Lots of talk but no action

Greetings all,

Many thanks to all of you who retweeted and replied to my blog post entitled “Not thinking before you speak”. It seems many are as outraged as I am about Mr Latham’s comments towards Lisa Pryor, and more importantly to The Financial Review for not retracting them.

As I have said, yes, all are entitled to freedom of speech but some acknowledgement that these comments are hurtful, stigmatising and lacking any credibility is still sorely missing.

The Royal Australian and New Zealand College of Psychiatrists have also replied to my post, stating via Twitter,

“Absolutely, Mark Latham’s comments are concerning and not helpful in removing stigma attached to mental illness.”

On this WhiteRibbon Day, I will keep up the fight to support Lisa Pryor, soon to be a medical colleague of mine, as well as advocate for public understanding and respect for my patients who ask for help and should not feel ashamed for receiving it. I will also continue to follow the campaign at Change.org and encourage others to do so as well. Over 1500 people have signed the petition so far.

Let's keep this going,

Best wishes,

Helen

Dr Helen Schultz is a consultant psychiatrist at MindAdvocacy in Richmond, Melbourne, Australia. She is a recent author of “How Shrinks Think” which can be purchased here.

Shrinks and Social Media

I don’t ever remember learning about social media at medical school back in the '90s. Social media was reading the newspaper or a magazine before uni started. In the olden days, merely 20 years ago, we had no idea the www was coming.  Dr Google was somewhere in the lecture theatre but we didn’t recognise him/her, and we couldn’t imagine that there would be communal platforms like Facebook around to unite strangers and label them friends.

Lecturers teaching ethics in medicine did not fathom a world where doctors would live within social media, and have to work their way through the twists and turns of setting up and maintaining Facebook personal pages, doing their best not to be found on social media by their patients, yet really wanting to share photos of recent holidays, and remain in touch with colleagues.They certainly wouldn't have envisaged doctors embracing socila media as an effective means of building communities, promoting evidenced based helath messages and influencing for change. 

Regulatory bodies such as AHPRA and professional associations such as the AMA have tried to keep up with the growing trends of what was considered a fad and considered absolutely not relevant to professionals, certainly doctors, but then had to begrudgingly accepted social media as something here to stay. Unfortunately the regulatory bodies, not the medical profession have advocated for the way social media should be used in medicine, and many doctors remain unaware that they need to know more about social media in medicine.

More and more, doctors want to influence debates on health matters, and nowhere is this more real than in psychiatry and mental illness. In 2014 we must realise that stigma is rife and campaigns such as ’@RUOKday’ and days dedicated to suicide prevention are popular because there still exists a fundamental belief that to be depressed is weak and something to suffer in silence. Large NGO’s with stacks of cash  have departments that run social media campaigns, driving their messages home, influencing the debate and keeping the radar on the topics. But what about doctors? Why do we believe others can pledge our plights and we can be taken as read, without being read, that we support or refute an argument or counterargument without making our own unique and collective point of view known? How do doctors, particularly psychiatrsts feel about campaigns such as @RUOKday, and what are they saying about it?

In Australia, the ABC is running a campaign called 'Mental As' to coinicide with national Mental Health week in October 2014. Great to use high profile celebrities to 'raise awareness', but what does a psychiatrist feel about a campaign being labelled "Mental As?" How do psychiatrists feel about raising awareness for a most valuable area of health, yet with limited funding to provide care when patients seek help?  How do psychiatrists feel about being labelled as those that treat 'mental patients, a most derogatory and stigma enhancing term. Isn't that where psychiatrists can have a say? In summary, advocacy about mental illness on social media is one sided, lacking a robust evidence base and not informed and influenced by experts in the field - psychiatrists themselves.

In the last 5 years it is pleasing to see medical colleges such as RANZCP and RACGP join social media, tweet regularly and highlight very important policy decisions they are making regarding such critical issues as the mental health issues facing asylum seekers and offshore detainees. In recent times we have seen doctors unite over issues they are passionate about such as #AHPRAaction, #ScrapTheCap and #CoPayNoWay. Because the fact is this. Social media is not for posting what you ate for lunch or where you spent your holidays. Social media is for connecting, uniting and advocating as a mass of people from so many walks of life that would never have been able to come together so quickly in any other way. Campaigns on social media work quickly, they pack a punch and they influence.

I write as a novice to social media, coming on board in January 2014 as a naysayer and critic. It was because I didn’t know about this side of social media. I learnt from other professional bodies, dipped my toes in the twitter universe and discovered to my amazement there were people I could find and follow who felt like me. People who admired what I did and followed me back. I quickly joined an amazing campaign called #AHPRAaction and stood up to our regulatory body to defend our rights in the context of social media. Four months after I opened my twitter account. Now I blog regularly, have a company Facebook page, tidied up my LinkedIn profile, set up a psychiatrist’s and registrars group on Linkedin (PARA) which is gaining membership, and have almost finished my first book.

