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One day in the life of old age psychiatrists in the United Kingdom

Published online by Cambridge University Press:  02 April 2013

Susan Mary Benbow  and
David Jolley
Susan Mary Benbow*
Affiliation:
Centre for Ageing and Mental Health, Faculty of Health and Sciences, Staffordshire University, Stafford, UK; and Older Mind Matters Ltd., Altrincham, Cheshire, UK
David Jolley
Affiliation:
Personal Social Services Research Unit, The University of Manchester, Dover Street, Manchester, UK
*
Correspondence should be addressed to: Prof. Susan M Benbow, Centre for Ageing and Mental Health, Faculty of Health and Sciences, Staffordshire University, Blackheath Lane, Stafford ST18 0AD, UK. Phone: +44-1785-353742. Email: drsmbenbow@gmail.com.
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Abstract

Background: The provision of mental health care for older people will become increasingly important with rising demand related to global demographic changes. This project aimed to identify changes in work patterns of UK consultant old age psychiatrists between 1993 and 2012.

Method: A link to an online questionnaire was circulated to consultant old age psychiatrists through the Faculty of Old Age Psychiatry, Royal College of Psychiatrists.

Results: In all 210 usable responses were received. On the survey day 71% of old age psychiatrists arrived at work before 9 am, and 40% left work after 6 pm. Over one-third (35%) worked for another hour or more at home. The range of activities was broader than previously reported. Administrative activity was undertaken by over 60% and acute ward work by only 26%. Few consultants reported time in long-stay care or day hospitals. Outpatient activity included Memory Clinics and Health Center Clinics. The main stressors reported by consultants were lack of resources and pressures from management-imposed, financially driven service changes. Relationships with people at work (including patients and their families) and outside work were the main identified support.

Conclusions: Consultants’ working hours have changed little since 1997, but the range and emphases of activities have changed. Changes in service organization are stressful and consultants are supported by relationships with colleagues and patients. Work patterns are changing in response to demands and constraints on the specialty. Research is needed into service design and work patterns, which can provide humane care in the current economic climate.

Keywords

service designstresssupportswork patternsworkload
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 6 , June 2013 , pp. 1023 - 1032
Copyright
Copyright © International Psychogeriatric Association 2013

