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  • Become a psychiatrist

    Become a psychiatrist

    • Choose Psychiatry

      Choose Psychiatry

      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • What next?
      • On a break from training?
      • Continuing to choose psychiatry
      • Help support our campaign
      • Choose Psychiatry – Guidance for Medical Schools
      • 'Make this a better world'
    • Sixth formers and school students
    • Medical students

      Medical students

      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National Student Psychiatry Conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
      • The Student Psychiatry Audit and Research Collaborative (SPARC)
    • Foundation doctors

      Foundation doctors

      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
      • Applying to Core and Higher Training
    • Help us promote psychiatry

      Help us promote psychiatry

      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • RCPsych Recruitment Strategy 2022-2027
    • Supporting Medical Students: Medical Schools
    • Careers past events
    • Choose Psychiatry
      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • What next?
      • On a break from training?
      • Continuing to choose psychiatry
      • Help support our campaign
      • Choose Psychiatry – Guidance for Medical Schools
      • 'Make this a better world'
    • Sixth formers and school students
    • Medical students
      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National Student Psychiatry Conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
      • The Student Psychiatry Audit and Research Collaborative (SPARC)
    • Foundation doctors
      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
      • Applying to Core and Higher Training
    • Help us promote psychiatry
      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • RCPsych Recruitment Strategy 2022-2027
    • Supporting Medical Students: Medical Schools
    • Careers past events
  • Training

    Training

    • Exams

      Exams

      • Can I take an exam?
      • Contact the Exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • A fair exam
      • Examiners and exam panels recruitment
      • FAQs about applying for exams
      • FAQs about preparing for exams
      • FAQs about the day of the exam
      • FAQs about assessment and results
      • Exams news and updates
      • Invitation to tender to develop an international CASC examination centre
    • Curricula and guidance

      Curricula and guidance

      • 2022 Curricula Implementation Hub
      • 2014 GMC approved curricula (ending July 2024)
      • Specialty guides
      • Dual Training
      • Assessment Strategy Review
    • Portfolio Online
    • Your training

      Your training

      • Psychiatric Trainees' Committee: supporting you
      • Time out of training
      • Run-through training
      • Prizes and bursaries for trainees
      • Training less than full time
      • Routes to Registration
      • Cost of Training
      • Leadership and Management Fellow Scheme
      • Understanding Career Choices in Psychiatry
      • Industrial action FAQs
      • Distribution of medical training posts
    • Medical training initiative (MTI)
    • International Medical Graduates
    • Deanery/LETB Hub
    • Undergraduate education forum
    • Quality Assurance in Training
    • Credentialing
    • CPD eLearning
    • Dean's Quarterly Updates

      Dean's Quarterly Updates

      • Dean's update - 2022
      • Dean's Quarterly Update - March 2023
      • Dean's Quarterly Update - June 2023
      • Dean's Quarterly Update - October 2023
    • Neuroscience in training

      Neuroscience in training

      • About the project
      • Neuroscience resources
      • Multimedia learning
    • Building Capacity in Perinatal Psychiatry

      Building Capacity in Perinatal Psychiatry

      • Perinatal 2023 Masterclass Programme application and process details
      • About the Building Capacity Project
    • Exams
      • Can I take an exam?
      • Contact the Exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • A fair exam
      • Examiners and exam panels recruitment
      • FAQs about applying for exams
      • FAQs about preparing for exams
      • FAQs about the day of the exam
      • FAQs about assessment and results
      • Exams news and updates
      • Invitation to tender to develop an international CASC examination centre
    • Curricula and guidance
      • 2022 Curricula Implementation Hub
      • 2014 GMC approved curricula (ending July 2024)
      • Specialty guides
      • Dual Training
      • Assessment Strategy Review
    • Portfolio Online
    • Your training
      • Psychiatric Trainees' Committee: supporting you
      • Time out of training
      • Run-through training
      • Prizes and bursaries for trainees
      • Training less than full time
      • Routes to Registration
      • Cost of Training
      • Leadership and Management Fellow Scheme
      • Understanding Career Choices in Psychiatry
      • Industrial action FAQs
      • Distribution of medical training posts
    • Medical training initiative (MTI)
    • International Medical Graduates
    • Deanery/LETB Hub
    • Undergraduate education forum
    • Quality Assurance in Training
    • Credentialing
    • CPD eLearning
    • Dean's Quarterly Updates
      • Dean's update - 2022
      • Dean's Quarterly Update - March 2023
      • Dean's Quarterly Update - June 2023
      • Dean's Quarterly Update - October 2023
    • Neuroscience in training
      • About the project
      • Neuroscience resources
      • Multimedia learning
    • Building Capacity in Perinatal Psychiatry
      • Perinatal 2023 Masterclass Programme application and process details
      • About the Building Capacity Project
  • Members

