Columns E-interview

e-interview columns Richard Warner What is the greatest threat? Fads, like multiple personality disorder, Richard Warner is Professor of , childhood bipolar disorder, and the next University of Colorado, Director, Colorado one along. Recovery, and formerly Medical Director What single change would of the Mental Health Center of Boulder substantially improve quality of care? County, USA. He trained at King’s College Training more broadly in Hospital, London, Littlemore Hospital, psychosocial rehabilitation. Oxford, and Dingleton Hospital, Roxburghshire, UK. His special interests What conflict of interest do you include social and economic factors encounter most often? influencing the development of, and Psychiatrists allowing pharmaceutical outcome from, mental disorder and the representatives to be their most usual development of effective community source of in-service education. treatment and rehabilitation programmes. What is the most important advice If you were not a , you could offer to a new trainee? what would you do? If you can’t say ‘No’to a patient when Right now? Study history. needed, don’t become a psychiatrist. What has been the greatest impact Do you think psychiatry is brainless of your profession on you personally? psychosis, pulled me up short and sent me or mindless? It has provided me with opportunities for scurrying to study the research on outcome Neither. It often fails to grasp the impor- innovation and a sense of helping people. from throughout the 20th tance of the social context of the person. century. Do you feel stigmatised by your What is the role of the psychiatrist profession? How has the political environment in rebuilding healthcare systems? Hell, no! influenced your work? Vital, but not automatic.The psychiatrist The unholy political alliance between the must earn this role by demonstrating an What are your interests outside understanding of systems. of work? right and the left in the USA of the1960s, Running, cooking, travel, languages, whichled to the hasty What single change to mental health culture, theatre. of people with serious mental illness and legislation would you like to see? their eventual abandonment in the commu- In the USA, the provision of universal What values do you live by? nity, revealed to me that a wholesome healthcare coverage (which is feasible) and Loyalty, truthfulness, and helping people. movement (in this case, community treat- the creation of a national system of care Who was your most influential trainer, ment) can be transformed into its opposite, (which is an impossible dream). and why? without the transformation being apparent What single area of psychiatric Ben Pomryn, Consultant Psychiatrist at until it is too late. practice is most in need of Littlemore Hospital, Oxford, who intro- development? duced me to the power of the therapeutic What part of your work gives you Psychosocial rehabilitation. community. the most satisfaction? Creating effective treatment and What single area of psychiatric What job gave you the most useful rehabilitation programmes. research should be given priority? training experience? Removing disincentives to employment in Littlemore Hospital, Oxford, where half of What do you least enjoy? national disability pension systems. the hospital was operated as a series of The day-to-day management of therapeutic communities. programmes, once created. How would you like to be remembered? Which publication has influenced What is the most promising As someone who helped create you most? opportunity facing the profession? programmes that expanded people’slives. The data from Loren Mosher’s Soteria Partnerships between psychiatry and other Project in California, in the late1970s, social and health agencies to create cost- Dominic Fannon demonstrating that medication is not effective solutions to social problems (such essential for good outcome in early as child abuse and jail overcrowding). doi: 10.1192/pb.bp.109.025791

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