021, I was delighted. We know early intervention offers the best chance of recovery and it’s great to see that 66 new specialist services have been set up across the country.
Voters in six regions are to elect mayors, who could provide the biggest surprise when it comes to health policies
While Labour will be desperate to push the NHS to the centre of the general election campaign, and the Liberal Democrats will be emphasising their commitment to mental health services, it is the six regional mayors being elected for the first time in May who could provide the biggest surprise when it comes to health policies.
The exact powers of the six – covering Tees Valley, Greater Manchester, Liverpool city region, West Midlands, West of England and Cambridgeshire & Peterborough – vary depending on the deal each region reached with the government, but none of them will control the NHS.
Related: Are we ready for a grown-up election debate on the NHS and social care? | Niall Dickson
Mayors could easily derail STP plans without any obligation to provide a coherent alternative
An online therapy service for depression, anxiety and substance misuse is cheap and effective and could provide inspiration for the NHS
When Aino Korhonen*, 69, saw an advert for online mental health therapy in a newspaper, she went to her GP and asked if she could be referred to try it.
The lifelong Helsinki resident had been diagnosed with depression and had attended a few sessions with a psychologist but the two didn’t get along. She remembers: “We didn’t [seem to] talk the same language. I went a couple of times and it didn’t help me at all.”
It’s a win-win for patients, for professionals, for [hospital] management and for the taxpayer.
Team bursts into song to celebrate Advancing Healthcare Awards win
There was dancing to the Jailhouse Rock when a community choir formed in a prison in Northern Ireland was named overall winner of annual awards for therapists and health scientists.
Organisers, supporters and past members of the Voice of Release choir burst into an impromptu chorus of Elvis Presley’s hit in celebration of their success at the 2017 Advancing Healthcare Awards, held at Chelsea Harbour in London.
Sarah needed medication but could not see that she was unwell. Restraint in her case was planned and not some awful mistake
People imagine mental health nurses like me as kind and gentle, as mother figures in uniform. What they don’t see is the harm we do to our patients: we lock them away, we restrain them and we take away their freedom. We do this in line with the law and we firmly believe we are doing the right thing. We are not “nice”, but when I look at my colleagues, I see strong, selfless, determined heroes.
I wish I could offer service users something better: a peaceful outdoor space, their own room, something less clinical than easy wipe armchairs. Most of them do not even agree that they are unwell and this deeply felt sense of injustice permeates the ward.
Related: End humiliating restraint of mentally ill people, say charities
Related: We need safe, compassionate mental health care | Norman Lamb