    Members

    • Membership

      Membership

      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Submitting your CPD
    • Workforce Wellbeing Hub

      Workforce Wellbeing Hub

      • Psychiatrists' Support Service
      • How the College supports workforce wellbeing
      • Top 10 tips for wellbeing
      • Coaching and mentoring
      • If a patient dies by suicide
      • If a patient commits homicide
    • Supporting your professional development

      Supporting your professional development

      • New consultants (StartWell)
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • Writing clinic letters
      • If a patient dies by suicide
    • CPD eLearning
    • Your Faculties

      Your Faculties

      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic psychiatry
      • General adult psychiatry
      • Intellectual disability psychiatry
      • Liaison psychiatry
      • Medical psychotherapy
      • Neuropsychiatry
      • Old age psychiatry
      • Perinatal psychiatry
      • Rehabilitation and social psychiatry
      • Faculty job descriptions
    • Specialty and Specialist Doctors

      Specialty and Specialist Doctors

      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
      • Startwell and Staywell
      • SAS Strategy
    • Devolved Nations

      Devolved Nations

      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg y Seiciatryddion
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions

      English Divisions

      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • South West
      • Trent
      • West Midlands
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
    • Special Interest Groups

      Special Interest Groups

      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Digital psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice
      • Rainbow SIG
      • Spirituality and Psychiatry 
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international (VIPSIG)
      • Women and mental health
      • Annual SIG Newsletters
    • Public members list
    • RCPsych Insight magazine

      RCPsych Insight magazine

      • RCPsych Insight Cover Art Exhibition
    • Publications and books
    • Members' eNewsletters
    • Posts for members
    • Jobs board
    • Committees of Council
    • President's lectures

      President's lectures

      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • eLearning Hub
    • Obituaries

      Obituaries

      • Submit an obituary
      • Remembering Dame Fiona Caldicott
      • Memorial service for Professor Andrew Sims
    • Mindmasters quiz

      Mindmasters quiz

      • Attend Mindmasters 2023
      • Who won in 2022?
      • The rules of the quiz
      • Sample quiz questions 
    • RCPsych ceremonies

      RCPsych ceremonies

      • New Members Ceremonies
      • Fellowship ceremonies
      • Specialist Registration Ceremonies
    • 2021 membership survey
    • Membership
      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Submitting your CPD
    • Workforce Wellbeing Hub
      • Psychiatrists' Support Service
      • How the College supports workforce wellbeing
      • Top 10 tips for wellbeing
      • Coaching and mentoring
      • If a patient dies by suicide
      • If a patient commits homicide
    • Supporting your professional development
      • New consultants (StartWell)
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • Writing clinic letters
      • If a patient dies by suicide
    • CPD eLearning
    • Your Faculties
      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic psychiatry
      • General adult psychiatry
      • Intellectual disability psychiatry
      • Liaison psychiatry
      • Medical psychotherapy
      • Neuropsychiatry
      • Old age psychiatry
      • Perinatal psychiatry
      • Rehabilitation and social psychiatry
      • Faculty job descriptions
    • Specialty and Specialist Doctors
      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
      • Startwell and Staywell
      • SAS Strategy
    • Devolved Nations
      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg y Seiciatryddion
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions
      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • South West
      • Trent
      • West Midlands
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
    • Special Interest Groups
      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Digital psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice
      • Rainbow SIG
      • Spirituality and Psychiatry 
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international (VIPSIG)
      • Women and mental health
      • Annual SIG Newsletters
    • Public members list
    • RCPsych Insight magazine
      • RCPsych Insight Cover Art Exhibition
    • Publications and books
    • Members' eNewsletters
    • Posts for members
    • Jobs board
    • Committees of Council
    • President's lectures
      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • eLearning Hub
    • Obituaries
      • Submit an obituary
      • Remembering Dame Fiona Caldicott
      • Memorial service for Professor Andrew Sims
    • Mindmasters quiz
      • Attend Mindmasters 2023
      • Who won in 2022?
      • The rules of the quiz
      • Sample quiz questions 
    • RCPsych ceremonies
      • New Members Ceremonies
      • Fellowship ceremonies
      • Specialist Registration Ceremonies
    • 2021 membership survey
  • Events

