Can Channel 4's Bedlam do for psychiatry what Educating Yorkshire did for teaching?

While an under-performing school holds ample opportunities for teachers to turn lives around, inpatient psychiatric units are where lives get put on hold.

There can be few professions more in need of a boost of good PR than psychiatry. The least popular of all medical specialties, we’ve been struggling to recruit young doctors to our ranks for years. In 2012, there were more training posts available in psychiatry than doctors applying for them. So as a psychiatrist, I’m keeping everything crossed, hoping that Bedlam, a new series airing Thursday 31st October on Channel 4 is going to change all that. Set in one of the country’s best-known psychiatric hospitals, it promises to give unrivalled insights into the lives of patients and staff over 4 episodes. With access to actual NHS consultations and treatment, the programme hopes to challenge the ‘myths and taboos’ around mental illness and psychiatry.

We know TV can do wonders for a profession down on their luck. It was with more than a little envy that I witnessed teachers getting a much-needed lift from the final episode of Educating Yorkshire last week. Who could have failed to be moved by Musharaf’s dogged determination to overcome his stammer for his English speaking exam, and the efforts of his teacher Mr Burton to help him? Though the profession has been in for a battering over their recent strike action in hard times, it reminded all of us how magical good teaching can be, the difference it can make to the lives of young people, and the benefits it brings to society as a whole. The inherent value of teaching shone from our screens. Up and down the country, thousands of sparks of inspiration were stuck, and people, perhaps unknowingly, started on a journey to a new career in education. As the credits rolled, I thought, ‘My lot could do with a bit of that.’

While other doctors have positive aspirational role models from glamorous American TV series, psychiatrists are linked in the popular imagination to serial killers like Dr Hannibal Lecter. And if we’re not characterised as evil or flawed, then the ‘go to’ image is comic. I was amused and saddened to learn at a recent psychiatry conference that if you do a Google image search for the word ‘surgeon’, you reveal countless images of attractive men and women in blue scrubs looking important and performing heroic acts, whereas typing ‘psychiatrist’ returns a tranche of barely humorous cartoons, and photographs of couches. In terms of inspiring tomorrow’s doctors and firing up passions, there’s no doubt that we’re up against it.

Am I nervous about Bedlam’s impact? You bet. While an under-performing school holds ample opportunities for teachers to turn lives around, inpatient psychiatric units are where lives get put on hold. Nothing can prepare you for the sheer strangeness of a psychiatric ward, a place that can seem untouched by hope, a temporary refuge for people at their lowest ebb.

I distinctly remember the first time I visited one fifteen years ago, not as a naïve medical student, but as a carer, visiting my friend hospitalised with depression after a serious suicide attempt. Having already seen the inside of many hospital wards, I felt well prepared for the experience, confident I would be unflustered by the surroundings. This left me plenty of emotional room to focus on coming across as sympathetic and patient, rather than showing that I was actually angry with her for what she had done, and petrified that we nearly lost her.

But no sooner had I stepped onto the ward than I was on the back foot. Where were the nurses? And who was in charge? Nobody had uniforms on and people just seemed to be milling about. There was no medical equipment of any type that I recognised. A stranger approached me, a young woman who made no eye contact and started to tell me something I no longer remember, then began to cry. My confidence had left me. I was totally out of my depth. Where was my friend? Was she going to be safe here?

It hardly seemed like the kind of place miracles happen. But the reality is that they do. I try to hold on to that first experience and how it affected me when meeting patients and families for the first time. It is easy to forget that they may not know what I know - that odds on, things are going to get better.

Mental illness can be shocking, devastating, harrowing. It can wreck lives in countless ways, and be harder to come to terms with than heart disease, diabetes or cancer. As mental health professionals, it is our job to do what we can to help turn these lives around. When people are at their most desperate and can’t see light at the end of the tunnel, we must not only be a shoulder to cry on, but help them find a way out.

Despite poor first impressions, psychiatric hospitals can play host to thousands of acts of kindness every bit as moving as Mr Burton’s. Look beyond the peculiarity of its wards, routines and functions, and you will see dedicated professionals doing what they can to make a difference, helping people overcome symptoms, move on, and recover. For too long there has been too much attention on the negative aspects of psychiatry. Yes, some of the medications we prescribe can have horrible side effects. Yes, sometimes we detain people in hospital against their will. But in making these difficult decisions, our intentions are invariably good. The factors and outcomes we need to consider are arguably more complex and life-changing than those faced by other doctors. We don’t shy away from making tough decisions. It’s hard to help people in profound distress, but we’re proud of what we do.

