RCPsych eNewsletter July 2018

Wendy looks back on an amazing Congress and a ‘terrifying’ first year as President.

Read the full update.

So it’s all over for another year. Giant exhale. What a Congress!

This year’s Congress was a sold-out success with 2,700 delegates from 54 countries - more countries were represented than in the World Cup! We are very proud we continue to attract people from every corner of the globe.

The beauty of Congress has always been the diversity of speakers and alongside leading psychiatrists and researchers, we had service users, carers, journalists, authors and a fabulous performance by MiXiT (a theatre company of people with and without a learning disability).

With the canals of Birmingham sparkling in the sun, 2,700 eager delegates gathered in the ICC, pens and notepads at the ready. Let’s take a look at 7 highlights from the week…

  1. Baroness Hale kicked off proceedings on Day 1 with a very topical lecture “Is it time for yet another Mental Health Act” – the first female president of the UK Supreme Court spoke on the urgent need for the Mental Health Act to be updated and said many people were not receiving sufficient care in the community to prevent them from reaching crisis point. Baroness Hale expressed full support for Prof Sir Simon Wessely’s work “There is a real need for the Wessely review”.

  2. Dr Altha Stewart, President of the APA, started Day 3 with a passionate and powerful talk on global health implications of childhood adverse experiences. Dr Stewart drew on the harrowing experiences of migrant children in America and the consequences of current immigration policies. A wonderful talk by an inspiring woman. "It is easier to build strong children than to repair broken men".

  3. "When we are asked at medical school why we want to become doctors, we say 'Because we like humans' - but what we really like are stories” - Dr Joanna Cannon struck a chord with many of the doctors, she spoke of her unusual path to becoming a psychiatrist, her time in the NHS and the process of writing her best-selling novels. For many in the audience, this session highlighted the interface between psychiatry and the arts and captured the wonderful elements of being a psychiatrist.

  4. Prof Hamish McAllister-Williams delivered an excellent keynote on “The Management of Depression: Is it depressing?” on Wednesday morning. He delivered piercing insights – among them advised consideration of non-standard treatments for depression and emphasised the importance of maintaining hope for the future.

  5. Jonny Benjamin MBE was our final keynote speaker and what a way to wrap up proceedings. Jonny, mental health campaigner, and his father Michael spoke of their moving and powerful story and Jonny’s suicide attempt and subsequent recovery. Jonny and his father spoke with immense courage and honesty and there was not a dry eye in the house. “I wouldn’t be here if it wasn’t for psychiatrists”, Jonny said, providing the psychiatrists in the audience with a poignant reminder of the importance of the work they do every day.

  6. Prof Sir Robin Murray’s keynote address “Schizophrenia is a myth with a significant genetic component” received rave reviews. He delivered a fantastic and thorough talk on schizophrenia research and theory and was a highlight for many. One delegate described it as an “inspiring talk from an expert who has a detailed understanding of his area”.

  7. You may think it is difficult to become excited about a lanyard but our rainbow lanyards (sponsored by the LGBT SIG) elicited an overwhelmingly positive response in delegates. A wonderful sign of the progressive times we live in!

Social events

We organised some social events for our hard-working delegates – can’t be all work and no play!

Congress had a lot to offer in terms of play – from the Student and Trainees' dinner, to the Retired Members' Lunch to the Gala dinner – there was something for everyone.

The annual Congress fun run was a great success with a group of extra brave delegates running around Birmingham at 8.00am on Tuesday morning. 

Next year’s Congress will be in London on 1-4 July – save the date!

On 1 March 2018, the College responded to the Government’s Green Paper on children and young people’s mental health.

The Government published their response to the Consultation on 25 July. Many of our recommendations (pdf) are reflected in the document, which is positive.

It's particularly good to see that:

  • Funding will be allocated to provide supervision to the newly formed Mental Health Support Teams from qualified staff in NHS children’s mental health services.

  • Additional resources are being made available to enhance the workforce.

  • The Green Paper proposals will be included in the new ten-year ambitions on mental health, which should be at the heart of the NHS plan published in November 2018.