    Events

    • Conferences and training events

      Conferences and training events

      • Register your interest - CESR in Psychiatry Training
      • MHA Section 12 and Approved Clinician Training
      • Subscribe to receive the Events eNews
      • RCPsych Certification Courses
      • Grand Rounds
    • International Congress 2023

      International Congress 2023

      • Register your interest - Congress 2023 exhibitors
      • Travel and accommodation guidance 
      • Registration
      • Congress 2023 FAQs
      • Poster Presentations 2023
      • Programme
      • Social Media
      • Exhibition opportunities 2023
      • Your guide to Congress
      • Social and Fringe Events
      • Congress 23 Webinar Package
    • International Congress 2024

      International Congress 2024

      • Poster Presentations 2024
      • Exhibition opportunities 2024
      • Poster reviewers
    • In-house training

      In-house training

      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Events held by other organisations
    • Free webinars

      Free webinars

      • Free webinars for members
    • Recruitment events
    • Claiming expenses
    • Terms and conditions
    • Speaker guidance for online events
    • Conferences and training events
      • Register your interest - CESR in Psychiatry Training
      • MHA Section 12 and Approved Clinician Training
      • Subscribe to receive the Events eNews
      • RCPsych Certification Courses
      • Grand Rounds
    • International Congress 2023
      • Register your interest - Congress 2023 exhibitors
      • Travel and accommodation guidance 
      • Registration
      • Congress 2023 FAQs
      • Poster Presentations 2023
      • Programme
      • Social Media
      • Exhibition opportunities 2023
      • Your guide to Congress
      • Social and Fringe Events
      • Congress 23 Webinar Package
    • International Congress 2024
      • Poster Presentations 2024
      • Exhibition opportunities 2024
      • Poster reviewers
    • In-house training
      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Events held by other organisations
    • Free webinars
      • Free webinars for members
    • Recruitment events
    • Claiming expenses
    • Terms and conditions
    • Speaker guidance for online events
  • Improving care

    Improving care

    • College Centre for Quality Improvement (CCQI)

      College Centre for Quality Improvement (CCQI)

      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
      • CCQI news
    • Campaigning for better mental health policy

      Campaigning for better mental health policy

      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • Cross-government mental health and wellbeing plan 
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position Statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • Reforming The Mental Health Act
      • Don't overlook mental health campaign
      • The Mental Health Policy Group (MHPG)
    • Planning the psychiatric workforce

      Planning the psychiatric workforce

      • About workforce
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
      • Job description approval process
    • Public Mental Health Implementation Centre

      Public Mental Health Implementation Centre

      • Partnerships and events  
      • How to work with the Public Mental Health Implementation Centre
      • About the PMHIC
      • Aims and objectives
      • Reports
      • About public mental health
      • PMHIC Parliamentary Launch 
      • PMHIC Commercial Determinants of Mental Health (CDoMH) Symposium 
      • PMHIC Parliamentary Roundtable 
    • National Collaborating Centre for Mental Health

