What has been the most rewarding achievement in your career to date?
Establishing the Meriden Family Programme 1998, and being able to keep a focus on families for the past 13 years in services that frequently ignore the needs of families has been good. We have been fortunate enough to win numerous awards over the years. For me it has not just been about the awards, but what they have been for, as I feel they indicate that our programme has made a difference. The National Institute for Mental Health in England award in 2003 was for modernising mental health services, the National Health and Social Care award in 2006 was for innovation and improvement, and in 2008 we received a Health Service Journal award for mental health innovation.
Receiving a lifetime achievement award, the Marsh Award for Mental Health, in 2009 was really special - although I still feel a bit too young for such as award - as the nomination came from carers and family members of those with mental health problems, and it is awarded ‘to recognise those who aim to improve the world we live in.’ I felt a bit overawed and very grateful for the opportunities I have had.
The NHS is in a state of flux, facing wholesale reforms drawn up by the coalition. What is your take on the White Paper?
I have mixed feelings. Coming from Ireland, where people have to pay for health care and the quality of health services is inconsistent, I have a very genuine and deep appreciation of the NHS and how lucky we are to have such an excellent system of health care. The reforms being proposed are radical, and like many people I have anxieties about whether the outcomes will result in improved services.
A particular concern is whether mental health issues will be adequately addressed or get lost among other priorities. However, I see all change as an opportunity for improvement.
The Meriden Family Programme focuses on the needs of families, so I see a fantastic opportunity with the establishment of the new commissioning arrangements and the development of GP consortia. GPs are traditionally family doctors, so I am really hopeful the new arrangements will lead to the development of improved and comprehensive services for families. In traditional mental health services, the focus has been on the individual with the mental health problem, and it has been a struggle to have the entire family and social network recognised. I think that GP commissioning should result in us having a much more holistic view of the person and those close to them.
Something else that I think will improve is the awareness of the physical health needs of those with mental health difficulties, which is something that has not been given enough attention in specialist mental health services. I hope that with GP commissioning much more attention will be paid to issues such as diabetes, obesity and smoking cessation.
How can GPs gain a better understanding of mental health issues?
Through increased contact and joint training with mental health specialists. There are important issues such as ensuring those with long term mental health issues who may be quietly living in their homes are not forgotten. There are some crucial issues that GPs need to understand, for example if a young person is experiencing psychosis, it may be their parents who approach the GP for help rather than the person themselves.
I have come across many occasions where a GP has said that they cannot do anything in such circumstances as the young person is over the age of18, and therefore as an adult must come along themselves. Issues such as confidentiality can be complex in situations involving mental health difficulties, so close liaison between GPs and mental health professionals is crucial.
Do you think GPs have a role to play in helping to tackle the stigma attached to mental illness, if so how can they work to address this issue?
Definitely they have a key role to play in terms of normalising and dealing with mental health issues in the same way as physical health issues are dealt with. Making people attending surgeries aware of what help is available for those with mental health difficulties, employing people with mental health difficulties, and being open about their own mental health problems are all helpful.
