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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
    • 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
    • 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
      • Isotretinoin and mental health
      • 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
      • Valproate in women and girls who could get pregnant
      • 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
      • Isotretinoin and mental health
      • 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
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Autism in clinical practice: two great challenges

Disability, Equality, Diversity and Inclusion blog

27 September, 2022

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In this blog post I will tell you about the two great challenges facing psychiatrists in the field of adult autism.

The first is the ever-increasing demand for autism assessments, which now massively exceeds clinical capacity across the country. The second is the high prevalence of autism in all mental health settings and the challenges and opportunities this presents to psychiatrists.

I work in a specialist autism diagnostic service in Leeds (for international readers, Leeds is a city in the North of England, home to 800,000 people and an exceptional football team). My service is called LADS, which is nothing to do with the ‘extreme male brain’ theory of autism, but in fact stands for Leeds Autism Diagnostic Service. LADS was founded by my predecessor and mentor, Dr Alison Stansfield, over ten years ago. At that time it consisted of a part-time psychiatrist, part-time learning disability nurse, and whatever admin support could be cobbled together. The service received five or six referrals a month.

Today, LADS is a full MDT with 14 staff, including three psychiatrists. Despite this, we are struggling to cope with a tsunami of demand. At this point you might be thinking, ‘yeah, join the club’. It is true that psychiatric services everywhere are facing greater demand following the pandemic. However, the situation in autism services is particularly stark. As public awareness of autism grows, particularly how it presents more subtly in females, more and more people are coming forward for autism assessment. Referral rates have risen exponentially in recent years and show no sign of abating. Waiting times for autism assessment in the UK are now typically two to three years or more.

Meanwhile, it is becoming crystal clear that autism is exceedingly common in mental health settings. Autistic people are more vulnerable to mental health problems, for a variety of reasons. At least one third of adults with autism have one or more co-occurring mental health conditions. Most often this is anxiety or depression, but major mental illnesses like schizophrenia and bipolar disorder are also more common. A conservative estimate is that 1 in 25 Community Mental Health Team patients, and 1 in 10 adult inpatients, are autistic. It follows that all psychiatrists, regardless of specialty and setting, are seeing large numbers of autistic people in their clinical practice.

Despite this, autistic people consistently report difficulties accessing appropriate mental health support, and lack of reasonable adjustments and adaptations in mental health treatment. Outcomes are poor as well, including greatly increased risk of death by suicide. The leading autism researcher William Mandy recently described this situation as a ‘crisis’. He writes:

“The autism mental health crisis can be described with the following paradox: autistic people have a high chance of developing mental health problems but a low chance of receiving effective help.”

Mandy suggests six ideas to address this. Amongst them is more timely recognition and diagnosis of autism. I would argue this is particularly important in mental health settings: it is unacceptable for patients to be in the psychiatric system for long periods of time – sometimes many years – before their autism is picked up and treatment adapted accordingly.

Another of Mandy’s recommendations is improved autism training for mental health professionals. In July this year it became mandatory for all health and social practitioners in England and Wales to have autism training. Here, there is a great opportunity for psychiatrists. We are highly skilled in the assessment, differential diagnosis, and formulation of psychiatric conditions. We have a deep understanding of neurological development and functioning. We are clinical leaders and set the tone within our teams and services. Psychiatrists should be at the vanguard of improving mental health services for autistic patients. You can help by making autism part of your Personal Development Plan, booking onto appropriate training, and visiting your local specialist autism team or autism community hub. At the College, we are working on enhancing our autism CPD offer for psychiatrists; I will tell you more about this in future blog posts.

Blog Author
Dr Conor Davidson

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