      National Collaborating Centre for Mental Health

      • About NCCMH and our work
      • Clinical guideline development
      • Competence frameworks
      • Quality improvement programmes
      • Reports and research
      • Service design and development
      • Work with us
    • Physician Associates

      Physician Associates

      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
      • The Competence Framework for Physician Associates in Mental Health
    • Act Against Racism

      Act Against Racism

      • Tackling racism in the workplace
      • Adopt the guidance and join our network
      • Act Against Racism: a toolkit to support the campaign
      • If you're experiencing racism at work
      • Allies: information and signposting
      • FAQs about the campaign
      • Act Against Racism campaign films
      • Resources
    • Sustainability and mental health

      Sustainability and mental health

      • Why is sustainability important?
      • In your community
      • In your practice
      • In your trust
      • Sustainability at RCPsych
      • Nature matters
      • Sustainability scholars
      • Sustainability resources
      • College position on sustainability
      • RCPsych at COP26
      • The eco-crisis and CAMHS
    • Invited Review Service
    • Public Health and its role in mental heath
    • RCPsych Course Accreditation
    • Using quality improvement
    • Net Zero Mental Health Care Guidance and Education
    • Mental Health Awareness Week
    • College Centre for Quality Improvement (CCQI)
      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
      • CCQI news
    • Campaigning for better mental health policy
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • Cross-government mental health and wellbeing plan 
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position Statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • Reforming The Mental Health Act
      • Don't overlook mental health campaign
      • The Mental Health Policy Group (MHPG)
    • Planning the psychiatric workforce
      • About workforce
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
      • Job description approval process
    • Public Mental Health Implementation Centre
      • Partnerships and events  
      • How to work with the Public Mental Health Implementation Centre
      • About the PMHIC
      • Aims and objectives
      • Reports
      • About public mental health
      • PMHIC Parliamentary Launch 
      • PMHIC Commercial Determinants of Mental Health (CDoMH) Symposium 
      • PMHIC Parliamentary Roundtable 
    • National Collaborating Centre for Mental Health
      • About NCCMH and our work
      • Clinical guideline development
      • Competence frameworks
      • Quality improvement programmes
      • Reports and research
      • Service design and development
      • Work with us
    • Physician Associates
      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
      • The Competence Framework for Physician Associates in Mental Health
    • Act Against Racism
      • Tackling racism in the workplace
      • Adopt the guidance and join our network
      • Act Against Racism: a toolkit to support the campaign
      • If you're experiencing racism at work
      • Allies: information and signposting
      • FAQs about the campaign
      • Act Against Racism campaign films
      • Resources
    • Sustainability and mental health
      • Why is sustainability important?
      • In your community
      • In your practice
      • In your trust
      • Sustainability at RCPsych
      • Nature matters
      • Sustainability scholars
      • Sustainability resources
      • College position on sustainability
      • RCPsych at COP26
      • The eco-crisis and CAMHS
    • Invited Review Service
    • Public Health and its role in mental heath
    • RCPsych Course Accreditation
    • Using quality improvement
    • Net Zero Mental Health Care Guidance and Education
    • Mental Health Awareness Week
  • Mental health

    Mental health

    • Mental illnesses and mental health problems

      Mental illnesses and mental health problems

      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety and generalised anxiety disorder (GAD)
      • Avoidant/restrictive food intake disorder (ARFID)
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Catatonia
      • Club drugs
      • Cocaine dependence
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Feeling overwhelmed
      • Gambling disorder
      • Heroin dependence
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness and mental health
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post-traumatic stress disorder (PTSD) 
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self-harm
      • Shyness and social phobia
      • Sleeping well
    • Support, care and treatment

      Support, care and treatment

      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Antipsychotics in pregnancy
      • Being sectioned
      • Benefits, financial support and debt advice
      • Benzodiazepines
      • Caring for someone with a mental illness
      • Children's social services and safeguarding
      • Cognitive behavioural therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Hypnosis and hypnotherapy
      • Liaison psychiatry services
      • Lithium in pregnancy and breastfeeding
      • Mental capacity and the law
      • Mental health in pregnancy
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Mental Health Tribunals
      • Mother and baby units (MBUs)
      • Neuromodulation
      • Perinatal mental health services: what are they?
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Social prescribing
      • Spirituality and mental health
      • Stopping antidepressants
      • What to expect of your psychiatrist in the UK
      • COVID-19: for patients and carers
      • Veterans' mental health
    • Young people's mental health

