Stigma against mental illness is putting medical students off academic psychiatry, but a new report seeks to address the issues.
It’s one of the most exciting times to work in psychiatric research, yet the field is losing out when it comes to recruiting medical students, and is suffering in the current economic climate where the needs of clinical services take priority over academic research. So says a new report by the UK’s Academy of Medical Sciences, published today. The report proposes measures to change the way psychiatrists are trained in order to make sure that mental health research meets its potential.
Naturejobs asked Professor Nick Craddock, Treasurer of the Royal College of Psychiatrists, who was involved in putting together the report, to talk us through the findings.
Why did the Academy commission this report now?
It’s a time of very exciting scientific development in the field, but it’s also a time when there has been some difficulty in recruiting sufficient people into psychiatry. So there’s a capacity issues. If we don’t produce sufficient high calibre academic psychiatrics, ultimately patients will suffer, because we won’t be driving the research forward. I am confident people are recognising the issues, but it’s up to the different stakeholders to come together and make that work.
Why is it such a good time to get into the field?
For anybody who is interested in the workings of the brain and interested in driving science forward then doing research training in psychiatry is really a very exciting opportunity, because things are going to change more during their career in psychiatry than in any other field. It’s a very special time in psychiatry because of the scientific tools available now, such as neuroimaging, strong neuroscience developments, molecular genetics. It’s where a lot of the action will be in medicine over the next 20 or 30 years.
In that case, why is there a problem recruiting people?
One of the problems relates to the fact that sometimes the clinical training can seem quite far away from the research and sometimes it’s not very flexible and doesn’t allow people to do the research that they are hoping to, so one of the principles of the report is to try and make things more flexible so that the research and the clinical training can be combined more easily.
I also think there is a stigma generally in mental illness. Because it’s not as well understood as things like cardiology or cancer, for instance, people stigmatise the illness and mental health services. They often think people don’t recover or there aren’t good treatments and those are actually not correct assumptions at all. We do have treatments that are as effective as a lot of other treatments in medicine, and a lot of people recover fully and do extremely well. So there are definitely issues that need to be challenged. We need to get the message out that it’s a very rewarding area to work in, a lot can be done to help people, and there’s a lot of extremely exciting science that can be done to better understand the underpinnings of mental illness.
We know mental health is linked to other health issues. How important is it for people to get interdisciplinary training?
The Academy of Medical Sciences report, and my own view, would be that it’s very beneficial that when people are specialising in psychiatry they also gain some further experience after medical school that will equip them to understand the physical illnesses as well – for instance general practice experience, or neurology experience. So this also relates to the training regulations and increasing the flexibility. There are certainly plenty of people who would like to be able to do that, and at the moment it’s very difficult.
Is there a lack of funding?
Overall about 15 percent of the disease burden in the population relates to mental illness, but at the moment only about five percent of the research funding [in the UK] is allocated to mental illness, so clearly that’s a situation that needs to change over the coming years. There is a willingness by funders to do that, but what we need is sufficient psychiatric researchers applying for funds and actually bringing those funds in.
What about from charities?
The thing that has been a problem in the past and may be less so in the future is there hasn’t been a disease specific charity relating to things like depression and psychosis. There are lots of charities for cancer and heart disease, but for some peculiar reason, probably because of the stigma, there hasn’t been a big funder for psychiatric research. There is a big charity about to launch in a couple of weeks that’s going to be funding research into mental health, so this is going to change, but that does of course require the public to recognise the importance of giving money to a charity like that, and to treat psychiatric illness just as seriously as it treats cancer and heart disease.
What’s the difference between a clinical and an academic psychiatrist?
There are non-clinical neuroscience researchers who are people who are trained in brain sciences who have not got a medical qualification so they can’t treat people as a patient. Those are non-clinical researchers. You then have clinical psychiatrists who have undergone a medical training, and then specialise in treating people with psychiatric illness, but they haven’t particularly trained in any neuroscience or research areas, and those are your clinical psychiatrists. Then there is the mixture where someone has trained to be a brain scientist who is also trained as a clinical psychiatrist, and those would be clinical academic psychiatrists. We need people like that because they blend together the understanding of diagnosis and management in relation to patient care, but they also have an understanding of the scientific areas too.
What could someone considering becoming an academic psychiatrist expect from the job?
From my own perspective I think it’s a wonderful area to work in because there’s the intellectual challenge relating to the research, there’s the opportunity to teach both fellow psychiatrists and non-psychiatrists about how to help people, you can think about things broadly from the biological to the psychological to the social, and then in terms of helping people clinically you can do an awful lot for somebody. It’s a very rewarding area. I, for one, haven’t felt for one moment that it isn’t the best career to be in.