I have worked as a Consultant Child and Adolescent Psychiatrist in the NHS in England for 7 years and recently we have received news that our fabulous small team is being cut further. How can we deliver a comprehensive and high quality service in this NHS environment. Maybe we should innovate, but not reinvent the wheel or cut corners.

Looking after out own health in paramount. If we are not in good health and living our personal lives happily then we cannot be deliver a service. Should we all go into survival mode? Should this be done in isolation or in collaborative encouragement with others? I like the idea of a collective survival strategy as it can support teams. I think teams should have a clear strategy that every one understands and we should be open to be encouraging and supportive and challenging of each other in our work.

We should also model the resilience and energy we want to cultivate to the young people we see with depression and be open to recognizing and reflecting on their coping strategies. How about our own coping strategies which include good sleep, exercise and time with friends, family, faith and hobbies? We must manage the anxiety we could feel safely and not allow ourselves to succumb to the pernicious nature of stress. 

How are we known to other people? This is a question that often arises for me in my discussions with colleagues and young people. Some young people conduct virtual friendships on line and have emotional responses to whatever is typed. Mental health professionals probably spend 30% or to much time in front of a computer screen typing in details that will prevent a suicide, whilst feeling quite anxious or relieved. Surely face to face, meaningful dialogue is what really matters. We have our agendas for the consultation in order to fulfill our professional duty, but meeting a young person well and understanding how they are known to others is important in enabling them to connect with family and friends and society.

We must find a way to endure organizational changes in our professional work and try to deliver our best care to young people each day.