The vision of Cambridge Children’s Hospital to treat mental and physical health together, alongside research, is pioneering. But what does that really look like and why is it important? For Children’s Mental Health Week, consultant psychiatrist Dr Isobel Heyman, our co-clinical lead for mental health, reflects on key moments in her 30 year career where the mind-body link has been most apparent.
The theme of Children’s Mental Health Week is ‘Let’s Connect’. How will Cambridge Children's Hospital support connections?
Connections are crucial. Children thrive with a network of friends and family. One of the aims for the new hospital is to minimise the disruption that coming into hospital can cause. We want to make sure there are inside and outside spaces to welcome friends and families; that wellbeing is supported by healthy food and spaces to eat together; that all children and young people can make use of the hospital school; and that staff are supported in their teams and groups. Keeping those networks open and available is so important for mental health.
When you were named in the King’s New Year Honours list, you told us that the Cambridge Children’s Hospital project was the highlight of your career so far! What did you mean by that?
The opportunity to work on the Cambridge Children’s hospital project feels like something I’ve been working towards - step by step - over my whole career. I’ve always believed that mental and physical health are equally important.
As a career, psychiatry sort of crept up on me. I was working as a very junior doctor at Middlesex Hospital in London on one of the first HIV/Aids wards in the world. I became aware of how important the patients’ psychological wellbeing and mental health was, often during the last weeks of their lives. An inspiring liaison psychiatrist, Ulrike Schmidt, took me under her wing and taught me the importance of detecting and treating mental illnesses, such as depression, in these seriously ill adults. It often made an incredible difference to their remaining time with friends and family, such as finding the energy and motivation to write an important letter, get out of bed for a short walk in the sun, or enjoy a meal.
Being invited to help with the planning, development and concept of a brand-new hospital where physical and mental health will be fully integrated for children, families and staff is like a dream come true.
Why is it vital that research makes up the third arm of the Cambridge Children’s Hospital vision?
It always struck me that if a child had physical illness and also a mental illness, the latter often got overlooked. This was never more evident than in the work I did with complex epilepsy patients at Great Ormond Street hospital. It was a key factor that led me into measuring rates of mental ill health in this population (up to 60% compared with about 15% of the general population of children) and devising research studies and clinical programs to increase access to mental health care for children with epilepsy.
Putting research into real life clinical practice – translational medicine - has been a key part of my career. It’s another of the hugely exciting aspects of Cambridge Children’s Hospital. The University of Cambridge will partner NHS mental and physical health services which means that the very best health care will take place with research fully integrated, too.
Tell us a bit about your current work with children and young people...
One group I am working with are children who have ‘attacks’ that look just like epileptic seizures but are actually not epilepsy. These are called non epileptic seizures or functional seizures and they emerge in children who are stressed and overwhelmed. Working with these children and families is a bit like detective work. Sometimes the stress is long-standing, such as being unhappy or bullied at school, or occasionally is a more immediate trauma, like a physical accident or psychological upset.
A key part of treatment is helping families understand that this is not a dangerous neurological illness, but these are real and serious symptoms. This work can only be done with a skilled team including psychologists, physiotherapists, teachers and others. Cognitive behaviour therapy, rehabilitation back to school, and identifying and dealing with triggers are all important. These young people make full recoveries, so it is highly rewarding work.
Have you ever worked on a project like this before?
No! It’s a privilege to be able to do new things with new people at this stage of my career.
Although I’m an experienced child psychiatrist and researcher, I have never worked on such a huge, multifaceted, and complex project. I meet and work with marvellous and inspiring people and touch on topics I’d never had to consider in relation to a hospital, its design and its work.
For example, there are impressive project managers who seem to juggle multiple tasks from high level political liaison, to tendering processes and everything else imaginable. Then, the incredible fundraising and campaign teams whose skills and insights amaze me, and outstanding senior clinicians across disciplines who have patiently led me through the local clinical landscape. The architectural and engineering teams are passionate about health care, learning from clinicians about how to meet our patients’ needs. There is also impressive commitment to communication and engagement, not least working with children, young people, parents and carers. They have helped advise and inform the project at every stage, which is an exciting, surprising and humbling process.
This project showcases the best sort of collaborative and multidisciplinary working.
What do you do to support your own wellbeing?
I make sure I take time to relax with friends and family, and I especially enjoy cooking and listening to music. I have also done yoga since I was a teenager. I really couldn’t imagine life without it and my longstanding yoga teachers have been some important connections.
I also remind myself and children I see that feeling anxious, or stressed or sad at times is a normal part of life. Realising that it will pass, in most cases, can be a mindful way of coping with a bad patch.
What is a simple tip you could offer to support someone who might be struggling with their mental health?
If that bad patch continues or begins to affect your life, my simple tip is to talk to someone and get help. Sometimes just a talk with a friend or family member puts perspective on a difficult time, but there should never be hesitation or shame in seeking professional help as we have really good treatments for mental ill health.