April 2019 - Dr John Crichton, RCPsych in Scotland Chair

5/4/2019

This month's guest blog is written by RCPsych in Scotland Chair, Dr John Crichton. Dr Crichton will be updating you on the College in Scotland's activities quarterly via the guest blog.

When I started as chair of the College in Scotland I was concerned that there wouldn’t be enough material to write a regular blog. As I sit and write I have more anxiety that there is too much to convey whilst being constantly distracted by events in Westminster. Those who follow me on Twitter will see I’ve challenged broadcasters for their clumsy use of terms like ‘schizophrenic’ to describe various facets of the current political debate – instead, I was taken by the Gaelic term bourach – a right mess – used somewhat inventively for the modern age.

Another new word I have learnt recently is whanau – Maori for extended family or community. It was used by a Scottish psychiatrist in Australasia reaching out in compassion following the mosque killings in New Zealand. It was the second time I had learnt something of Maori culture recently. I heard at the Forensic Faculty Conference about patients held in secure facilities in Auckland who have the option of following a Maori cultural treatment route. The spirituality expressed appeared fitting for the modern age and embraces something of the social prescribing movement which I had learnt about at Dumfries House.

In January our Royal Patron Prince Charles opened the Health and Wellbeing Centre at Dumfries House – it is a real showcase for social prescribing and we are lucky to have it on our doorstep. They welcome professional visitors to learn about their approach. I am looking forward to attending a conference at Prescot Street on 12 June on the topic.

Our own winter meeting in January included yoga sessions with audience participation as we breathed deeply and learnt from Edinburgh’s Yoga squad, who visit teams of clinicians from operating theatres to outpatients and had the pictures to prove it. The meeting’s key theme was the wellbeing of the workforce. It was encouraging to hear from Clare Gerada and Dame Denise Coia about the importance of supporting doctor’s mental health and developments in Scotland which the College has been supporting for some time. Student wellbeing and belonging were themes of Peter Matheson, Principle of Edinburgh University in his President's Lecture, the first in Scotland, which was part of the event. All of the President’s Lectures are available online.

The wellbeing of the NHS workforce is rightly emerging as a priority for health boards. We cannot recruit our way out of workforce pressures and there is a wide acceptance that retention – including the retention of recently retired colleagues part-time – is needed. Retention and wellbeing are joined at the hip. Thanks to generous support from the Scottish Government we have had a series of events promoting both recruitment and retention for Medical Students, FYs and CTs using the Choose Psychiatry materials and influenced by Shrink Rethink. Next year I would like to expand the meetings aimed at medical students so that every year we have a major student event in each corner of the country. We are also seeking a commitment to expand the number of FY Psychiatry posts in Scotland.

The end of 2018 saw the exciting announcement of substantial new funding for mental health in the Scottish Government’s Programme for Government. With emerging governance and accountability structures in IJBs it will be important to follow the money to ensure that funds identified for mental health are spent on mental health. I was delighted to join the newly established Mental Health Delivery Board which is chaired by the Minister, Clare Haughey and which met for the first time in January. It will have an important role in ensuring that recommendations from the Children and Young People’s Mental Health Task Force and the National Suicide Prevention Leadership Group are implemented across Scotland. I am delighted that the College is well represented in both groups. I will also be looking for opportunities to promote the ideas contained in our recently published report, aimed at improving how those with personality disorder are responded to by services.

It has been a busy beginning of 2019 for Scottish Government with announcements in March of major reviews of both Forensic Mental Health Services and Mental Health, Incapacity and Adult Support and Protection legislation. Drivers for the Forensic review included the falling bed occupancy at State Hospital which is partly due to the success of excessive security appeals in the 2003 Act.

The review of the law is a very substantial and ambitious piece of work. It will involve a great deal of time from everyone in the College and I suspect Scottish faculty executive groups will need to meet more regularly. There is room for everyone in the College in Scotland – including retired and trainee members - to contribute to this review, which will shape our professional lives for a generation. I have already had the agreement in principle from our President, Wendy Burn to give additional support to the Office in Queen Street for this vital piece of work. The aspiration is to have world-leading fusion legislation – combining mental health and incapacity – whilst embracing the ECHR ruling in Bournewood, the Supreme Court in Cheshire West and supported decision-making as advocated by UNCRPD. It is quite an aspiration. We await news of the Chairs of both groups (Simon Wessely tweeted he pitied whoever was asked to review the law – the Scottish review has approximately three times the scope of the one he has just chaired - he was supported by 16 civil servants and it took 15 months).

A colleague who would have been thrilled to see this announcement and who would have been bursting with ideas was Jim Dyer. Jim was one of the architects of our current legislation and it was encouraging to see so many colleagues at his funeral. I was pleased to see Karen Addie at that event and you should have received news that Karen has now left her post at the College after struggling with illness over the last couple of years. I am delighted she is able to join us for our autumn meeting on the 19-20 September in Dunblane which will include a gala ceilidh to celebrate 25 years of the RCPsych Office in Scotland. I met Pauline McConville to plan the programme last week which I promise is exceptional and will have a broad appeal – save the date!

We were also sad to hear about the untimely passing of Dr Gary Morrison. Dr Morrison sat on the Scotland devolved council for many years and more recently had been the Executive Director (Medical) at the Mental Welfare Commission. He also led national work on early-diagnosis dementia and best practice in old age psychiatry.

We are very sad to announce that Dr Sue Whyte passed away peacefully on Friday 29th March. Dr Whyte, Liaison Consultant in Glasgow was the Chair of the RCPsych in Scotland between 1997-2001 and was also Chair of the Academy of Royal Colleges in Scotland. She had a lifelong passion for medical education and training. Post-retirement she carried on that interest as a non-exec member of NES. She was awarded a CBE for her role in medical education. Sue was endlessly supportive of trainees around Scotland. One former trainee has already contacted the College remembering Sue as being friendly, warm, kind and organised. Many colleagues will have fond memories of working with her. She was also a great champion for women in medicine and was the first female Chair of the College in Scotland. Our thoughts are with her husband and family at this sad time.

We continue to work, though the implications of our changed College constitution which recognises us as a devolved council. One development I am delighted to announce is that Laura Varney has joined us as Devolved Nations Press Officer. Laura will be based in Edinburgh and will be invaluable to us and colleagues in Wales and Northern Ireland as we respond to the plethora of press and social media activity that is part of College life. I am also delighted that I will be able to announce other exciting appointments at the Queen Street office shortly. Meanwhile, Colleagues will be pleased to learn that our recent interim manager Elena Slodecki has been successfully recruited to the Royal College of Psychiatry Australia and New Zealand in Melbourne.

So as ever we have a lot going on but let us all take a moment to pause. If Psychiatry is anything it is about triumphing in adversity – finding unexpected value and truth. In that spirit of whanau let’s look out for the other whether unsettled by Brexit, religious hate, the casual unkindness of modern communications or just by what life throws our way. Let’s remember to check in with colleagues that they are OK – that’s what communities do.