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References

Age Concern. (2007). Improving Services and Support for Older People with Mental Health Problems. The Second Report from the UK Inquiry into Mental Health and Well-Being in Later Life. London: Age Concern England, Mental Health Foundation.Google Scholar
Alzheimer's Society, UK. (2007). Home from Home. London: Alzheimer's Society.Google Scholar
Alzheimer's Society, UK. (2009). Counting the Cost. Caring for People with Dementia on Hospital Wards. London: Alzheimer's Society.Google Scholar
Andrew, M. H. and Shea, C. (2010). Geriatric psychiatry education in Canada: the pathway to subspecialty recognition. International Psychogeriatrics, 22, 919–926.CrossRefGoogle ScholarPubMed
Banerjee, S. (2009). The Use of Antipsychotic Medication for People with Dementia: Time for Action. London: Department of Health.Google Scholar
Bazeley, P. (2007). Qualitative Data Analysis with NVivo. London: Sage.Google Scholar
Benbow, S. M. and Jolley, D. (1997). Old age psychiatrists: what do they find stressful? International Journal of Geriatric Psychiatry, 12, 879–882.3.0.CO;2-R>CrossRefGoogle ScholarPubMed
Benbow, S. M. and Jolley, D. J. (1999). Gender, isolation, work patterns and stress among old age psychiatrists. International Journal of Geriatric Psychiatry, 14, 726–732.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Benbow, S. M. and Jolley, D. J. (2002). Burnout and stress amongst old age psychiatrists. International Journal of Geriatric Psychiatry, 17, 710–714.CrossRefGoogle ScholarPubMed
Benbow, S. M., Jolley, D. J. and Leonard, I. J. (1993). All work? A day in the life of geriatric psychiatrists. International Journal of Geriatric Psychiatry, 8, 1019–1022.CrossRefGoogle Scholar
Challis, D., Reilly, S., Hughes, J., Burns, A., Gilchrist, H. and Wilson, K. (2002). Policy, organisation and practice of specialist old age psychiatry in England. International Journal of Geriatric Psychiatry, 17, 1018–1026.CrossRefGoogle ScholarPubMed
Colenda, C. C., Wilk, J. E. and West, J. C. (2005). The geriatric psychiatry workforce in 2002: analysis from the 2002 national survey of psychiatric practice. American Journal of Geriatric Psychiatry, 13, 756–765.CrossRefGoogle ScholarPubMed
CSIP/NIMHE. (2007). New Ways of Working for Everyone. A Best Practice Implementation Guide. London: Department of Health.Google Scholar
Dale, J. and Milner, G. (2009). New ways not working? Psychiatrists’ attitudes. Psychiatric Bulletin, 33, 204–207.CrossRefGoogle Scholar
Day Hospital Network (Faculty of Old Age Psychiatry). (2008). The Changing Face of Day Hospitals for Older People with Mental Illness. Consensual Development of Functions and Standards. London: Royal College of Psychiatrists.Google Scholar
de Mendonça Lima, C. A., Draper, B. and Benbow, S. M. (2012). Old Age Psychiatry: Challenges for the Development of the Specialty. Available at: http://www.ipa-online.org/ipaonlinev4/main/homepagearticles/oap.html; last accessed 11 February 2013.Google Scholar
Department of Health. (2004). National Service Framework for Children, Young People and Maternity Services. Core Standards. London: Department of Health.Google Scholar
Department of Health. (2005). New Ways of Working for Psychiatrists: Enhancing Effective, Person-Centred Services Through New Ways of Working in Multidisciplinary and Multi-Agency Contexts. Final Report “But Not the End of the Story.” London: Department of Health.Google Scholar
Department of Health. (2009). Living Well with Dementia: A National Dementia Strategy. London: Department of Health.Google Scholar
Department of Health/Care Services Improvement Partnership. (2005). Everybody's Business. Integrated Mental Health Services for Older Adults: A Service Development Guide. London: Department of Health.Google Scholar
Department of Health Social Services and Public Safety, Northern Ireland. (2011). Improving Dementia Services in Northern Ireland. A Regional Strategy. Belfast, UK: Department of Health Social Services and Public Safety, Northern Ireland.Google Scholar
Draper, B. and Anderson, D. (2010). The baby boomers are nearly here – but do we have sufficient workforce in old age psychiatry? International Psychogeriatrics, 22, 947–949.CrossRefGoogle ScholarPubMed
Draper, B., Reutens, S. and Subau, D. (2010). Workforce and advanced training survey of the RANZCP faculty of psychiatry of old age: issues and challenges for the field. Australasian Psychiatry, 18, 142–145.CrossRefGoogle ScholarPubMed
Faculty of the Psychiatry of Old Age of the Royal College of Psychiatrists. (2011). In-Patient Care for Older People Within Mental Health Services. Faculty report FR/OA/1. London: Royal College of Psychiatrists.Google Scholar
General Medical Council. (2012). The State of Medical Education and Practice in the UK 2012. London: General Medical Council.Google Scholar
Goldberg, D. (2008). Improved investment in mental health services: value for money? The British Journal of Psychiatry, 192, 88–91.CrossRefGoogle ScholarPubMed
Greaves, N. and Greaves, I. (2011). The Gnosall project: setting new benchmarks for dementia care. Journal of Care Services Management, 5, 49–52.CrossRefGoogle Scholar
Hill, L. (2008). The dilemma of age integration. Old Age Psychiatrist, 50, 12.Google Scholar
Hilton, C., Arie, T. and Nicolson, M. (2010). A witness seminar: the development of old age psychiatry in Britain, 1960–1989. Themes, lessons and highlights. International Journal of Geriatric Psychiatry, 25, 596–603.CrossRefGoogle ScholarPubMed
