Working in mental health

We know crises can bring the worst out of people – that’s just human nature. But on the frontline of the NHS, in our mental health services, I have seen the best humanity has to offer: commitment, compassion and selflessness. Working in mental health draws on everything you have to offer – but also gives you back much more: a sense of pride and achievement that only a few careers can provide.

During the COVID-19 pandemic I have carried on working with homeless people in Sheffield. I have seen first-hand the impact of the crisis on people’s livelihoods and their already poor mental health. I am worried about the growing number of people on the streets. It breaks my heart to recognise a familiar face at a homeless shelter – a chef I used to know now forced to use food banks. I wish I could help them all, and as a society we must try.

As a consultant psychiatrist, I know that my contribution through my clinical practice can only be small. Yet I know that across England, providing mental health care is vital. It does make a difference to people’s lives, to people who are well-off as well as less well-off, no matter how young or old they are. A truism that has to be endlessly restated: there is no health without mental health. And as we now enter a new phase of the crisis, with fewer COVID-19 cases in general hospitals and an easing of the lockdown, we must not forget that a new and rising wave of need might be upon us, this time in mental health.

We need our mental health workforce more than ever – and we need more people to join our ranks. Today I want to urge doctors to consider a career in community mental health – a sector in rapid expansion, with fantastic opportunities to help people and develop your leadership skills. I am talking of the kinds of jobs where ‘person-centred care’ takes-on all its meaning. A job focused on improving the lives of people in their neighbourhoods; but also on building teams across the health, care and third sectors to bring a wide range of expertise and resources together to make a real difference in a community.

Choosing mental health for a doctor nowadays means having the opportunity to become an expert in a fast-developing field, where funding is increasing, progress is rapid, and teams are growing to help meet the existing and new needs of patients. There is increased evidence of the value of different medical, psychological and social interventions – and doctors play a key role in ensuring patients get the right treatment, in the right place, at the right time.

Working in mental health in the community means seeing people at their most vulnerable, when a severe mental illness can take over and daily life is often deeply impacted, both for patients and for their families. It requires that doctors find solutions to keep people at home, or close to home; while protecting their safety and that of their loved ones. It entails advocating for some of the most disadvantaged people in our society and helping to address factors that contribute to their severe mental ill health, including loneliness, financial health, physical health problems, traumatic experiences and accommodation. It provides opportunities to work with partners from a wide range of organisations as well as patients and carers themselves; including GPs, social care and charities, towards a common goal: ensuring that patients in a community can live as full and meaningful lives as possible.

I couldn’t think of a career with more purpose. I couldn’t think of a part of the health sector with more promising developments. When I started my training all those years ago, asylums were still in existence. I recall several fellow trainees advising me against specialising in psychiatry because there were “no treatments”, and most probably “not much of a career” in mental health. Not only were the patients subject to stigma, so were we, as the doctors who chose to work in mental health.

But look at where we are today. Never before has mental health had such focus across government and across the NHS. In 2019, the NHS Long Term Plan announcement meant that vastly greater new funding has been earmarked for community mental health than ever before. This year, COVID-19 has highlighted how much we need the NHS, more than ever, for physical but also mental health, especially in our communities. We have thousands of jobs waiting for you, and patients need you. Come and join us. Choose mental health.

Further information

Professor Tim Kendall

Professor Tim Kendall is NHS England’s National Clinical Director for Mental Health. He has been Director of the National Collaborating Centre for Mental Health at the Royal College of Psychiatrists for 15 years and Visiting Professor at University College London for the last eight years.

Tim has also been Medical Director for 13 years and continues as Consultant Psychiatrist for the homeless at Sheffield Health and Social Care NHS Foundation Trust.

As Medical Director, Tim has set up a service user experience monitoring unit, led the reconfiguration of acute care and rehabilitation leading to the elimination of out of area treatments, the modernisation of the acute and crisis care pathways and initiated the development of NICE recommended personality disorder services within the community.

He chaired the first NICE guideline, launched in December 2002, on the management of schizophrenia and the first National Quality Standard (Dementia) for NICE.

Tim has published numerous articles and papers and often represents the NCCMH, NICE or the Royal College of Psychiatrists in the media. In 2004, he was awarded “Lancet Paper of the Year” for showing the impact of selective publishing by the drug industry about antidepressants in the treatment of childhood depression; and with others was awarded the Paper of the Year Award for the Health Economic Journal ‘Value in Health’ in 2012 for work on schizophrenia.