We still have some concerns however, and some of our questions remain unanswered.

For instance:

  • The overall ambition won’t change, meaning that the time it will take to implement the plans will leave so many children without the care they need for at least another 10 years.

  • The response does not specifically refer to initiatives to improve recruitment and retention of psychiatrists and multi-professional teams.

  • Data quality generally remains a concern and is not properly addressed in the response.

  • The Government remains of the view that a Designated Senior Lead role should not be mandatory.

We will continue to work with NHS England on the implementation of the proposals and the development of the long-term plan for the NHS.

For further information, please contact Zoé Mulliez, Policy and Campaigns Officer zoe.mulliez@rcpsych.ac.uk.

Working as a trainee psychiatrist is exciting but it can also involve long commutes, working in isolation, and mentally demanding, lengthy tasks.

The Psychiatric Training Committee (PTC) has conducted a review, and produced a new report Supported and Valued? Staying Safe, which makes recommendations to improve the way psychiatrists are trained.

Our key findings include:

  • covering multiple sites on-call

  • working in isolation

  • engaging in mentally-demanding, complex and lengthy tasks

  • long commuting times

We have asked mental health trusts to consider our findings and make small but practical adjustments which will improve the working lives and safety of both psychiatric trainees and the patients they care for.

Read the full report and recommendations necessary to provide a comprehensive strategy to managing fatigue within psychiatry –  Supported and Valued: Staying safe.

'Researchers at King's College London are looking to recruit over 40,000 people to take part in a study about depression and anxiety and would like your help.

They want to hear from anyone aged 16 or over who has experienced anxiety or depression during their lives, to join the Genetics Links to Anxiety and Depression (GLAD) database to facilitate future research.

Participants will also join a national Mental Health BioResource and contribute to the largest ever single study of anxiety and depression.

How can I help?

Depression and anxiety are incredibly important disorders. This project will enable not only better understanding of their genetics, but also will facilitate many future studies on their development and treatment.

Please support this effort by informing your patients about this exciting new opportunity to help future generations.

How do my patients take part?

They can enrol on the GLAD study website from September 2018.

An online animation explains the consent process with more detailed information in text format. Once participants provide consent and complete a questionnaire they are sent a saliva DNA sample kit to enable genetic studies.

We really hope you will encourage your patients to support this important endeavour!

Contact: gladstudy@kcl.ac.uk

Dr Jamie Richardson has spent the last year working as one of two of the College’s Sustainability scholars. This is his story.

Building sustainability into education

As well as attending the sustainability committee, I have been spending my weekly special interest day working on a project for the College with a sustainability theme.

My project focused on integrating ideas related to sustainability into the educational life of the College. This has taken two different, but connected approaches.

Firstly I was involved in proposing changes to the College curriculum to including sustainability as intended learning outcomes.

Making sustainability part of the curriculum

Focusing on the core curriculum initially, I searched the curriculum as it stands looking for areas which include sustainability already, and areas which could easily be changed or adapted to do so.

This led to the production of a proposal document with potential changes to the curriculum, including three specific areas where I felt effective changes could be implemented.

I was lucky enough to be able to attend the College curriculum committee to present my proposal, giving me a valuable opportunity to experience a College committee meeting first hand, and to present my case for change to the members.

An online module on sustainability

The second element of my work, and my current focus, is writing an online teaching module on sustainability as part of the CPD online system.

The College has approved the inclusion of a sustainability module into the CPD online collection, and I have been working on creating the initial draft of the document for inclusion.

Challenging and stimulating

Although I have reasonable experience in producing and giving presentations as teaching, I have found the approach needed to write the module more challenging and stimulating than I expected.

Aside from getting to grips with the material available on sustainability, I have also had to adapt my writing style to make sure I am able to clearly express my points in a written format without the opportunity to explain my thought process to the potential module users in person.

I am now most of the way through the scholarship year. I hope the module shall be completed shortly, and I will also be returning to the curriculum changes to see what progress has been made there.

