Many psychiatric wards are kept under lock and key, but one NHS doctor is throwing open the doors to give people an insight into what working in acute mental health is really like.
Dr Benji Waterhouse has been a psychiatrist for 10 years, specialising in the diagnosis and treatment of mental illnesses.
His role is not to be confused with a psychologist (or a psychic), things he’s previously been mistaken for but are very different jobs. The 39-year-old is in fact a medical doctor who learned how to treat the body, before moving on to the mind.
‘Psychiatrists are doctors, so we can also prescribe medications, and boy do we,’ he tells Metro.co.uk.
Dr Benji currently works part-time as a locum consultant psychiatrist in London and most recently he’s been helping at a Crisis Assessment Centre, which he describes as n A&E for mental health problems. He also covers psychiatric emergencies for three actual A&E departments at hospitals.
‘It’s a strange job which mainly involves dishcharging people or sectioning them,’ he says.
Previously he was working full-time in psychiatry but decided to take a step back after facing burn out. This has given him time to consider all that he’s learned and experienced in the role – and he’s weaved this all together in a new book.
Published by Penguin, You Don’t Have to Be Mad to Work Here, is out now and is intended to shine a light on the ‘less palatable’ aspects of mental health.
He explains: ‘There is a welcome mental health conversation in society nowadays but the focus tends to be at the milder, more palatable end of the spectrum.
‘I wanted to give a voice to people with more serious mental illnesses like schizophrenia who are often left out of the conversation. Those people for whom some cold water swimming and mindful colouring in probably won’t do much. Those people muttering to themselves on the bus who you may even move away from. They’re there the sort of people I help — or at least try to help — in my work.’
As such, the book features numerous cases of patients he’s worked with over the years, their stories anonymised and amalgamated to preserve confidentiality. One example is a woman in her late 50s who arrived at a hospital in a wedding dress looking to marry Harry Styles.
There’s also the tale of a 45-year-old man with psychosis who believes he’s a werewolf, and an elderly lady with Cotard’s Syndrome, a rare illness more commonly known as walking corpse syndrome — she’s convinced she’s already dead and wants to be buried.
While these anecdotes might initially sound comical, Dr Benji ensures patients are never the butt of the joke, but rather aims to shed light on the realities of acute mental health conditions.
He has also revealed some little-known secrets about his profession, including that in addition to medical training, a judo lesson is mandatory for all psychiatrists.
‘On day one newbie psychiatrists have to do mandatory training including things like PMVA training where we learn how to verbally de-escalate agitated patients. And if that doesn’t work they also teach us judo self-defence,’ He tells Metro.
PMVA stands for prevention and management of violence and aggression and the course is intended to provide staff with the skills and knowledge to safely navigate aggressive or violent situations with patients.
It often covers last-resort physical intervention techniques such as restraint, and how to escape from someone who is assaulting you.
Dr Benji says this was an ‘alarming’ introduction to his career, but thankfully he hasn’t had to use the training very often in the last decade.
‘This training only happens in psychiatry. It feels slightly OTT, although admittedly I’ve had a few close shaves,’ he says.
Despite this, he believes the link between violence and mental illness is often ‘unhelpfully exaggerated’ and says horrendous incidents only occur ‘very occasionally’.
‘It’s important to remember that most people with serious mental illness will never be violent and are actually more likely to be victims of violence than perpetrators of it,’ he says.
‘Drug and alcohol misuse are far bigger risk factors for homicide so statistically I’m actually safer in a psychiatric patient’s home than I am at a psychiatrist’s house party.’
As well as this, the doctor also debunks a few myths about his job in his book, which he describes as ‘a fly on the padded-wall account of NHS psychiatry’, but this is the first myth it busts — there aren’t really any padded walls.
Another surprising admission is that psychiatrists have poor mental health themselves.
‘Working in psychiatry isn’t particularly good for a person’s mental health.
‘During my first supervision session on a hot summers day I asked my boss if we could get some fresh air but she said “the windows don’t open up here to stop people jumping out of them”. I said “what, even in the psychiatrists offices?”. She said “especially in the psychiatrists offices”.
‘It’s chicken and egg though. Research suggests that med students wanting to specialise in psychiatry are already more depressive than med students wanting to go into other medical specialties. So it inherently attracts troubled souls and then being around human misery all day at work doesn’t help much either.
‘Maybe the logic is that if you’re going to end up in a psychiatric hospital one way or another you may as well get paid for it.’
You Don’t Have to Be Mad to Work Here: A Psychiatrist’s Life by Dr Benji Waterhouse is available to buy now. The book explores the complicated nature of working in mental health, and sheds a light on how NHS psychiatry is in crisis.
There’s plenty of humour as well as heartbreak, but the author is hoping it will also help encourage more people to take up the career.
‘Recruitment and retention is a huge problem in the NHS and especially in psychiatry,’ he adds. ‘I hope that writing this book might help to raise the profile of the specialty so that more medical students might consider specialising in it.’
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