The live power of small conferences

You don’t need me to tell you about the success of this year’s Liverpool Congress. Social media showed us a summer festival without music or marquees but complete with mud and celebrities. I wasn’t even there, but there was no avoiding the razzmatazz in tweets and retweets of images of storm-drenched tandem cyclists. I almost regretted being on holiday, missing out on meeting personal heroes, the selfies, the hugs, the new learning, the controversies, the networking.  

It was the best of Congresses; it was the worst of Congresses. For some of my colleagues, it came across as an exclusive party rather than the inclusive organisation we want to be. Only 95 Scottish members attended, mostly for only a couple of the four days. It fell in the Scottish school holidays, and very few Scottish speakers were involved. In fact, only 2% of speakers were from Scotland (less than 1 per million per head of population) whilst 38% were from London alone (nearly 10 per million).

Let me tell you about a couple of conferences I did manage to attend this year. You probably haven’t heard of them, but I suspect they have done proportionately more to save the psychiatric profession for Scotland than any comparable spend.

Working Retired Psychiatrists

The first was the tiny one-day event of the Working Retired Psychiatrists, in an attic in central Glasgow.  Delegates disclosed feeling under-appreciated by employers, working for little if any financial benefit, in a highly stigmatised profession at a crisis point.  They juggled the joys of maintaining a professional identity, and passing on expertise, with disappointment in the decline of Psychiatry over their working lives.

Yet like Liverpool Congress delegates, we felt the sheer joy of being together in person, heightened by the lockdown experience, amplified by the experience of retirement, and especially relished by delegates from remote and rural areas. (Scottish Conferences inevitably start with stories of cancelled ferries, deer in the roads and seagull attacks.) The atmosphere was effervescent. The nearest thing I can compare it to is the wonderful funerals I have attended lately – as you do at my age – but there was a lot of determination for Psychiatry to stay alive.

In our current workforce crisis, retention is a greater priority even than recruitment.  The very existence of such a Group as ‘Working Retired’ is precious. These tiny conferences are something that the staff at Queen Street pull off with panache, going above and beyond to ensure that our treasured Faculties continue to function.

General Adult and Liaison Joint Conference

They did it again with a joint conference for Liaison and General Adult Faculties, in central Edinburgh.  These Faculties work at the heart of Psychiatry. Both could do with more glamorous names and new thinking about their focus and boundaries – but that is for another blog. As I arrived at a comfortable hotel to the scent of decent coffee and a choice of pastries, I could feel the strength of the College around me.

In these times, such a feeling is indispensable to support the survival of the psychiatric workforce. General Adult Psychiatry has bucked the trend of 100% training fill, with only two-thirds of places filled this year, and too many Consultant posts are empty or rely on locums.

However, powerful presentations from Robbie Steele and David Christmas inspired us to reexamine the central role and practice of mainstream psychiatry, whilst Priti Singh described her flourishing CESR project. The AGM allowed the election of an enthusiastic new Chair for GAP, so that the day went some way to restoring the energies of a depleted Faculty.

The value of Scottish Faculties

In a devolved nation with its own NHS, its own distinct legal system and Mental Health law, our Faculty structure is the backbone of our Devolved College. Resource constraints affect Scotland disproportionately – neither Wales nor Northern Ireland have particularly active Faculties, and our tiny staff contingent is close to overwhelmed by their provision of member support, events, efforts to address workforce challenges, policy and public affairs.

Staff must economise by rationing the number of live events and conferences, limiting them to one day only and minimising outside speakers.  We encourage Faculties to join together - as well as the GAP-Liaison event, Eating Disorders and Psychotherapy met jointly. The networking and cross fertilisation bring benefits beyond the economic.

A Faculty gives us a peer group, a reference to share conundrums and solutions. It gives us a public voice by empowering members to offer expert comment to media and government.  It’s a forum for comparing conditions, services, and expectations across the nation, for succession planning and publicising of vacancies. For Faculties to keep the faith they need a venue, a platform and congregation, some ritual. There must be an AGM, a Chair, and in some cases voting happens. In the College in Scotland everyone who pays a membership fee gets a vote, including our SAS doctors.  

I haven’t worked out the mechanisms to explain the power of meeting in person, but I’ve observed and felt it. Just as I wouldn’t stop prescribing effective treatments because their mode of action is unexplained, so I won’t stop prescribing live Faculty Conferences because I can’t justify them theoretically.  They allow us to meet others for whom this work really matters, in mutual appreciation, sympathy, and determination to rescue our profession.

Dr Jane Morris, Vice Chair, RCPsych in Scotland