Attending events

As well as the summer sustainability committee meeting at the College, I am have attended the medical psychotherapy conference in Cardiff to represent the committee on the sustainability stand.

I applied to be a sustainability scholar at the College as sustainability and the environment are particular interests of mine, and have certainly had opportunities to expand my understanding of the concepts and the solutions to making a more sustainable healthcare system.

What I did not necessarily expect, was the opportunities I have had beyond my projects, for example at committee meetings, which has given me a greater understanding of not just sustainability, but also the running of the College and the healthcare system more broadly.

Dr Jamie Richardson MBBS MSc MRCPsych

Exclusive offer on RCPsych mental health leaflets

If you or your patients require easy-to-access information about the wide range of mental health topics we cover, we are offering a member-only exclusive offer of 30% off our current stock of award-winning printed leaflets from today until the end of September 2018.

Our leaflets can be handed out to patients and carers, put in waiting rooms, or shared with colleagues during mental health awareness weeks.

Please add the code MEM18 on this order form to redeem the offer.

To place your order please email your order form to our leaflets department.

Terms and conditions

  • Offer applies to current leaflet stock
  • Offer is open to 30 September 2018
  • Offer available until stock runs out.

Sometimes we don’t fully appreciate a crisis that almost occurred, but was averted, a veritable Rumsfeldian known-unknown. In recent weeks industrial carbon dioxide shortages were leading to shortages of beer in manufacturers’ supplies, and that ship was heading towards the World Cup shore.

Fortunately the CO2 production was resumed, and we were all able to merrily watch the football and, now, drown our #ThreeLions sorrows.

If your eyesight is good, you might have noticed the ‘Please drink responsibly’ microprint on the bottom of your beer bottle or a TV ad; indeed ‘please do X carefully’ is now attaching itself to almost all of my favourite vices. Does this, and other apparent magnanimous gestures of social care from the alcohol manufacturing giants shift harmful behaviour?

Six years ago, a dozen international alcohol manufacturers jointly declared a ‘wish to demonstrate their support of international efforts to improve health and social outcomes for individuals, families and communities’.

Kaleidoscope discusses the impact of corporate social responsibility initiatives from the alcohol industry, covering five initiative types: information and education, drink driving prevention, research involvement, policy involvement and creating ‘social aspects organisations’. The outcome?

There was no evidence of any reduction in harmful use of alcohol. Of note, what did emerge was that corporate social responsibility initiatives changed the framing of debates so that they often appeared more in line with the interests of the industry itself.

The manufacturers’ body, the International Alliance for Responsible Drinking, has stated it wants to be ‘part of the solution’; these findings suggest that the solution is about 80% proof. Somehow, I find myself drawn ineluctably to the late great Bill Hicks and his diatribe on marketing and advertising, but I will let you Google that for yourself.

Problematically, there can be hostile debate about the origin of hallucinations or voices, which can create additional distress for those in whom this phenomenon occurs.

There is a more reductionist biomedical view invoking a cognitive neuroscience model, and a counter-point such as that proposed by ‘Hearing Voices’ networks that reminds us to see people in the context of their lives and individual stories.

Now, a piece reviewed in Kaleidoscope pulls off the trickiest marriage arrangements since the Montagues met the Capulets, and joins these two theories in peaceful union. Here’s the skinny: they propose what’s known as a Bayesian theory of perception – essentially there is uncertainty about all sensory input into the brain – and, crucially, they demonstrate how prior beliefs and life experiences have an excessive influence over this. Let’s turn theory to people: consider someone who has immigrated to a new country, is relatively isolated, and doesn’t speak the language well – sensory input, such as language, will be quite alien, and depending on their past and current circumstances, potentially frightening.

These novel factors bombarding the person, and interplaying with their prior expectations, significantly increases their uncertainty and likelihood of misperceiving, to the point of generating hallucinations. The authors propose that all perception is controlled hallucination; something VAR technology tried to correct in some lines-men this summer.

Win a College mug in our Kaleidoscope’s Quiz!

Get in contact to receive further information regarding a career in psychiatry