So here’s hoping Bedlam will reveal miracles. Here’s hoping we’ll glimpse some moments of magic. We need to find the next generation of doctors who want to become psychiatrists. People who experience mental illness deserve highly trained, highly motivated professionals who want to relieve suffering and hold their head up high. Here’s hoping sparks of inspiration are struck.

People's ideas about psychiatry are more often than not related to patients lying on couches and inkblot tests. Image: Getty
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The deafening killer - why noise will be the next great pollution scandal

A growing body of evidence shows that noise can have serious health impacts too. 

Our cities are being poisoned by a toxin that surrounds us day and night. It eats away at our brains, hurts our hearts, clutches at our sleep, and gnaws at the quality of our daily lives.

Hardly a silent killer, it gets short shrift compared to the well-publicised terrors of air pollution and sugars food. It is the dull, thumping, stultifying drum-beat of perpetual noise.

The score that accompanies city life is brutal and constant. It disrupts the everyday: The coffee break ruined by the screech of a line of double decker buses braking at the lights. The lawyer’s conference call broken by drilling as she makes her way to the office. The writer’s struggle to find a quiet corner to pen his latest article.

For city-dwellers, it’s all-consuming and impossible to avoid. Construction, traffic, the whirring of machinery, the neighbour’s stereo. Even at home, the beeps and buzzes made by washing machines, fridges, and phones all serve to distract and unsettle.

But the never-ending noisiness of city life is far more than a problem of aesthetics. A growing body of evidence shows that noise can have serious health impacts too. Recent studies have linked noise pollution to hearing loss, sleep deprivation, hypertension, heart disease, brain development, and even increased risk of dementia.

One research team compared families living on different stories of the same building in Manhattan to isolate the impact of noise on health and education. They found children in lower, noisier floors were worse at reading than their higher-up peers, an effect that was most pronounced for children who had lived in the building for longest.

Those studies have been replicated for the impact of aircraft noise with similar results. Not only does noise cause higher blood pressure and worsens quality of sleep, it also stymies pupils trying to concentrate in class.

As with many forms of pollution, the poorest are typically the hardest hit. The worst-off in any city often live by busy roads in poorly-insulated houses or flats, cheek by jowl with packed-in neighbours.

The US Department of Transport recently mapped road and aircraft noise across the United States. Predictably, the loudest areas overlapped with some of the country’s most deprived. Those included the south side of Atlanta and the lowest-income areas of LA and Seattle.

Yet as noise pollution grows in line with road and air traffic and rising urban density, public policy has turned a blind eye.

Council noise response services, formally a 24-hour defence against neighbourly disputes, have fallen victim to local government cuts. Decisions on airport expansion and road development pay scant regard to their audible impact. Political platforms remain silent on the loudest poison.

This is odd at a time when we have never had more tools at our disposal to deal with the issue. Electric Vehicles are practically noise-less, yet noise rarely features in the arguments for their adoption. Just replacing today’s bus fleet would transform city centres; doing the same for taxis and trucks would amount to a revolution.

Vehicles are just the start. Millions were spent on a programme of “Warm Homes”; what about “Quiet Homes”? How did we value the noise impact in the decision to build a third runway at Heathrow, and how do we compensate people now that it’s going ahead?

Construction is a major driver of decibels. Should builders compensate “noise victims” for over-drilling? Or could regulation push equipment manufacturers to find new ways to dampen the sound of their kit?

Of course, none of this addresses the noise pollution we impose on ourselves. The bars and clubs we choose to visit or the music we stick in our ears. Whether pumping dance tracks in spin classes or indie rock in trendy coffee shops, people’s desire to compensate for bad noise out there by playing louder noise in here is hard to control for.

The Clean Air Act of 1956 heralded a new era of city life, one where smog and grime gave way to clear skies and clearer lungs. That fight still goes on today.

But some day, we will turn our attention to our clogged-up airwaves. The decibels will fall. #Twitter will give way to twitter. And every now and again, as we step from our homes into city life, we may just hear the sweetest sound of all. Silence.

Adam Swersky is a councillor in Harrow and is cabinet member for finance. He writes in a personal capacity.