Dale Carnegie’s “How to Win Friends and Influence People” is one
of the most successful books ever written. Since 1936 it has sold
over 30 million copies, and is the 11st highest selling non fiction
book on Amazon. It is part of a self help tradition that goes back
to Samuel Smiles, although I prefer Toby Young’s “How to Lose
Friends and Alienate People”. Failure is always more amusing than
But making friends and exerting influence is a core part of what
I am supposed to do as President. And like everything that is
important, no one ever tells you how to do it, although they are
always on hand to let you know when you have done it badly. Indeed,
much like Toby Young, I remember rather more easily how I failed to
influence people than when I succeeded.
But let’s have a go. A journalist writes a bad piece on
antidepressants. I immediately write an email telling him that this
is ridiculous, ill informed, prejudiced and will cause great harm
and distress, and I will be complaining to the editor. And then
delete it. Why? What does Dale say? “Try honestly to see things
from the other person's point of view”.
You are dealing with a professional journalist. They are just
reporting what someone told them, or what was in the press release.
It’s a story. And as anyone who has read Nick Davies “Flat Earth
News” knows, they will probably have written three other stories
today, plus tweeted, blogged and so on. They are tired, and don’t
have time to do a literature search, Cochrane review and lots of
interviews. They are just doing their job.
So now you try again. Send another email, or even better pick up
the phone. You congratulate them on a well written piece. Perhaps
however because of space they over simplified a bit. Maybe they
would like to return to the subject at a later date? How can you
help? Would they be interested in a “comment” piece, bringing the
reader up to date with some new research?
Always have a story
Now what about a politician? Two rules. First tell a story.
Politicians love stories. I have given evidence on numerous
occasions to select committees, commissions, ministerial round
tables, consultations etc on the subject of military mental
Often we turn to the topic of mental health screening. They tell
me of a terribly sad case of a young man recruited to the Armed
Forces who comes back from deployment in a very bad way, and
sometimes has done something terrible to himself or someone
The politician says it’s a disgrace that they weren’t screened
before they deployed – because all this would never have happened.
I can talk statistics, NICE criteria, evidence – I can see their
eyes glaze over. But if I agree, and then ask them if they can
think of another constituent, from the same sink estate, left
school at the same age with no qualifications, had a father in
prison and a mother on the bottle and so on, and who also joined
They usually can. How did that person do? “Really well,
actually, became a Sergeant Major, I gave him a medal on the home
coming parade a few months ago”.
“Well, if we had screened out your first case, we would also
have screening out this chap and four more like him”.
They get that. I could have sent them our study showing this,
new randomised controlled trial only out last week, and they
wouldn’t even have opened the email. But a story they will remember
for ages… (BMJ
IOPPN press release)
So always have a story.
And even better than you doing this, get patients and relatives
to do the job for you. Give them the address of their MP. One of
the virtues of our system is that even if your MP happens to be a
Secretary of State or even Prime Minister, sooner or later they
really will see you. It makes a difference.
And ride the wave. Mental health is fashionable. More and more
people “get it”. And even those who don’t really get it, which is
probably still the majority still, they know that they are supposed
to, and that’s almost as good. You and I know that we deal with
mental illness, but, button your lip for the duration of the
meeting, and talk mental health and well being until you are out of
the door with the commitment that you wanted.
Get allies. When I started in psychiatry it was fair to say that
the main user group, MIND, didn’t like us and the feelings were
reciprocated. A lot of careful work by my predecessors has reversed
this. And now we are alongside MIND in the Mental Health Policy
Group, which contains the six key influencing organisations in the
field. When we hunt as a pack we are a very powerful lobby – as was
the case with the Five Year Forward View and also getting a voice,
not a large voice, but still a voice, in the Holy of Holies, the
And then lobby, lobby and lobby again. Politics finally depends
on people. Get to know them. It is fashionable to be cynical about
politicians, but I have a shameful secret that only now as I come
to end of my term I am now prepared to admit. I like most
politicians. There, I have said it. Nearly all work very hard and
don’t actually get that much pay for the hours.
Try, try again
Very few will reach the glittering prizes, but that doesn’t
deter them. I have now dealt with 11 ministers for veterans’ health
during my time working in that field, from all main parties. All
but one were very good. 90%, wasn’t party political. Most really
wanted to do the best they good for those who have served. And I
find most politicians, once they have decided that you aren’t
secretly filming or recording them, are decent people with a sense
of humour and of the absurd. I did say “most”, not “all”.
But whatever their personality or party affiliation, my job is
to get to know them. It is important to develop personal links. It
sounds cheesy but it is. And how does one do that? If at first you
don’t succeed, try, try and again. And if that still hasn’t worked,
befriend the person who keeps the minister’s diary. They know
what’s going on.
Lobbying works. Sometimes. We have lobbied I think successfully
for changes to the Prevent programme, Mandatory Reporting on Child
Abuse, sensible outcome measures (well, more sensible than they
would have been if we hadn’t bothered). the way in which NHS
Digital use data, persuading NHS-E to accept the findings of the
Crisp Commission on beds, and many more.
And what about the longer game? When I started this role we went
through a big review of our communications, which wasn’t easy. But
in the end we decided that what we really wanted to be was not so
much a campaigning organisation - there are organisations better
placed to do this.
We want to become a trusted source of advice – to be in effect a
calm, authoritative voice for mental health, one that is visible,
credible, and useful. And I think we are achieving that. Here’s one
example – in February 2015 we had 106 media pieces with audience
reach of 30 million, Last month it was 283 media places reaching
We’re trying to use digital more effectively too. See our
short video for Members which explains
what you can do to embed recommendations to improve acute adult
psychiatric care in your Trust. It’s just one of many improvements
we’re introducing, I hope you like it.
Finally, being a psychiatrist can be a help. After all, Dale
Carnegie said that one of the best ways to exert influence was to
“become genuinely interested in other people”. If we aren’t, then
Professor Sir Simon Wessely
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