&me anti stigma campaign

&me Anti Stigma Campaign 

A campaign to encourage senior, currently well healthcare professionals including doctors, vets, dentists and pharmacists to informally self identify as having experienced a mental health condition in order to reduce the stigma of mental health in the healthcare professions. 

&me is a joint project with the Royal College of Veterinary Surgeons' 'Mind Matters Initiative'.

Introducing &me volunteer - Dr Malcolm Kinnear

10th May 2017

Malcolm Kinnear graduated in 1990, but had not completed his psychiatric training when he went on long term sick leave with depression in 1997.  He joined the Doctors' Support Network in 1999 and became active in organising its Scottish activities from 2004 as his mental health very gradually improved.  In 2009 he attempted to return to clinical practice, initially struggling to find a way back as no official route existed, but obtained a specialty doctor post with NHS Fife in open competition on the basis of his work with DSN as well as his independent Continuing Professional Development (CPD).

Malcolm resumed full time practice after a period of shadowing and part time work.  He applied successfully to re-enter higher psychiatric training in 2014 and obtained his Certificate of Completion Training in adult psychiatry in February 2017.  He was then appointed to a substantive consultant psychiatrist post with a community mental health team in Dundee, with sessions in the Tayside specialist adult autism team.
Doctors' Support Network 2017 Malcolm Kinnear mental health
Malcolm has actively advocated for better healthcare for doctors and is currently involved in a multi-organisation working group to set up a Managed Clinical Network for doctors with mental health problems in Scotland.  He has an honorary teaching position with the University of Dundee (twice nominated for a FaME - Faculty of Medical Educators - award) in which capacity he reminds medical students to look after their own health and to remember that doctors can find themselves patients too.  He also finds that having taken some of the medications he now prescribes can be rather helpful in terms of understanding their effects!

Introducing &me volunteer - Dr Caroline Reed O'Connor

29th March 2017

Caroline Reed O'Connor is a senior trainee psychiatrist and psychotherapist working in South West London.  She had recurrent episodes of depression throughout her twenties and when she experienced periods of high mood in her early thirties she was diagnosed with bipolar disorder.  Her mental illness hasn't stopped her from getting her dream job and has fuelled her passion for working in the field of doctors' health.  Caroline is involved in running the Facebook 'Tea and Empathy' group facilitating informal peer to peer support for NHS staff.
Doctors' Support Network 2017 Caroline Reed O'Connor mental health
Caroline says 'The worst stigma I've experienced over the years was the stigma I put on myself.  Speaking out about my illness has helped me to feel less ashamed - I now feel incredibly proud of my experiences and the way I manage my mental health.  I am open with everyone about my illness - it helps me and it helps them.  From individual private conversations to speaking to a room of over 300 trainee doctors.. I'm passionate about encouraging all doctors to talk more openly about our day-to-day struggles.  Sharing really does kill stigma.'

Author and psychiatrist Dr Linda Gask speaking about &me and her recent Guardian column

'There are many people working in medicine who have mental health problems, but currently few feel able to speak out. I’ve had mental health problems throughout my career. I’m not ashamed to say so in the hope that this will help others. The &me campaign is a powerful way for us to stand up together, support each other and challenge stigma.' 

Linda's recent Guardian column describing how her psychiatrist told her that a history of a mental health problem did not preclude a medical career: https://www.theguardian.com/commentisfree/2017/feb/17/moment-changed-me-mental-health-problems-psychiatrist

Follow Linda on Twitter : @suzypuss
Doctors' SUpport Network 2017 Linda Gask at &me launch mental health
Linda Gask (left) at the launch of the &me campaign

&me launch at House of Commons Tuesday 31st January 2017

The &me campaign was officially launched at an afternoon tea event at the House of Commons sponsored by Kevan Jones MP (Labour, North Durham) who has spoken about his own experiences with depression, and featured first-hand testimonials from senior veterinary surgeons and doctors who have experienced mental ill-health.
Doctors' Support Network 2017 Kevan Jones group &me mental health
Doctors' Support Network 2017 Kevan Jones &me mental health
In introducing the campaign Kevan Jones MP said: “The key message I have today with regard to mental health is talking about it and trying to get it out of the dark corners rather than it being something you are ashamed to talk about.  That is how we get people to help themselves with their own condition and to seek help.  The other key thing is not to write people off if they have a mental illness.”
Doctors' Support Network 2017 Dr Louise Freeman &me mental health
The floor was then opened to personal stories from those who have lived experience of mental ill-health. Dr Louise Freeman is Vice-Chair of the Doctors’ Support Network and was diagnosed with depression in 2009 as a result of the way in which her return to work was handled after having time off work as an emergency medicine consultant following a bereavement.
 
