A moment that changed me: my psychiatrist told me I could be one too | Linda Gask

During my years of medical training I was tense and wound up almost all of the time. Then, just before my finals, things got very much worse. I began to draw up a complex revision timetable, which I obsessed over. I was as fearful of failing as I had been with my A-levels, but there was also a terrible sense of unease about what was happening to me, to which I couldn’t put a name.

I convinced myself that the best way to stay in control of my world was to design a kind of map for my mind and contain everything within it by the time the exams arrived. I ruled out lines on sheets of paper to create a chart to govern every waking hour for the next few months. I did not want to acknowledge the obvious parallels with my brother, whose strange behaviour would later be diagnosed as obsessive compulsive disorder.

The idea of studying medicine had come to me quite suddenly around the age of 15. I had discarded my previous ambition of being a biology teacher, and when I received an offer from Edinburgh medical school I had been determined to make the most of it.

But my confidence was in short supply, and I felt out of place in Edinburgh from the start – like many students, I self-medicated with alcohol. As a working-class girl, the first in my family to ever think of going to university, I didn’t share the same background as most of my fellow students. My mother worked in a factory, assembling transistor radios, my father in an amusement park repairing fairground rides, and my relationship with both had been increasingly difficult in the years before I left home. As a result, I felt even more alone.

I also had problems with anxiety which began before my A-levels. I hadn’t made the grades that Edinburgh asked for in their offer, but unexpectedly they had still given me a place. As the tension built during my years at medical school I had a few appointments with a student counsellor, but didn’t find it very helpful. I couldn’t understand what the problem was, although I know now, having had psychotherapy many years later, that it had a great deal to do with unresolved problems with my family from my childhood.

As I prepared for my finals, with my mind map, and my chart of each available hour, there came a point when I couldn’t go on. I can’t remember exactly what happened. I wasn’t sleeping or able to work. Sometimes I didn’t bother to get dressed, and it felt as if everyone in my year knew that I was a complete failure. My head felt like it was splitting open and I was struggling to hold the pieces of my brain together. I finally went to see my GP and he referred me to a psychiatrist who did sessions at the university health centre. With some medication, a lot of tears, and support from him I managed to pass my final examinations.

I had no idea where to go next with my life. I had wanted to specialise in general medicine, but my attempts at getting a training post were unsuccessful, and deep down I knew I didn’t really have the right talent for it. I began to seriously question my ability once again. The real problem was that the specialty for which I seemed to have the most aptitude as a student now seemed closed to me. During my student attachment in psychiatry I had been able to imagine myself without too much difficulty in the world of the people on the psychiatric unit. However, the fact that I could relate only too well to some of the experiences described by the patients also worried me.

I needed to find out if my fears were warranted, and finally plucked up the courage to telephone the psychiatrist I had seen a few months earlier.

“I wanted to thank you,” I said, “and ask if you thought it would be out of the question, after what happened to me this year, for me to train as a psychiatrist?”

“No,” he said warmly, “I don’t think it would be out of the question at all.”

Those few words of encouragement set me off on a very successful career path in psychiatry. It’s not been without problems. I’ve had recurrent episodes of depression, and at times it’s been hard. But I would not have fitted in better anywhere else in medicine, and I think I’ve been a more empathic doctor because I know what it’s like from both sides. I’m determined that medical students who experience mental health problems and worry about the stigma that still exists in medicine should not assume that they are simply “weak”, or that the door into a career in psychiatry is closed to them. It certainly isn’t.

A moment that changed me: my psychiatrist told me I could be one too | Linda Gask

As a psychiatrist I"ve seen how culture affects views of mental illness

“I am already dead! I have been buried.” said a young south Asian girl on the psychiatric ward. Prior to her admission she had stopped going to school, and instead isolated herself in her room spending hours on the internet searching for her grave. She was not eating much and losing weight. There had been occasions when she wandered off at night. With poor eye contact and slow speech, she added: “I can feel the worms crawling inside my body.”

After an assessment she was found to have developed a severe form of depression with Cotard syndrome (a rare mental illness in which the affected person holds the delusional belief that he or she is already dead).She wanted me to let her access the internet so she could view her grave online. Her family thought that the girl was possessed by a jinn (a demon in Muslim culture). The family wanted to take her to a spiritual healer, away from the hospital, but we were concerned about her wellbeing.

