What motivated you to specialise in mental health?
Mental health is a neglected area though it could not be possibly separated from physical health. It is amazing how the body and mind interact together in a continuous melody until something happens to interrupt this harmony, leading to either psychiatric or physical manifestations depending on a multitude of factors that we could not easily comprehend.
Mentally ill individuals are indeed vulnerable and needy in many aspects, supporting and helping them is very rewarding though it can also be very challenging. We try to follow a medical model, sometimes, to classify psychiatric disorders as we do in dealing with physical disorders, but the variation and personalisation of psychiatric presentation give no chance for monotony. A career in mental health is very interesting, challenging and also rewarding.
What has been the most rewarding achievement in your career to date?
The most rewarding achievement is to see your patients coming back to show their gratitude and happiness with the service they had; nothing can be more rewarding. I am very pleased with the way RAID has been proven to be very successful to the point of receiving special interest from the Department of Health and NHS Confederation.
However, the summit was receiving a very favourable report from the London School of Economics (LSE) which scrutinised RAID in their evaluation. LSE reported that RAID saves 44 beds per day in a 600 bed hospital which is about £4 million per year. Savings have been achieved by improving quality of mental health in acute hospitals rather than through cuts. LSE reported that our cost: return ratio is £1 to £4, which is a very significant investment. But I am very pleased that LSE commented on our success in discharging more older people back to their homes rather than to care homes and calculated that by doing so we have saved the wider economy £60,000 per week.
The NHS is in a state of flux, facing wholesale reforms drawn up by the coalition. What is your take on the White Paper?
The White Paper has already gone through a significant change following the consultation phase and numerous debates. I hope it will open opportunities for us to do more joint working and joint planning with our colleagues in primary care. Contrary to the general view, I believe that it could work very well if we manage to collaborate with the new clusters and acute trusts. RAID is a very good example of joint thinking and planning which lead to benefits to all.
Are you confident that an improved NHS will be the result of the Government’s reforms, if approved by Parliament?
We have had a number of reforms over the recent years but reform alone will not achieve much. We need a new NHS where there is joint thinking and joint commissioning to address the main issues. One of the main challenges, as highlighted by the recent CQC report on dignity in acute hospitals, is elderly care especially those who suffer with dementia. We need to make sure that our staff are highly trained and supported. Also, we need to bring the human touch and personal interaction back to our care approach.
How can GPs gain a better understanding of mental health issues?
GPs are the front line and they already deal with huge number and wide varieties of mental illness. We need to encourage GPs to champion mental health in their practices and to build more robust links with primary care. I always wonder whether we should run some of our clinics from GP surgeries. There is a new model of memory clinics which are run jointly by GP and consultant psychiatrist which have showed proven evidence for success. Training, collaboration and innovation are the answer to better working relationship with GPs.
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?
There are very good examples of GPs who have done a fantastic work to reduce stigma. We need to encourage and promote their way of working. But, being an old age consultant, I am very keen to see GPs addressing the issue of undiagnosed dementia to increase support to older people. Dementia among the Asian elderly population continues to be a taboo. We need to work with our GPs colleagues to reach out to people from black and ethnic minority communities. I believe the local media has an important role to play.