She said: “This experience made me think that doctors with mental health problems were in a small minority and that it was probably our own fault anyway. Both impressions are completely wrong. The incidence of mental health problems is one in four people in any one year and is actually higher for doctors, who are often slower to seek help than non-medics. The good news is that well supported doctors have excellent treatment outcomes.
“During my own return to work, I was told by my clinical lead that they had ‘always thought that I was a mental health problem waiting to happen.’ I think this says more about them than it did about me! On reflection, yes that was true, but only in as much as this applies to all of us during our lives.

“I hope that the ‘&me’ campaign can start to address this by encouraging senior healthcare professionals, who are currently well, but have experienced mental health problems, to disclose that they have ‘been there themselves’. I think that this will help to normalise mental ill health for healthcare professionals and therefore remove some of the barriers to unwell professionals seeking help at an earlier stage. Overall this would be better for healthcare professionals, their colleagues and their patients.”
Doctors' Support Network 2017 Dr Jonathan Richardson &me mental health
Dr Jonathan Richardson is Group Medical Director for Community Services at the Northumberland, Tyne and Wear NHS Foundation Trust.  He had a mental health condition when he was a medical student and spoke about how it is possible to flourish in your career with a mental health diagnosis.
 
“I was unwell as a teenager with a physical illness and later as a medical student with a mental illness… these two experiences crystallised my drive to become a doctor and my own approach to healthcare.  I wanted to be able to deliver the care that I was fortunate to receive. I wanted to be as patient-centred and compassionate with the patients I would serve, in the same way as the teams who delivered my care.  I was lucky to have support when I was unwell from very good friends, some from school and some from university; and a very close family.  I have been able to recover.
“It is 24 years since my mental illness. I now work in Northumberland, Tyne and Wear NHS Foundation Trust, one of the largest mental health and learning disability trusts in England – and one of only two to be rated outstanding by the Care Quality Commission…. I do not feel that my illnesses have stopped me.”
Doctors' Support Network 2017 David Bartram &me mental health
David Bartram, Director of Outcomes Research for the international operations of the largest global animal health company and a member of the Royal College of Veterinary Surgeons’ governing Council, spoke next. He gave his perspective on coming to terms with a mental health condition in a profession that has some stigma attached to it.
A number of years ago David attempted suicide following the breakup of his marriage and explains what happened from there:
“I just thought I was stressed – after all, who wouldn’t be in those circumstances? But in fact I was becoming progressively more unwell. What started as worry, early waking and palpitations – which I recognised – led to patterns of thinking which I did not recognise as being disordered. I felt trapped and worthless – suicide was the only escape. From a medical perspective, my biological, social and psychological risk factors had converged and tipped me into major depression."

"That was the first of multiple suicide attempts and several prolonged stays in hospital. Over a three-year period I spent 12 months as a psychiatric inpatient. I was treated with antidepressants, antipsychotics, mood stabilisers, talking therapies and electroconvulsive therapy."
 
“But now thankfully I am well – and I have been for 14 years…. To what do I attribute my recovery? A mixture of medical treatment, psychological therapies, supportive friends and family, rest and time – they all contributed, probably in similar measure.” 
 
He added that while his episode of mental ill-health does not define him it has changed him in a positive way and that no one is immune from it. 
Doctors' Support Network 2017 Dr Angelika Luehrs &me mental health
Dr Angelika Luehrs is the chair of the Doctors’ Support Network and a consultant psychiatrist who was diagnosed with bipolar affective disorder while she was a trainee psychiatrist. She said: “When I asked for advice about how to access help one of the answers I got was one of ‘whatever you do, make sure that you don't have any mental illness in your medical records otherwise you will never go anywhere in your medical career'. However, getting the diagnosis and help from a Consultant Psychiatrist was the best thing that ever happened.”
She added: “The reality is that my diagnosis has not stopped me – I have been a consultant psychiatrist since 2010 with the Avon and Wiltshire Mental Health Partnership NHS Trust, last year I was appointed as medical lead for West Wiltshire including early intervention, intensive services and primary care liaison services.  I have a special interest in supporting doctors with mental illness and I am delighted to be appointed by the newly launched GP Health Service as a special advisor for complex mental health cases.”
Doctors' Support Network 2017 Neil Smith &me mental health
The last speaker was veterinary surgeon Neil Smith, who chairs the RCVS Mind Matters Initiative, who outlined how to participate in the campaign.
 