Holmes, J.et al. (2010). Liaison Mental Health Services for Older People: A Literature Review, Service Mapping and In-depth Evaluation of Service Models, Research report SDO Project (08/1504/100). London: HMSO.Google Scholar
Horgan, S., LeClair, K., Donnelly, M., Hinton, G., MacCourt, P. and Krieger-Frost, S. (2009). Developing a national consensus on the accessibility needs of older adults with concurrent and chronic, mental and physical health issues: a preliminary framework informing collaborative mental health care planning. Canadian Journal on Aging/La Revue Canadienne du Vieillissement, 28, 97–105.CrossRefGoogle ScholarPubMed
Jeon, Y.-H. (2012). Psychogeriatric Nursing Workforce in Australia: An Endangered Species? Available at: www.ipa-online.org/ipaonlinev4/main/homepagearticles/pnwa.html; last accessed 11 February 2013.Google Scholar
Jolley, D. J. and Benbow, S. M. (1997). The everyday work of geriatric psychiatrists. International Journal of Geriatric Psychiatry, 12, 109–113.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
Jolley, D., Benbow, S. M. and Grizzell, M. (2006). Memory clinics. Postgraduate Medical Journal, 82, 199–206.CrossRefGoogle ScholarPubMed
Jolley, D., Greaves, I., Greaves, N. and Greening, L. (2010). Three tiers for a comprehensive regional memory service. Journal of Dementia Care, 18, 26–29.Google Scholar
Keown, P., Weich, S., Bhui, K. S. and Scott, J. (2011). Association between provision of mental illness beds and rate of involuntary admissions in the NHS in England 1988–2008: ecological study. British Medical Journal, 343, d3736.CrossRefGoogle ScholarPubMed
Macdonald, A.et al. (2007). The birth of a specialty: the first ten thousand patients of an old age psychiatry service. International Psychogeriatrics, 19, 53–63.CrossRefGoogle ScholarPubMed
National Institute for Health and Clinical Excellence. (2011). Donepezil, Galatamine, Rivastigmine and Memantine for the Treatment of Alzheimer's Disease. Review of NICE Technology Appraisal Guidance 111. London: NICE.Google Scholar
NHS Business Services Authority. (2009). NHS Pension Scheme: Mental Health Officer (MHO) Status Factsheet. Available at: http://www.nhsbsa.nhs.uk/Documents/Pensions/Mental_Health_Officer_Status_Factsheet.pdf; last accessed 11 February 2013.Google Scholar
NHS Workforce Review Team. (2008). Workforce Summary – Old Age Psychiatry December 2008 – England Only. London: NHS.Google Scholar
NICE/SCIE. (2007). Dementia. A NICE–SCIE Guideline on Supporting People with Dementia and Their Carers in Health and Social Care. London: NICE/SCIE.Google Scholar
Pachana, N. A., Emery, E., Konnert, C. A., Woodhead, E. and Edelstein, B. A. (2010). Geropsychology content in clinical training programs: a comparison of Australian, Canadian and US data. International Psychogeriatrics, 22, 909–918.CrossRefGoogle Scholar
Pitt, B., Arie, T., Benbow, S. M. and Garner, J. (2006). The history of old age psychiatry in the UK. IPA Bulletin, 23, 8–10.Google Scholar
QSR International. (2011). NVivo9 Getting Started. Available at: http://www.qsrinternational.com; last accessed 11 February 2013.Google Scholar
Rathod, S., Mistry, M., Ibbotson, B. and Kingdon, D. (2011). Stress in psychiatrists: coping with a decade of rapid change. The Psychiatrist, 35, 130–134.CrossRefGoogle Scholar
Ribeiro, O., Fernandes, L., Firmino, H., Simões, M. R. and Paúl, C. (2010). Geropsychology and psychogeriatrics in Portugal: research, education and clinical training. International Psychogeriatrics, 22, 854–863.CrossRefGoogle ScholarPubMed
Royal College of Psychiatrists. (2005). Who Cares Wins. London: Royal College of Psychiatrists.Google Scholar
Royal College of Psychiatrists. (2009). Age Discrimination in Mental Health Services: Making Equality a Reality. Position Statement PS2/2009. London: Royal College of Psychiatrists.Google Scholar
Royal College of Psychiatrists. (2011). The Equality Act and Adult Mental Health Services: Achieving Non-Discriminatory, Age-Appropriate Services. Joint Guidance from the Royal College of Psychiatrists’ Faculties of Old Age and General and Community Psychiatry. Occasional Paper No. 82. London: Royal College of Psychiatrists.Google Scholar
Royal College of Psychiatrists. (2013). College calls for halt in development of ageless mental health services. Enewsletter February. Available at: http://www.rcpsych.ac.uk/usefulresources/rcpsychenewsletters/enewsletters2013/february2013/agelessmentalhealthservices.aspx; last accessed 11 February 2013.Google Scholar
Singhal, A., Garg, D., Rana, A. K. and Naheed, M. (2010). Two consultants for one patient: service users’ and service providers’ views on “New Ways.” The Psychiatrist, 34, 181–186.CrossRefGoogle Scholar
Stek, M. L., Eikelenboom, P. and Beekman, A. T. (2008). Old age psychiatry in the Netherlands. Tijdschrift voor Psychiatrie, 50, 131–136.Google ScholarPubMed
St John-Smith, P. et al. (2009). The trouble with NHS psychiatry in England. Psychiatric Bulletin, 33, 219–225.CrossRefGoogle Scholar
Suh, G.-H. and Han, C. (2008). Mental health economics, health service provision, and the practice of geriatric psychiatry. Current Opinion in Psychiatry, 21, 546–550. doi:510.1097/YCO.1090b1013e32830f32831bd32835.CrossRefGoogle ScholarPubMed
The Scottish Government. (2010). Scotland's National Dementia Strategy. Edinburgh, UK: Scottish Government.Google Scholar
Welsh Assemby Government. (2011). National Dementia Vision for Wales. Dementia Supportive Communities. Cardiff, UK: Welsh Assembly Government.Google Scholar
World Health Organization. (2012). Dementia: A Public Health Priority. Geneva, Switzerland: World Health Organization.Google Scholar