It’s a message we have been told, and have been telling others, since the outbreak of the COVID-19 pandemic. Through all the sacrifices and efforts of our members to continue to deliver essential, potentially life-saving services, we’ve also needed to reassure those we care for, and society more widely, that the feelings they are experiencing, of loss, grief, trauma and instability, are natural responses to times like these.
Yet as we move into the winter months, your medical managers have highlighted that the strain on the services in which you work has become ever more severe. As a College, we have a responsibility to recognise these concerns and reflect them nationally. It is our priority to ensure your experiences and expertise can inform the solutions needed to address that demand.
While this engagement may not be as public as some of the other medical representative organisations, I want to assure you that these concerns have been raised at the highest levels of clinical and health policy governance. They have been expressed in clear terms as to what the current demand on services means for those patients seeking specialist mental health care, and those providing it. I am optimistic that the national dialogue we have requested on these issues will be forthcoming.
The College’s ability to influence on your behalf is greatly enhanced if we receive inputs from members. Views and suggestions on what we can be proposing as solutions to the critical capacity issues you’re facing will be well received by our RCPsych team.
Continuing the dialogue
The increasing demand on services has been part of a constant dialogue alongside other key stakeholders with government since the pandemic’s outset. Whether it be pushing for a national group therapy platform on Near Me to be expedited or successfully advocating for the Scottish Government to commit to develop Quality Standards in adult mental health care, we continue to try to ensure your experiences and expertise is recognised by the powers that be and acted on.
The College has also stressed that dialogue must take place locally, with clear expectations given to you with regards to safely meeting clinical demand with reduced service capacity. There can and must be mechanisms and communication in place to ensure those working on the frontline are supported around the extremely challenging clinical decisions which we are being presented with.
Many of the choices we are making are incredibly difficult for clinicians as we prioritise caring for those most in need. We have reiterated that structures should be in place in local boards to ensure those making these difficult decisions are confident of Board support.
There will be different mechanisms in different areas, with some Boards still in command structures and others moving partially or wholly back to ‘business as usual’ governance and decision-making structures. Regardless of this, where clinicians are having to prioritise care to those most in need, this should be done within clear governance structures, with the parameters clearly agreed and articulated at the operating division or Board level.
Addressing the concerns of our ethnically diverse communities
As we seek to meet these challenges, we as a College are also cognisant that the weight of the pandemic’s impact has fallen harder on our ethnically diverse communities. While we have taken positive steps through the UK-wide Equality Action Plan and the creation of an Ethnically Diverse Communities group, today’s report from the Mental Welfare Commission into these communities and their interactions with mental health services outlines the scale of work required.
We will respond in detail to its recommendations, including around the low representation of these communities among our College fellows, as well as analysis indicating that a Black, Asian and minority ethnic individual is likelier to be seen as a harm to others and less likely to be seen as a harm to themselves. We would urge members who want to participate in this response through our Ethnically Diverse Communities group to please get in touch.
A final word
In the meantime, I want to assure you that your college in Scotland will continue to work with Government to ensure that the situation we currently face does not become an accepted way of working.
It is important that while we care for our patients, we are also mindful of our own and our colleagues' mental wellbeing.
It’s ok not to be ok.
Dr Linda Findlay, Chair, RCPsych in Scotland
If you do feel you are struggling at the moment, the National Wellbeing Hub can provide some helpful resources and guidance. If your need is more urgent and severe, please get in touch with the Workforce Specialist Service. For peer support from fellow College members, you can also get in touch Psychiatrists' Support Service.