“This event is just the start… the real challenge is to start to get this message out to the wider professions. Stigma is a difficult thing to tackle, but the good news is that changing our minds is within the power of every individual to do,” he said.

Following the launch the ‘&me’ campaign is now encouraging other senior health professionals to step forward and talk about their own experiences with mental ill-health, especially as both medical doctors and veterinary surgeons have higher suicide rates than the general population but often have more reluctance to seek help because of the impact it may have on their career.
 
The campaign is interested in hearing from not only doctors and veterinary surgeons but also nurses, veterinary nurses, dentists, pharmacists and other healthcare professionals who want to open up about their experiences of mental ill-health. To participate in the campaign email Dr Louise Freeman on vicechair@dsn.org.uk.
 
On social media tweets about the campaign will be sent from @vetmindmatters and @DocSupportNet using the hashtag #AndMe

Press coverage of &me

GP Online article about the launch:

Politics Homes article about the launch :

The Dentist

Vet Times

&me Anti Stigma Campaign Outline

What we know 
The annual incidence of mental health disorder in the UK population as a whole is that 1 in 4 people in any 1 year will suffer a mental health problem and the lifetime incidence is closer to 1 in 2.  Healthcare professional groups are at even higher risk than the general population.  For example, doctors are at relatively higher risk of suicide than non medics and vets have quadruple the suicide risk of the general population.  A recent survey showed GPs to be 3 times more likely to be depressed than the general population - but there are well-identified barriers to healthcare professionals seeking support and treatment when they are unwell with a mental health problem.  

A major factor is the potential stigma and worry about subsequent detrimental career effects.  Stigma was noted to be a factor in the events leading to the tragic deaths of psychiatrist Daksha Emson and her baby daughter Freya. Reluctance to seek help can contribute to sickness absence, and reduced staff retention as well as the presenteeism effect where staff are at work but do not function optimally due to their ill health – highlighted in the 2009 Boorman review

What about the General Medical Council (GMC) / regulatory bodies? 
The potential intervention of regulatory bodies such as the GMC can affect practitioners’ willingness to seek help for mental health issues. In reality, GMC guidance is that there is no need for the GMC to be informed about an individual doctor’s mental health diagnosis unless there is a risk to patient safety, for example due to the doctor refusing to follow the advice of their own medical advisors. 

Would healthcare professionals currently unwell with a mental health problem be expected to ‘out’ themselves? 
Definitely not. The campaign specifically does not wish to risk increasing unwell professionals’ concerns about stigma or breach of confidentiality as this would be likely to lead to reluctance to seek help.

How will the &me campaign help? 
Healthcare organisations such as regulatory bodies and colleges are united in urging individual practitioners to seek help if they are unwell with a mental health problem and reassuring them that this is normal.  There is a marked absence of leaders within the healthcare professions who have admitted to themselves having been affected by a mental health problem.  The effect of this combination is that healthcare professionals, with a mental health problem, can feel as if only they have had a problem and that successful people in their chosen field have not.  This is not true but can act as a significant barrier to help seeking behaviour from affected healthcare professionals.  

The idea of the campaign is for a group of senior, currently well health care professionals to self identify as having previously been unwell with a mental health problem and that this has not prevented them from succeeding in their chosen field.  And doctors seem to have more of a problem in admitting to their own mental health issues than other healthcare professionals.  We would suggest that if doctors could improve their approach to their own mental health, this would be likely to lead to better medical care for everyone (patients) with mental health problems. 

 We hope that this campaign will add to the overall anti stigma message of campaigns such as ‘Time to Change’.   

Partners for the &me campaign
Campaign
The &me campaign will be launched at the House of Commons on Tuesday 31st January at an afternoon tea event kindly sponsored by Kevan Jones MP.  Kevan is open about his own history of depression and has done much excellent work in this area.  Senior volunteers from within the professions will talk briefly about their experiences and there will be an opportunity for networking.

The campaign will continue for one year and will feature volunteer senior role models via website and social media posts using the hashtag '#AndMe'.  

If you would like to volunteer as a senior healthcare professional role model, please email Dr Louise Freeman to discuss this.
Email Dr Louise Freeman
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