I spent hours explaining to them the need for medical treatment while listening to their cultural understanding of such mental health problems. As mental illness is a taboo in so many cultures, it is easier to see it as a spiritual problem rather than a medical one. I agreed to talk to the spiritual healer, so that he could explain to the family the serious nature of her mental health problems. We finally came to an agreement whereby the girl would continue to have treatment in hospital and the family would place spiritual amulets around the room. There was a good outcome and the young girl was discharged after recovery.

This was my first exposure, as a psychiatry trainee, to cultural issues entwined with mental health problems in England. Although I had an understanding of some of the cultural issues highlighted in this case, I learned it was important to make sure we listened to and respected all views before coming to a decision.

The UK has become more ethnically diverse in the past 20 years. Generally, stigma and shame have heavily influenced any help-seeking behaviour in the black and ethnic minority groups. Even if they do seek help, the lack of cultural and spiritual understanding of their problems may lead to non-attendance and disinterest by the patient and the family. We come across this in our daily practice.

A middle-aged women of African descent was referred to us for dependence on prescribed painkillers. Following a thorough assessment it transpired her initial complaint of “aches all over her body” were cultural expressions of low mood and depression rather than actual pain. This was explained to us by her young daughter who described how feelings of lethargy and lack of energy are expressed as weakness and body aches.

Related: How can mental health services deliver better care for black patients?

Once we helped the person detoxify from the painkillers, we started treating her for depression which dramatically improved her life.

We need to target communities to increase awareness and challenge stigma which would help to reduce the barriers in seeking help. We should work to develop community champions and work with spiritual healers who can refer individuals needing mental health treatment.

As a British south Asian Muslim, I can identify with some of the issues I see in my clinical practice. I think appropriate, localised training on cultural awareness for all staff in the NHS can help in a better understanding of the patient’s needs.

Transcultural psychiatry has always been at the forefront of the Royal College of Psychiatrists’ agenda and now it is needed more than ever.

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As a psychiatrist I"ve seen how culture affects views of mental illness

"Extremist" doing work as psychiatrist for NHS

Under a caliphate, guys and women would be segregated in public places and females and non-Muslims would be banned from holding positions of energy. Alcohol would also be banned, along with exact same-intercourse relationships. Critics have explained his skilled part conflicts with his excessive views on women’s rights, alcohol, and exact same-sex relationships.

Dr Waheed has referred to as on supporters of Hizb ut-Tahrir to undertake “jihad” against Israel and when mentioned he would only condemn the 2005 London bombings if Western leaders criticised what they had accomplished in Iraq and Afghanistan.

Khalid Mahmood, the Labour MP for Birmingham Perry Barr, final night named on both the NHS and the Standard Health care Council to examine no matter whether Dr Waheed’s role as a consultant psychiatrist is compatible with his political actions. They in contrast the circumstance to getting a British Nationwide Party activist functioning in a multiracial location this kind of as Birmingham.

He explained: “If Dr Waheed is as fervent about his views as I suspect he is, I locate it hard to believe he can maintain them separate from his practice as a psychiatrist working with extremely vulnerable individuals.”

Ghaffar Hussain, from Quilliam, which campaigns against radicalisation, explained: “Vulnerable people have a proper to know if they are receiving counselling and care from an person who is extremely senior in an extremist organisation such as HuT.”

Hizb ut-Tahrir is banned from Birmingham Central Mosque. Dr Mohammed Naseem, its chairman, mentioned: “Their views are not compatible with Islam and the Muslim neighborhood in Britain rejected them a extended time ago.”

Following the July seven bombings, which killed 56 individuals, Tony Blair announced his intention to ban the group, but abandoned the strategy after police and the safety providers advised that such a ban would drive it underground and make it more difficult to check its members’ activities.

However, the party is considered to be responsible for radicalising thousands of younger British Muslims. Despite the fact that it says it opposes acts of violence in the title of Islam, some protection professionals claim the organisation acts as a “gateway” for much more excessive organisations.

Dr Waheed’s operate leaves him accountable for the mental wellbeing of a enormous quantity of men and women in the care of Birmingham and Solihull Psychological Wellness Trust, which covers one.2 million folks.

Last year he delivered a speak at the Arab Uprising conference in Manchester in which he urged the adoption of a caliphate type of government, claiming it provided “superior and sophisticated political, economic and social solutions” to modern issues.

