Healthcare for vulnerable groups

Profile: Sheila Hollins

Sheila Hollins BMA President 2012Professor Sheila Baroness Hollins of Wimbledon and Grenoside recognises that her full title ‘is rather a mouthful’.

But she adds that when she became a life peer in 2010, she was told that her future signature would be just Hollins.

‘There is some interesting etiquette to get used to,’ she admits.

 

In memory

The title was chosen to honour her mother, who was born in Wimbledon, and her father, who was in local government in South Yorkshire. Baroness Hollins says it was through him that she was first introduced to politics.

‘He would be the returning officer at local elections, and would often take us along to help count the votes,’ she recalls. ‘Also, when I passed my O-levels, he took me to Parliament to meet our MP and to sit in the Commons and listen to debate.’

The cross-bench peer believes she was appointed to the Lords partly due to her medical career and interest in learning disability. She is emeritus professor of psychiatry of disability at St George’s University of London, and has two adult children with disabilities, one of whom has a learning disability.

 

Teaching

She has always taught medical students and junior doctors that if they could get health services right for people with learning disabilities, then they could get them right for everybody else.

‘Unfortunately we tend to do it the other way round, we try to get it right for people like ourselves first and then are surprised when somehow services don’t quite meet the needs of those with more complex needs or who perhaps need a bit more help navigating their way around the health system.

‘Medical students and juniors get very little help to develop the skills that they need to be able to communicate effectively with patients with learning difficulties.’

 

Skillful communication

But she recognises that there are aspects of skilful and compassionate communication which are relevant to other clinical situations too. For example, patients with physical illness and disability who are experiencing suicidal thoughts.

The suicide rate has been steadily going down and there has been a successful campaign to achieve this but she believes that more attention on mental healthcare is needed for patients in non-psychiatric services.

‘In mental health teams we see our job as being to treat our patients’ symptoms actively and to accompany them both in hospital and at home as needed,’ she says.

Baroness Hollins is keen on exploring the link between physical and mental health.

 

Holisitic view

She points out that people with schizophrenia have a raised incidence of diabetes, and will die much earlier from medical conditions than the rest of the population. Treating depression has also been found to result in faster rehabilitation for people who have experienced a stroke.

She says: ‘We have created much too big a split between mental and physical health, as if somehow they are happening to different people, as if there is no connection between them. There is such a big connection between them, and I think it will be a real area of growth in knowledge and practice in the years ahead.

‘I’m hoping that those doctors who don’t work in mental healthcare, and perhaps don’t feel they have skill in this area, will grow in confidence in seeing that there is a connectedness which really does need to be addressed.’

This scenario is not unlike the one Baroness Hollins found herself in many years ago as a newly qualified GP at a south London practice, where she suspected a large proportion of patients had emotional or psychiatric problems.

‘The first time I met somebody with a psychotic illness was as a GP, when I had a five-minute slot for that patient, which was probably double-booked,’ she says. ‘How on earth was I to know where to begin? How to respond appropriately to that patient? How to begin to understand the complexity of his needs?’

 

Inspired to act

Her experience prompted her initially to seek psychiatry training to become a better GP, and she then gained one of the first part-time psychiatry training posts set up in a pioneering scheme by Oxford assistant county medical officer Rosemary Rue.

‘She had this idea that letting women train part time would make very good economic sense, would keep women in medicine,’ says Baroness Hollins.

‘I think I was maybe the first or second consultant psychiatrist to graduate from that scheme, certainly in my region.’

The scheme allowed her to spend five years in a single hospital, which offered continuity, and meant she could see some patients over a longer period of time.

‘But the hospital also had a crèche, and I learnt more about how the NHS works through co-running a campaign [to save it], and explaining to the hospital managers and the district managers the economic benefits of keeping the crèche open and continuing to subsidise it and the effect on recruitment ... I believe the crèche is still open today.’

 

Personal experience

Baroness Hollins encourages doctors to draw on their personal experience to help their practice.

She says: ‘The experience of being the mother of a disabled child just made me so aware of the gaps in the knowledge that most doctors have and in the services that were available. So any opportunity I had to fill those gaps just seemed really important.

‘We are whole people. If you know something, in a way it doesn’t matter how you know it. But if you can apply that knowledge in a way that can help other people, that seems really important.’

In her case, that has included creating Books Beyond Words for people with learning disabilities, to which her son is a contributor. The series was inspired by picture stories she developed when he was a child to help him understand what was going to happen to him or things that were new to him.

Later, when she started working with adults with learning disabilities, she began using the picture techniques she had developed with him.

‘My son has inspired probably some of the best work that I have ever done,’ she says.

When she is not at the Lords, Baroness Hollins enjoys long-distance walking in far-flung destinations such as Peru and India but also in the gentler climes of Derbyshire and Devon.

She is also a music lover, as demonstrated by her recent appearance on Desert Island Discs, but insists it would be difficult to choose a single piece to take.

‘I love listening to Miles Davis in the evening but I would never put it on in the morning — not if I’ve got work to do. So if I was building my shelter, it wouldn’t be quite right,’ she explains. ‘Maybe Cleo Laine singing On a Clear Day would be just the thing to get me going.’

Listen to Baroness Hollins on Desert Island Discs (mp3)

Baroness Hollins was the President of the BMA for 2012-2013 and she is currently chair of the BMA Board of Science.