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The Royal College of Psychiatrists Improving the lives of people with mental illness

The View from the Chair

Amanda Thompsell

Since November 2016 there have been numerous changes and events which have challenged us - and I am not just talking about Trump! Harold Macmillan is famously attributed as having answered the question of what a prime minister most feared as being "Events, dear boy, events" and this reminder that we are never in charge of what comes next has been amply borne out by the last few months of activity for the Faculty and the Executive.


ICD 11 First there was the request from our American colleagues to weigh in against a proposal coming to the ICD11 committee to reclassify dementia under Neurology rather than under Mental and Behavioural Disorders.  This move was both illogical and potentially damaging. I thank the Executive for helping me write a robust response on this and I also want to acknowledge the work of members of the Faculty Executive in a whirlwind of activity to garner support from numerous other organisations such as The European Association of Geriatric Psychiatry, the IPA, RANZCP to name but a few. Unfortunately, I cannot at this stage say that the issue has been resolved but I will update you when I get any more information


NHSE's five year forward view Another area that has required urgent attention has been NHS England's Five Year Forward View which has moved into the phase of writing implementation guidance. There has been a lot to do to ensure that the mental health needs of the elderly are appropriately represented in this document.  NHS E and Professor Burns has been very supportive of our input to this important process, and we have developed an excellent working relationship, but this increased profile has meant a flood of invitations to attend meetings and a huge amount of work commenting on large documents.


The All Party Parliamentary Group for ageing and older people decided to focus on mental health and therefore when the opportunity came up to speak at the House of Commons about depression in older people this was too good an opportunity to miss.

However, we do try not to be driven by external events.  We have a Strategic Plan and I am pleased to report that there has also been a great deal of planned activity that has been closely focused on our four strategic objectives


1. Raise the profile of the Old Age Faculty.

As the profile of the Faculty is increasing we are being invited to more meetings at national level where older people's health is under discussion such as the Steering Group membership of the Adult Mental Health programme at NHS England and the Older People Mental Health Expert Advisory Group. We have also been asked to attend the HQIP Review of the National Audits for both Stroke and Falls


2. To improve how the Faculty engages with its members and ensures member retention.

We are a national body and it is important to resist a tendency to be London-centric and to ensure that we all learn from each other. I am liaising more closely with the members of the Executive who leaders of the devolved areas and they will now be giving their updates at the beginning of the Executive so that we can bear their particular issues in mind in our later wider discussions. I would like to take this opportunity to thank them for all their hard work

I am looking forward to visiting Falkirk in May to meet colleagues in Scotland.  I added my comments to the response on the new Welsh Dementia Strategy but I want to congratulate Dr Aziz on his written responses and excellent presentation to the Welsh Assembly which can be seen on their webcast.

One area we can contribute to is to ensure that when new posts are advertised the job descriptions are appropriate to make best use of our skills and produce jobs that are doable.

Mike Walker has kindly taken the lead and is piloting a review of some job descriptions currently in place and I look forward to hearing if members find this useful.

Thanks to Dr Krishnan the Annual Conference had a wide range of presentations which I hope colleagues have enjoyed and we will be reviewing the feedback and using it to design next year's programme.

We continue to add more useful resources to the resource section on the website. Please do take a look and share with others your good practice examples.


3. To identify and mitigate the current barriers to improving recruitment within the Old Age Psychiatry at all levels of training aiming to improve recruitment rates.

We commissioned a survey looking at why trainees do or do not choose to train in old age psychiatry.  The results are now being analysed so we can finalise our recruitment strategy based on the feedback.

We have also asked about trainees' training experiences to help with developing the curriculum. It is essential that we ensure trainees get an enjoyable relevant and inspiring experience when working in old age psychiatry.

I spoke at the National Old Age Trainees Conference and I was particularly struck by the enthusiasm, commitment and passion of the trainees who were in the room.

I was also interviewed by the Student BMJ explaining why old age psychiatry is such a great career and I am looking forward to seeing the result of this in print.


4. To increase awareness of mental health conditions in older people.

I have had a piece published in The Times on depression in older people and, as mentioned above. I have spoken at the All Party Parliamentary Group on depression in older people.

Excitingly at long last the older persons' version of “Mind Ed” (a web-based educational resource which can be accessed by carers and people with mental health issues) has the go ahead. Claire Hilton will be the Editor. If this is something that any of you would like to help contribute with then please do not hesitate to let us know. I am now looking at if there is anything we can do to raise awareness of the site when it is finished in about a year.

The Older People's Mental Health Primer for GPs is currently at the stage of seeking final endorsements before being disseminated. It will go on the resource page of the website when finalised.

We are starting a joint project with the British Geriatrics Society looking at depression in care homes and together we are developing an addendum to the Improving the Physical Health of Adults with Severe Mental Illness: Report -Oct-2016.

I have also had discussions with pharmacists about how the Faculty can support them with increasing awareness of the mental health needs of older people.  The Royal Pharmaceutical Society will be focusing on mental health and at the end of the year.  This will help get some real momentum behind raising awareness.

I have also been liaising with the communications department about our communication strategy and our stakeholder engagement. We have a real need for relevant and publishable case histories to help us engage effectively with the media so if you have anyone who could be contacted please let me know.

Finally, other new work

We are planning to update the "CR165 Our Invisible Addicts" report on Older Persons Substance Misuse with the help of the Addictions Faculty.



I see the next six months as being a very exciting time.  The wider community are beginning to realise that the mental health needs of older people are different and their needs must be met.  We have support in this from our College’s president-elect, Wendy Burn.  She has just given an interview in the Health Service Journal that has warned that mental health services for older people are being “neglected” and that she will make it a priority for the College. This is fantastic news and I think this is a wonderful opportunity for us to explain to the public and commissioners the extent of the need and what specialist skills we bring to meet this need.  We can use this momentum to make sure that our patients and their carers get the excellent care they deserve and our expertise in being able to deliver this care is realised.

Harold Macmillan also spoke of the “winds of change” and also said that we've "never had it so good".  It would be great if both aphorisms become true for our specialism and our patients.


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