"Extremist" doing work as psychiatrist for NHS

Psychological well being units "are heading for a Mid Staffs scandal", warns senior psychiatrist

Sue Bailey said mental overall health providers are approaching tipping stage. Photograph: Anna Gordon

Britain’s senior psychiatrist has warned that the mental overall health sector is heading towards its personal Mid Staffs scandal, as it emerged that NHS patients are currently being handled in a hospital in which workers have been lately accused of utilizing injections and seclusion as threats.

Professor Sue Bailey, president of the Royal School of Psychiatrists, mentioned she was increasingly concerned that psychological services were approaching a “tipping stage” with funding becoming lower regardless of a record 50,000 uses of the Mental Overall health Act to detain individuals in hospital for assessment or therapy in 2012-13.

Regardless of the government’s claims that mental health would be offered parity with bodily health, Bailey stated money that it was due to be given had been redirected to deal with the repercussions of the Francis inquiry into the scandal of the needless suffering, and attainable needless deaths, of hundreds of men and women at Stafford hospital.

Bailey warned that the mental overall health sector could only “cut its cloth” so far. She mentioned: “I do truly feel really strongly that if we keep constantly becoming the last in the line there will come a tipping stage and we will end up with our very own [scandal and subsequent inquiry]. We are under increasing stress. Carers will tell you that. Mental overall health practitioners who really feel it is risk-free to talk about these issues will tell you that – but whistleblowing is nonetheless not simple.”

Bailey spoke out as it emerged that a juvenile patient at a private mental overall health secure unit in Woking, Surrey, which has a chequered historical past of overall performance, had told Care Top quality Commission (CQC) inspectors in December that seclusion and intramuscular injections were regularly employed as threats by personnel. During a go to to the hospital, owned by the personal Alpha Group, inspectors also identified that a younger particular person who had banged his head in seclusion was left lying on the floor for 15 minutes getting sick.

Inspectors could locate no information of healthcare assist being provided to a youthful man or woman in seclusion who was mentioned to have signs of “rolling eyes and losing balance” for at least thirty minutes.

The hospital, which was instructed in January to show proof of improvement within weeks, had already been told to urgently improve its functionality following two prior visits. In a prior report, inspectors recorded that “one particular female adolescent patient had been restrained by 9 members of staff, one particular of whom was a male” since she refused to take away her underwear.

Alpha Group, which has two even more hospitals in Bury, Higher Manchester, and Sheffield, is owned by the controversial Liberal Democrat donor Sudhir Choudhrie, who was named by India’s Central Bureau of Investigation as a single of 23 “unscrupulous persons” in 2012 and is accused of currently being an arms dealer, a claim which he denies.

Bailey said that exactly where failings were emerging they were a symptom of a program below strain. She explained: “Just like the rest of medicine, items can go wrong. We know the factors that make issues go wrong. And we know one of the things that created Mid Staffs go wrong was finance driving the complete kit and caboodle. We’re worried.”

In December a freedom of data request revealed that mental wellness trust budgets for 2013-14 shrank by two.three% in genuine terms from 2011-12. 10 out of 13 trusts that supplied forecast budgets for 2014-15 have been projecting additional cuts.

On Friday the CQC announced that Alpha hospital in Woking was now compliant with the “needed requirements” but that the regulator would proceed to keep track of the support. NHS England confirmed that NHS sufferers would proceed to be referred there. It stated that there had been no block on NHS referrals given that issues initial emerged at the hospital eight months in the past, regardless of the scathing findings above a series of CQC inspections.

Surrey has no other secure hospital in which juvenile mental well being individuals can be inpatients.

Victoria Bleazard, Associate Director of Campaigns at Rethink Psychological Illness stated she was concerned that the lack of different amenities in the region left vulnerable mentally ill children with no other alternative but the Alpha hospital.

She mentioned: “The government says that individuals must be able to decide on exactly where they get treatment for psychological illness, in the same way that folks with physical well being problems can. But when there is this kind of an acute shortage of hospital beds, the thought that they will be ready to pick where they receive therapy is completely unrealistic. For many men and women, receiving remedy at all is a struggle in itself.”

Alpha Hospitals explained: “We quite considerably value suggestions from the CQC. Following its inspection of 1 of our wards in November and December 2013, we worked closely with NHS England and CQC to create and implement an action plan. We have given that been inspected by the CQC and obtained optimistic feedback.”

Psychological well being units "are heading for a Mid Staffs scandal", warns senior psychiatrist