Love, Sociology and Being Cool

I had a great supervisor for my PhD. He is someone I have mentioned here before, Professor Joel Richman. He taught me a great deal, and he was a giant upon whose shoulders I stood. Standing on his shoulders, I was able to see so much more than I even imagined was possible. He introduced me to sociology, anthropology and the art of writing, something I have grown to love. Joel encouraged me to be bold, authentic, and to find things to be passionate about. He was a great man, a wonderful academic colleague, a total eccentric and a true friend.

He was generous enough to introduce me to his many friends and colleagues during my PhD studies. Many of these were people I had previously only known about from reading their books and articles. For a few years, Joel took me to the Medical Sociology conference in York, where it was possible to have breakfast with those who, to me at the time, were the great and the good. I stumbled across one such person again last week while I was chasing down an evidence citation. His name is Robert Dingwall. Anyone who has studied sociology in the last 25 years will have come across his name and his work. He is semi-retired these days, although he is still a professor at Nottingham Trent University. Robert is one of the foremost international authorities on law, medicine, science and technology, focussing on the work of the professions, the work they do and the organisations they work in. His research portfolio is eclectic and fascinating. His work ranges from child protection, the history of nursing through to energy use and medical negligence. More recently, his previous work on pandemic planning (in the context of the UK experience, that almost feels like an oxymoron) has meant he has been much sought after by Johnson’s Government.

What I found was an article he wrote for the Elder magazine. It wasn’t dated, so I don’t know when during the pandemic he wrote it. Surprisingly, it was entitled, ‘Government coronavirus advice – where is it going wrong?’. You can read it here.  There was one aspect in his narrative that caught my attention, and that was around social distancing. These days it’s something most us of do without thinking, although that said, frighteningly there are also many people who don’t seem to understand what social distancing entails. Robert used this as an example of difficulties that can arise from a Government taking a one-dimensional view when making public policy. I have already elaborated more than enough in previous blogs my thoughts over the lamentable way Johnson et al have managed the country’s response to Covid-19. This time my interest was aroused over the impact (albeit, if I’m being generous) possibly unintentional, on people’s mental health, as a consequence of being ordered to socially distance, shelter and isolate.

The impact on people’s mental health and wellbeing was possibly most experienced by older people. I don’t know about you, but in the early days of lockdown I would notice the absolute look of horror on older people as I walked our dog Dylan – and I’m sure it wasn’t just my often dishevelled look (I call it original chic) that caused the concern, possibly more the fear they would get infected by passing me on the pavement. As a public mental health issue, Dylan and I took to walking early in the morning so as to not encounter too many other folk.

The mental health and wellbeing impact of Covid-19 is beginning to be seen now. Increased presentations at A&E are showing a rise in people presenting with mental health problems. The long- term issues that people might be facing (patients, professionals and all those in between) are at this point unknown. However, experience tells us there is likely to be many people who will experience mental health problems in the future.

Indeed, perhaps in recognition of this new reality, Jo Lenaghan, from Health Education England, was heard in the news last week saying we needed 1,200 additional psychiatrists by 2023, in order to deal with the emergent mental health problems post Covid-19. I’m not sure where she got this figure from. We know that there are 50% more psychiatrists in the NHS than they were some 15 years ago – she is undoubtedly right in one sense, but there are other options. Professor Helen Stokes-Lampard (I so love these impressive names) from the Academy of Royal Colleges takes a different view.

Now you might think, so what? But the Academy of Royal Colleges is an important organisation. They are the coordinating body for the UK’s 23 medical Royal Colleges and Faculties. In this respect they have a unique role to ensure that all of us as patients (and sooner or later we will be patients) are cared for by those who are educated, trained and supervised as they develop their careers. In that sense they are a body whose role it is to make sure we all get the medical care we deserve and expect. So, it was interesting to read that Prof Helen was advocating that in the future we patients might accept that we will be seen by non-doctors. She elaborates further by telling us that these non-doctors will include ‘nurse practitioners’, ‘physician associates’ and ‘social care navigators’. Given that there are nearly 4 million people in England awaiting either an operation or some other kind of treatment, I say, ‘bring it on’.

 But it may be difficult. My parents, both aged around the 90ish mark, complied with the lockdown, embraced on-line shopping, self-isolated, resigned themselves to Zoom and Facetime contacts with their children, grandchildren and even great grandchildren. However, if they wanted health care help, they would want to see their GP. End of. And believe me I have tried to get other professions to help them, but to no avail. Of course, I love them, and wouldn’t see them come to any harm, so I will continue to use what little knowledge I have to try and keep them safe. If I take a step back a pace or two, (and Robert Dingwall might be proud of me) I might think we have been here before and survived. I know you don’t believe me, but perhaps believe the authoritative National Geographic. At a time when we can’t sleep because of the heat, this historical account is really cool!