5 minutes with... A Consultant Psychiatrist

Around one in every 100 people will be affected by schizophrenia during their lifetime yet despite this, the illness is sadly still very stigmatised. In this week’s interview, Dr Erin Turner explains more about what schizophrenia and psychosis is and breaks down the common misconceptions about the illness.?

Hi Erin, please can you tell us a little bit about your role at BSMHFT?

As a Consultant Psychiatrist, I specialize in the early intervention and treatment of people with psychosis. Most of my patients have schizophrenia, some have bipolar disorder, and others have schizoaffective disorder, a combination of mood disorder and schizophrenia. I treat psychosis and schizophrenia holistically with a team-based approach. This includes the use of medication, talking therapies, family support and social interventions. I predominantly work in the community, however if my patients become too unwell or it’s unsafe for them to be at home, they are admitted to hospital.

I head one of the largest psychiatry teaching academies in the country, responsible for over 500 medical students each year. It is so important that we give our students a rich experience of psychiatry and challenge some of the myths they may believe about schizophrenia and other mental disorders.

What inspired you to choose your profession and what made you decide to specialize in psychosis?

I had an aptitude for surgery in medical school and gained a surgery scholarship to America. However, once I qualified as a doctor, I found surgery disappointing.?I really loved talking to the patients so, I decided to train to be a GP.

As part of GP training, I did a psychiatry job and for the first time in my career I realised that I was looking forward to going to work. It was then that I made one of my best life decisions - to train in Psychiatry.

What I love most about psychiatry is the patients. I have an empathy for people with mental illness and strongly feel the injustice of the stigma surrounding mental illness.

I love being part of a team. Mental health teams often have a camaraderie develop, in part due to the challenges of the job.

I also enjoy teaching medical students about mental disorders and how to undertake a mental state examination. I find delusional beliefs or auditory hallucinations significantly more interesting than chest pains or bowel movements. The brain and the mind are fascinating, and psychiatry is one of the few areas of medicine where we still rely on good history taking and mental state examinations to make a diagnosis.

What are the most common misconceptions that you've heard about either schizophrenia or psychosis?

One of the most common misconceptions is that people with schizophrenia are violent. The media unfortunately has fuelled this myth. However, the truth is that people with schizophrenia are more likely to be victims of violence rather than perpetrators

Another common myth is that antipsychotic medication is unsafe or that it changes people’s personality. Previously people were treated with very high doses of medication, however today treatments are better tailored to the individual. Antipsychotic medication not only treats the symptoms of psychosis it also prevents relapse. Antipsychotic medication is safe and does not change people’s personality.

There is also a misconception that people with schizophrenia never get better. Early Intervention teams strive to help our patients make a full symptomatic and social recovery and there are many of my patients who go on to lead incredibly fulfilling lives

If you could say one thing to someone who has just been diagnosed with schizophrenia, what would it be?

Don't be defined by this illness. You will feel empowered if you learn how to manage the illness, so that you control it rather than letting it control you. People sometimes lose their confidence and identity after experiencing an episode of psychosis; however, with time, and the right treatments, you can rebuild your confidence and rediscover your identity. Experiencing psychosis can make you stronger.

How is schizophrenia managed and what kind of treatment options are available?

Schizophrenia should be managed with holistic and integrated treatments, involving medication, psychotherapy, family support and social interventions.

When someone is experiencing psychosis, the brain shows hypersensitivity to a chemical called dopamine which can result in the symptoms of hallucinations and delusions. Antipsychotic medications reduce dopamine activity thereby treating delusions, hallucinations, and muddled thoughts. They also help to restore sleep, concentration, appetite and decrease a relapse of psychosis. They can be taken as tablets or by injection.

There is also a psychological component to psychosis and schizophrenia.?People with multiple adverse childhood experiences are more prone to developing psychosis. There are also social factors too - living in the city, significant stress and cannabis increases vulnerability to developing psychosis and schizophrenia.

The psychological treatments of schizophrenia and psychosis are varied, but we generally use a model called Cognitive Behavioural Therapy (CBT) adapted for psychosis. This can help people better manage their voices by gaining control over them and by minimizing the distress that they experience. Family therapy can help families who are under a lot of stress due to living with psychosis.

Social interventions may involve helping people find suitable housing and access benefits. It may involve simply taking people out to rebuild their confidence. We must also recognise the importance of helping people who are recovering and want to get back into employment.

What do you like to do outside of work?

I play tennis. I love my garden. I enjoy walking my dog- I've got a rescue dog named Kiku who I enjoy walking every morning and when I come back from work.

How do you look after your own health and wellbeing?

I love being surrounded by nature. Nature is very therapeutic, and I find it is good for my mental health. I have a lovely family, friends, and a husband who is incredibly supportive. I’d like to think of myself as a positive person as I try not to dwell on the negative too much.

Describe yourself in three words

Energetic, visionary, curious.