      Young people's mental health

      • Bipolar disorder for young people
      • Cannabis and mental health: for young people
      • Club drugs
      • Cognitive behavioural therapy (CBT) for young people
      • Coping with stress for young people
      • Depression in children and young people
      • Drugs and alcohol for young people
      • Eco distress: for young people
      • Physical activity, exercise and mental health for young people
      • OCD for young people
      • Psychosis in young people
      • Schizophrenia: for young people
      • When a parent has a mental illness
      • When bad things happen
      • Who is who in CAMHS?: for parents, teachers, young people and carers
      • Anxiety: for young people
      • Weight, exercise and eating disorders in young people
      • Preparing for a blood test or vaccine for young people
      • Use of digital media for young people
    • Translations

      Translations

      • Arabic عربى
      • Bengali বাঙালি
      • Chinese 中文
      • French Français
      • German Deutsch
      • Greek Ελληνική
      • Gujarati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian Italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Marathi मराठी
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Portuguese (Brazil) Português (Brasil)
      • Punjabi (Pakistan) پنجابی
      • Romanian Română
      • Russian Pусский
      • Sindhi سنڌي
      • Somali
      • Spanish Español
      • Swahili Kiswahili
      • Tamil தமிழ்
      • Telugu తెలుగు
      • Turkish
      • Ukrainian украї́нська
      • Urdu اردو
      • Vietnamese Việt
      • Welsh Cymraeg
      • התמודדות לאחר אירוע טראומטי Coping after a traumatic event in Hebrew
      • Mijûlbûna piştî bûyerekê trawmatîk Coping after a traumatic event in Kurdish
    • Order mental health resources

      Order mental health resources

      • Order mental health packs for schools
    • About our mental health information
    • Mental health information disclaimer
    • Mental health and psychiatry FAQs
    • Choosing Wisely - a national campaign
    • Mental illnesses and mental health problems
      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety and generalised anxiety disorder (GAD)
      • Avoidant/restrictive food intake disorder (ARFID)
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Catatonia
      • Club drugs
      • Cocaine dependence
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Feeling overwhelmed
      • Gambling disorder
      • Heroin dependence
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness and mental health
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post-traumatic stress disorder (PTSD) 
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self-harm
      • Shyness and social phobia
      • Sleeping well
    • Support, care and treatment
      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Antipsychotics in pregnancy
      • Being sectioned
      • Benefits, financial support and debt advice
      • Benzodiazepines
      • Caring for someone with a mental illness
      • Children's social services and safeguarding
      • Cognitive behavioural therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Hypnosis and hypnotherapy
      • Liaison psychiatry services
      • Lithium in pregnancy and breastfeeding
      • Mental capacity and the law
      • Mental health in pregnancy
      • Mental health rehabilitation services
      • Mental health services and teams in the community
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Concussion

Minds on film

03 October, 2016

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Film poster for 'Concussion'

Introduction 

Concussion, written and directed by Peter Landesman, was released in the USA in 2015.
 
The film tells the true story of how Chronic Traumatic Encephalopathy (CTE) was identified and named in 2002 by forensic neuropathologist, Dr Bennet Omalu (played by Will Smith), while he was working in Pittsburgh, USA. Omalu identified CTE as an entity after studying the deaths of several retired American football players.
 
He realised that these former players had suffered significant psychiatric morbidity in the years after their retirement from the game. This discovery has contributed to a greater understanding of the long-term effects of repeated concussions in those competing in contact sports and has influenced attitudes to the management of concussive episodes on the field in a wider number of sports such as rugby, ice hockey and horse racing as well as in American football.
 
There has also been a particular focus on the management of concussion in school age children, with more stringent pitch side assessments that prevent participants from re-entering a game until they are assessed as having fully recovered from a concussion under supervision.
 

