Intended for healthcare professionals

Rapid response to:

Practice A Patient’s Journey

Through the wasteland: chronic depression

BMJ 2011; 342 doi: (Published 11 April 2011) Cite this as: BMJ 2011;342:d93

Rapid Response:

My Journey in Psychiatry

Dear Editor,

It was interesting to read the paper of Hopson &
Holmes, Through the wasteland: chronic depression (1). During
my training I spent some time on the rotational scheme in Nottingham; one
of the Consultant Psychiatrists at Mapperley Hospital in Nottingham told
me that when he was appointed for the first time in
psychiatry during the 1950s/60s, they gave him a master key, and he used
to lock every door behind him! During my training in the late 1970s and
early '80s, the wards were overcrowded but the situation was more liberal.

I think nowadays, for example, we are using less ECT than before. We discuss the
treatment plan with the patients and have their agreement. They have many
assessments like risk assessment, capacity assessment, etc. Patients
receive copies of letters about them which have been sent to their GPs,
but still psychiatric illness carries a stigma. I think there is still
discrimination against people with mental illness. I heard a Mausdley
debate recently about Stigma and Discrimination; the lecturer gave an
example of when his mother had postpartum depression and she was off sick for
sometime. She was working as a charge nurse at that time and after discharge
he asked whether she was going to tell her employer after returning back
to work, she replied saying, definitely not, because they will sack me.
Is the situation different nowadays with the economic crisis? I don't
think so, although it is an offence to discriminate because of mental


1.Hopson J, Holmes J,A Patient's Journey: Through the wasteland:
chronic depression. BMJ 2011;342:doi:10.1136/bmj.d93 (Published 11 April 2011)

Competing interests: No competing interests

18 April 2011
Abdul K Al-Sheikhli
Consultant Psychiatrist
CRHTT,The Woodlands Centre for Acute Care,St.Leonards on Sea,TN377PT