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Yes, we can: interview with Mikkel Rasmussen

 

Psychiatrists could benefit from getting a greater insight into the political and administrative processes governing our health care system as part of their postgraduate education.



How has your professional career been?


After my specialization I have worked as a consultant for several years primarily in acute and subacute settings as well as in liaison psychiatry. Subsequently, I worked as chief psychiatrist in Vejle for 2½ years. For family reasons I resigned and work now partly as a psychiatric consultant in the municipal job center, partly in private practice. Parallel with this I have for years been politically active. I have been a cofounder of a regional political party “Psykiatri-Listen” and had had a seat in the regional council (that in DK is responsible for health services) for 3 years and I am still a board member of that party. Furthermore I am one of the vice-chairs of the Danish Psychiatric Association.


What were the reasons for you to engage actively in politics?


Well, there were several reasons. First of all, I feel that we as doctors have an obligation to engage actively in society. My ultimate wish would be to bring a change to the psychiatric system in order to improve it. I have enjoyed being part of a political movement and getting involved in decisions related to mental health services. Mental health pervades all aspects of society including children and adolescent with adjustment problems, problems related to long term sick leave, burn out, loneliness, traumatic experiences, substance abuse just to mention a few.


How does this relate to the seven competencies?


As medical doctors in general practice as well as in psychiatry we have a particular competence related to the societal perspective. We should acknowledge that using our professional knowledge and competence we may influence decision making and gradually push things in the right direction. We have to identify where we can make a difference and outreach for this goal. I find it important that we involve ourselves in society and avoid strict concentration on the narrow aspects of our discipline. We should open up and engage ourselves in various ways.


Do you have any more practical examples of how this could be done?


When I was chief psychiatrist, I invited one of the largest Danish newspapers to stay for 5 days at our psychiatric hospital in order to follow our every day work in all details. Their agenda was related to the corona pandemic and the economic and behavioral changes related hereto that as well as the shortage of resources allocated to psychiatry. We demonstrated both the positive sides like successful treatment, or new therapeutic approaches but also the more negative aspects related to e.g. coercion.


I think we have to be very careful not to focus primarily on the negative aspects of psychiatric care that is a dangerous approach as far as I see it. We have to demonstrate the huge spectrum of psychiatric care and try to have a dialogue with decision makers and politicians that is a fertile way forward.


A more clinical example from my department was a case where a staff member had mental health problems and difficulty in coping with the working conditions. Here an individual change was introduced recognizing her situation to alleviate her stress and with a very positive outcome. As psychiatrist we should spread out our knowledge. This way we might contribute to a better understanding of the importance of good mental health in the general population. This could help leaders and employees at workplaces and educational institutions.


And how about Danish psychiatry?


I am very pleased that DPS has a chairperson Merete Nordentoft who continuously speaks up for psychiatric patients and engages in societal and political discussions about the status of psychiatric services. I also think that the 10-year plan for psychiatry is paving the way for improvements of services. So the situation I consider as hopeful.


But how do you see all this integrated in the psychiatric training?


Today there is little focus on the overall political aspects. Frankly I had to learn it hands on. I find that it is important to learn how the system functions at all levels and where you as a doctor may have some influence. It is my conviction that such knowledge may reduce the risk of burnout and increase satisfaction recognizing that some thing may be achieved. We should never forget the relevance of psychiatry in modern society and how we may use our competencies for the benefit not only of psychiatric patients but society at large. □



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