A difficult month – a time for reflection but also action

I have been deeply concerned for RCPsych members, patients and carer representatives, and staff, who have felt frightened for their safety, and the safety of their loved ones, in light of the civil unrest.

Racism, discrimination and Islamophobia are not new, but it is still scary and troubling when we see them manifest in this way. I’m certain the events of the past month will have brought back terrible memories and experiences for many people.

There has been so much improvement over the years, but it’s saddening to see that a significant seam of racism still runs through the bedrock of our society. However, it was reassuring when many thousands took to the streets as part of peaceful counter-protests in solidarity with those directly affected by the riots.

Prejudice and discrimination affect us all in our personal and professional lives. Frankly, the racism, discrimination, and increasing Islamophobia and anti-Semitism that some of us are faced with can be particularly wearing if you are already under pressure at work - as we know many people working in mental health services currently are.

There is also evidence that the trauma associated with discrimination may be responsible for some of the excess rates of mental illness we see in minoritised ethnic groups (Hatch 2016, Jongsma 2021). This means that as psychiatrists, we likely have patients and/or colleagues who are battling the scourge of discrimination. We must work to recognise it and tackle it, because this is the right thing to do.

For those who wonder if this is the role of the College, I would suggest that discrimination, of any kind, not only increases our workload, but makes it harder to do our jobs and support our colleagues. Reducing discrimination is the right thing to do ethically, morally and clinically, as well as having enormous cost benefits.

Remember, it starts with us. We are the leaders of our services and how we treat people determines how well our services function. More than 45% of members in the UK, and 14% of our staff (employees, patient and carers), are from minoritised ethnic groups, this includes more than 7,200 International Medical Graduates. Without them, we simply could not deliver effective care.

One of my main priorities as President is “Fairness for All”. This means assertively tackling discrimination in all its forms.

Last year, we launched our Act Against Racism campaign which provides guidance and resources for employers on tackling racism in the workplace. The aim is to support employers to develop and provide practical strategies for tackling discrimination; to ensure they are creating a culture that feels safe for all staff and encourage openness and honesty about the impact of racism and discrimination.

A total of 16 mental health organisations have already signed up and agreed to adopt our 15 recommended actions. I’d encourage others to do the same. But in any case, I urge all of you to have a look at it, there are tips for individuals too.

This month also saw the publication of the Care Quality Commission’s (CQC) special review into patient safety concerns at the mental health services of Nottinghamshire Healthcare NHS Foundation Trust, following the deaths of Ian Coates, Grace O’Malley-Kumar and Barnaby Webber in 2023. I continue to think of them and my thoughts and heartfelt sympathies go out to their families and anyone affected.

The CQC has made recommendations that affect us all, as clinicians. The College doesn’t comment on individual cases, however, you can read our response to the CQC’s review on our website.

I have been thinking about their findings and the context within which most of us in mental health care now work. We are individuals working with people with complex needs in a complicated system that is overstretched and under-resourced. It is not working well enough.

This is a time for action – we know what works, for our patients, carers and for us as practitioners. We must reflect on how we came to this place – and then take the opportunity to improve models of care, driven by evidence and good practice rather than cost-saving.

I would encourage anyone who is struggling with the impact of these recent events to seek help (see a list of College resources below). We must all support each other as we confront what happened.

Take care of yourselves, your loved ones and your colleagues.

Lade

Advice and support

Staying safe

Take the right precautions, stay safe, and keep informed.

• Keep updated through reliable news sources.
• Remain vigilant, particularly when traveling to and from work.
• Keep your mobile phones charged and accessible.
• Stay clear of confrontations between protestors, counter-protestors, and law enforcement authorities.
• If you work or live near a protest epicentre, ensure your premises are secure.
• Avoid unnecessary travel to, from, and within areas that are affected.
• Call 999 if you need urgent help.
• Report any incidents of abuse or violence to the appropriate authorities immediately.

RCPsych support services

For members and affiliates in the UK - our Psychiatrists' Support Service (PSS) provides confidential free, rapid, high-quality peer support by telephone to psychiatrists of all grades. Contact them directly on 020 8618 4020 or email pss@rcpsych.ac.uk.

For RCPsych staff - details of our Employee Assistance Programme (EAP) can be found on COLIN, this includes full end-to-end mental health support for all our employees via a 24/7 helpline on 0330 333 5105.

For patients and carers - our Employee Assistance Programme (EAPs) for our patient and carer partners - ‘Be Well’ from Legal & General – offers free day-to-day wellbeing support and access to an expert counselling service to help you and your immediate family at any time. Contact them directly on UK Freephone: 0800 316 9337 / WhatsApp and SMS: Text 'hi' 07418 360 046.

Diaspora sources for support

There are many local charities, faith and diaspora groups that will also be a source for support. Details of our own relevant groups can be found below:

• Volunteering and International Psychiatry Special Interest Group (VIPSIG)
• Diaspora groups committee

College information and resources

Supporting psychiatrists during the difficult time when a patient under their care has perpetrated a homicide.

We have created a page that includes relevant mental health resources for anyone affected by the ongoing events.