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Medicine 2019: Mental health

Chaired by Dr Kate Lovett, dean of the Royal College of Psychiatrists, this session focused on the mental health of both patients and practitioners.

Dr Hermione Price, consultant diabetologist at Southern Health NHS Foundation Trust and Royal Bournemouth Hospital, opened the session by discussing the physical health of those with mental illness. She shared how people with schizophrenia die on average 25 years earlier than the general population, largely due to cardiovascular disease, however commissioning arrangements do not generally support ‘joined-up’ care.

Dr Price focused on the national guidance that has been written to address these issues and provides recommendations for commissioners, acute trusts and mental health trusts. She also provided examples of local implementation of an in-reach diabetes service and improvements made to the health of patients with serious mental illness and diabetes. ‘I work with psychiatrists, and sit within the medical and psychiatry professions; I would argue that there is a need for more people like me for this group of patients as there is a huge unmet need,’ she said.

‘We need to do something about this now. People are impassioned about this and want to make a difference,’ added Dr Sean Cross, consultant psychiatrist at South London and Maudsley NHS Foundation Trust, who presented next and discussed the mental health of those with physical illness. He shared how patients with long-term conditions who also have depression die sooner than patients who do not also have depression.

Dr Cross defined three key areas of focus to mobilise change:

  • screening
  • service development
  • education and training.

Continuing the focus on the mental health of patients, Professor Linda Gask (emerita professor of primary care psychiatry at the University of Manchester) discussed a patient’s experience. She described how it is inevitable that providers of healthcare will become patients too, and it is at this point that they begin to understand what being a patient truly means. She reflected on her personal experiences of being diagnosed with a chronic illness and how depression both detracted from and enriched her ability to work as a mental health professional.

‘This Cartesian divide of healthcare provision needs to be challenged more urgently than ever,’ said Gask.

Her key messages were:

  • provision of mental and physical healthcare needs to be better integrated
  • doctors have to take care of themselves
  • doctors need to not be afraid to ask others if they are OK.

The final talk, co-presented by David Parry (deputy director of education at the RCP) and Dr Emma Vaux (senior censor and vice president (education and training) at the RCP), focused on the wellbeing of practitioners. In this interactive session delegates undertook a number of learning activities which focused on the factors that can influence personal wellbeing as well as the use of validated tools to support wellbeing. In the conclusion of their session they examined the impact that small-scale interventions could have on improving both personal wellbeing and wellbeing of teams, and defined that small interventions can make a difference ‘for you and your teams’.

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