Intended for healthcare professionals


Complex but rewarding patients: the consultant in learning disabilities

BMJ 2022; 376 doi: (Published 15 March 2022) Cite this as: BMJ 2022;376:o564
  1. Adrian O’Dowd
  1. London, UK

The consultant psychiatrist for people with learning disability tells Adrian O’Dowd why he was drawn to help patients that he felt were sidelined in society

After completing his medical training at Trinity College, Cambridge, and Barts and The London School of Medicine and Dentistry, Ian Hall found himself drawn to psychiatry and says, “I felt that people with mental health problems were marginalised in society and that it’s important that they get the best care and support.”

He remembers warnings against taking up the specialty. “There were many people telling me not to do it and saying negative things about it,” says Hall. “But I am so glad that I followed my heart and did what I thought was right because I’ve had an incredibly satisfying job.”

Today, as consultant psychiatrist for people with learning disability at Hackney Integrated Learning Disability Service, East London NHS Foundation Trust, Hall spends his days working hard for patients and nurturing the next generation of doctors.

He enjoys his work, saying, “It’s rewarding because, clinically, the cases are very complex and there is a big interaction between mental health and physical health, but also the whole environment that people are living in.

“Also, it’s multidisciplinary and I enjoy working with speech therapists, nurses, psychologists, and all the different professions. And the patients are amazing people.”

This enthusiasm extends to mentoring and he has done this for many over the years, including consultant colleagues.

“When you start as a consultant, although you’ve been highly trained, there are lots of aspects of the role that you aren’t taught about, such as challenges around time management, managing services, and delivering the best education for trainees. People can find these difficult when they start, so it’s rewarding to mentor people through that stage.”

Hall spends half of his working time in his clinical position and the other half split between his more academic roles, including chief examiner for the Royal College of Psychiatrists, foundation tutor, and honorary lecturer at University College London. On top of this, he also gets involved in medicolegal work at the Court of Protection.

What is his advice for medical students and young doctors starting out in their careers? “I would say to follow your heart and trust your own judgement,” he says. “Like many people, I made the decision to go into medicine when I was 16 for quite naive reasons. I liked doing science and I wanted to care for and look after people but, in retrospect, I realise that there were other factors at play.

“There are several members of my family with autism spectrum disorders so although it wasn’t a conscious reason for me to go into this field, looking back on it, that was a factor. Also, when I was at university I did volunteer work in a school for children with intellectual disability and it was something I really enjoyed.”

About three years ago he became a governor for a school for autistic children. “It’s been satisfying to use my skills—as a doctor and in developing services—in a different way in order to contribute to the community,” he says.

Nominated by James Smith

“Ian is a fantastic trainer and his dedication to his job goes well beyond that expected of him. He has done a huge amount to show junior doctors the joy of working in mental health services and has enabled all of us to improve care for people with learning disabilities.

“I am forever astounded by Ian’s ability to hold all of his trainees in mind and ensure that they have an enjoyable and productive experience. He is passionate that junior doctors achieve both clinical and professional competencies way beyond their expectations and he has given numerous foundation doctors the opportunity to learn valuable skills in the community team.

“Ian has proved to me that you really can make a difference to patients, doctors, and the wider team while maintaining poise, compassion, and respect.”

  • James Smith is consultant psychiatrist in intellectual disabilities, Sussex Partnership NHS Foundation Trust