As well as telling the story of his scientific discovery, the film also depicts the enormous struggle that Omalu, an immigrant from Nigeria, and his few supporters faced when trying to report their findings to the scientific community and the wider world of sport, as his results appeared to threaten the corporate interests of the National Football League (NFL). As such, Concussion is a film about whistleblowing and Omalu has been likened to ‘David’ as he took on the NFL seen as ‘Goliath’. Although this aspect of the film is presented in the style of a classic Hollywood drama, the film still succeeds in raising the profile of an important and ongoing issue, namely how hard it may be to tell truth to power.

The film has been nominated for several awards, including a Golden Globe nod in 2016 for Will Smith.

The Film

Concussion opens with the death of former American football player Pittsburgh Steelers centre Mike Webster at the age of 50. His postmortem is carried out by Omalu in his very particular style of working. Webster's pre-morbid psychiatric difficulties are noted by Omalu and when another retired player presents with psychiatric problems before his early death too, the pathologist starts to look for a common neuropathology.

As Omalu suggests a connection between the repeated head traumas suffered in the course of playing American football and the microscopic findings post mortem, he begins to find his work obstructed and colleagues turning against him.

When he loses his research funding he is so determined to continue that he uses his own monies. It is only when a former football team doctor joins him and supports his research that he is able to take his findings forward and present them to the wider scientific community. Omalu’s resilience and determination are admirable but his ultimate satisfaction does not occur without a test of his character and of his close personal relationships.

Relevance to the Field of Mental Health

Concussion in sport is now increasingly recognised as something that needs more research, particularly into its long-term effects.

The International Concussion and Head Injury Research Foundation, (ICHIRF) is a London based not-for-profit organisation that has been created to carry out independent research into concussion and head injury. In its research project Concussion in Sport it aims to ascertain whether there is an increased incidence of neuro-degenerative disorders (such as Alzheimer’s disease, Parkinson’s disease and Chronic Traumatic Encephalopathy) in retired sportsmen and sportswomen who have competed in contact sports and sustained concussions, and whether these disorders might onset at an earlier age in this population.

The study is currently recruiting both retired athletes and controls and it involves an online questionnaire (this takes about 15 minutes) every year for at least the next 4 years.This research foundation works closely with the charity called The Concussion Legacy Foundation in America, whose website has a wealth of material for learning more about the subject and in particular some very good information about CTE.

Neuropathologist, Dr Ann McKee

Earlier this year the NFL finally acknowledged a link between playing American football and CTE (read this Frontline article written by Jason Breslow in March 2016) following the research findings of Boston based neuropathologist, Dr Ann McKee. In her research, McKee found evidence of CTE in 90 out of 94 brains she examined postmortem of former NFL players. In a fascinating 46 minute Frontline video interview, she describes her work and her consultations with the NFL about the effects of repeated mild brain trauma that takes place during the course of a football game.

She recounts how she had first encountered Omalu’s evidence in a poster presentation at an Alzheimer’s disease conference and later how she was asked if she would examine the brain of a football player by the co-founder of The Concussion Legacy Foundation, former wrestler Chris Nowinski.

The evidence is now so strong that current players are much more aware of the risks that playing presents and last year Chris Borland, a promising player for the San Francisco 49ers, quit at the age of 24 after fearing for the effects of repeat concussions on his health (see BBC report).

For anyone involved in providing medical support to players during competitive contact sports, there is a useful Pocket Concussion Recognition Tool on the BMJ website taken from the Concussion Statement on Concussion in Sport, published in the British Journal of Sports Medicine 47 (5), 2013, by McCrory at al, which provides clear guidance on screening anyone who is suspected of having suffered a concussion.

This film highlights a topical and very important issue that is especially relevant to anyone working in the field of Acquired Brain Injury or Sports Medicine.

• More information about Concussion can be found at IMDB, as can a short trailer.

Blog Author
Dr Joyce Almeida
Dr Joyce Almeida

Consultant Psychiatrist

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