And what about me as a doctor, passionate about psychiatry, and with my experience as a writer and learning the ropes about being a shrink? Well, now I have a voice and a brand. I have stepped forward and claimed my identity that is authentic to me, before others can post about who they think I am. I have bought my domain name www.drhelenschultz.com, and claimed the @Drhelenschultz  twitter handle before somebody else does and pretends to be me. Not a narcissistic thing to do, but a sensible thing to do, as the real estate space in social media gets clogged, people find new ways to influence and may wrongly do so by purporting to be somebody else. And because I want to guarantee my future both in the business and medical world as well as the social media world. The two are intertwined. I love the feeling that I can write what I think and own it, and others can truly decide whether they admire me or not because they know the real me.

As for psychiatry, I will continue to have a presence and a voice on social media, finish my book “How Shrinks Think” and be a thought leader when it comes to our treatment of those with mental illness, and what we can all do better. I’ll stand aside NGO’s and colleges as somebody who works within the system and has a right to have a say. That say will be shouted on social. 


Dr Helen Schultz is a consultant psychiatrist based in Melbourne, Australia. She is also founder of CPD Formulations, a medical education company that creates medical education programs written for doctors by doctors. Her new workshop is called @SoMebythesea, to be held on 15th November 2014, in Torquay, Victoria. It will be the inaugural social media workshop for the medical profession. 

Leading from the Couch - Psychiatry and Leadership

In just under a week, I will be attending the World Medical Association (WMA) Caring Physicians of the World Leadership Program at the INSEAD business school in Singapore. I will be one of a number of delegates from around the world representing our respective local medical associations. I am attending as a psychiatrist and will be learning and engaging as much as I can to become a better leader in this most challenging and important area of medicine.

Although a terrific honour, this is also confronting, and has led me to ponder what it is to be a psychiatrist and a leader? And even more importantly, can we still call ourselves leaders in debates around mental health or mental illness?

In a world that is post de-institutionalisation, over time more and more non-government organisations, consumer lobby groups and front line services such as Lifeline do an amazing job at helping people in crisis, enhancing the awareness of mental illness and attempt to reduce stigma. Government funding is directed at large organisations so that they can fund projects and inform the metal health debate. Office bearer positions within these organisations are not reserved for psychiatrists but a range of mental health clinicians. In fact WE are largely being labelled 'mental health clinicians' when we are Psychiatrists with medical degrees and post graduate training. And although funding and awareness is all important, I should not be at the expense of evidenced based care that psychiatrists are trained to deliver.

Today on Twitter, SANE posted a comment from their CEO, Jack Heath. In a recent comment in the Age he stated that more than 2500 people died by suicide in this country in 2012. He described this as deeply concerning, not least because it is the highest number of suicide deaths in the past 10 years. He called for collaboration between clinicians, NGO’s and Government. He believes mental health clinicians need more skills in recognising and managing suicidal tendencies. But what about psychiatrists, who are trained in this and can do this work being engaged in this debate. Actually, why aren’t we leading it?  

I am concerned about the ‘dumbing down’ of a profession I am very proud of. When I have a patient in crisis and need to call crisis services, I rarely get to speak to a medical colleague. Imagine a cardiologist sending in a patient to an emergency department with chest pain only to be told he cannot speak to the admitting officer, another doctor. And psychiatrists are largely losing traction as leaders in hospital multidisciplinary teams. Policy is often informed and determined by others.

Two ways I see that psychiatrists will continue to experience challenges as becoming leaders in the mental health debate:

1.    The Monash University Medical School now offers a course titled 'Medicine of the Mind' rather than psychiatry. I can only imagine the outcry if they offered orthopaedics as ‘Medicine of the Bones’. Not only is this a watering down of our skills and abilities, it may discourage medical students becoming future psychiatrists. Medical students need to be educated that psychiatry covers more than just the mind.

2.    On 16 April 2014, Dr Murray Patton, current President of the Royal College of Australia and New Zealand Psychiatrists (RANZCP) spoke on ABC Radio National about addressing community misunderstanding about psychiatry. He reported results from a survey of 1500 members of the public in Australia and New Zealand, which will be released shortly. Perhaps the most staggering finding was that more than half of Australians (56%) are unaware that psychiatrists have undertaken medical training as a doctor, and 15% of the community incorrectly thinks a psychologist has medical training. This would be unthinkable in other specialities in medicine, and one ponders how this has happened? If patients don’t know what we do, they may not feel comfortable being referred to us. Hence the barrier to effective evidenced based treatment widens.

So, I will be heading to off to Singapore, as a medical doctor, passionate about psychiatry and willing to work out how I can become involved as a leader in this very important debate. The incidence of mental illness is a global concern, a local issue, and we need a strong empowered medical workforce for generations to come.