Star Interview: ‘Ordinary people can get involved in what we do’: Professor Sir Simon Wessely on reviewing the Mental Health Act, his Sheffield childhood and life as a top psychiatrist

Professor Sir Simon Wessely
Professor Sir Simon Wessely

How often does Britain's top psychiatrist visit a doctor? Hardly ever, it transpires.

Professor Sir Simon Wessely is president of the Royal Society of Medicine, advises the military on soldiers' well being, has spent much of his career studying baffling conditions like ME and is leading an independent review of the Mental Health Act for Prime Minister Theresa May.

But the Sheffield-born Regius Professor of Psychiatry at Kings College London has not been, as he puts it, 'a consumer' of the NHS for 20 years.

Which is why it is unusual that we are meeting in the reception of Guy's Hospital in Southwark, where he has come for a last-minute appointment. 

"I suppose this is the strangest interview you've ever done," he says at one point, before being diagnosed with an unpleasant cough.

Most people would probably have cancelled, but Wessely is unfazed. And the way psychiatry - a specialism that gets to the heart of society's biggest challenges such as drug addiction and dementia - easily lends itself to conversation and debate is what drew him to the field in the first place.

"There are disputes and battles across medicine, but most people can't understand them," he says. "But in psychiatry a lot of people can: mad or bad? When does sadness become depression? What is autism? People know instinctively they can take part in those debates - drug legalisation, for example. Ordinary people can get involved in what we do. And if you don't like that, you won't really like psychiatry very much."

Simon was born in 1956 and grew up on Montgomery Road, Nether Edge. His father Rudi was brought to England on the Kindertransport just before the Second World War was declared in 1939. He later discovered his parents were sent to Auschwitz where they were among the six million Jews murdered in the Holocaust. Rudi served in the Navy and became a teacher - his first job was at Ecclesfield Grammar. 

In 1983, completely by chance, Rudi met a man called Nicholas Winton who revealed he was the organiser of the Czech Kindertransport, something he had never told anyone else. Winton later met more of the 669 people he had rescued and was knighted for his humanitarian work.

Simon, an only child, has previously said his father's experience was not 'a big thing' in his own youth, but it occasionally surfaced. The only time he saw his father cry was on a visit to Czechoslovakia in 1968 when he found his parents' names on a Jewish memorial.

Simon's mother Wendy, meanwhile, was also a teacher, as well as a professional musician. 

"I think I was very lucky really because it was quite a good time to be in Sheffield as a kid," he says. "We had a pretty thriving cultural life. It was very progressive. I do remember the fact that, all my childhood, the buses were 2p. And there was what, to a child, looked like a gigantic public library. I remember the opening of the Crucible. Obviously even The Moor looked fairly nice before Meadowhall wrecked it all - it's got better, but it went through a really dreadful time. I came from a nice, stable, family background, so I have very nice memories of it."

His parents always talked about moving, but never did. "And they were never going to. We only sold the house I grew up in after my father died about four years ago."

Simon attended King Edward VII grammar in Broomhill - it turned into a comprehensive while he was there - and went on to Cambridge and Oxford for medical training.

"It was assumed I would go to university," he says. "Both my parents had. I just thought 'I might as well be a doctor', and I don't know why because there were no doctors in the family or role models at all."

Gradually he realised psychiatry would be his forte. "I was much stronger on arts subjects than science. And I was completely cack-handed, I couldn't even change a wheel on a bike, so I wasn't going to do surgery. I was attracted to psychiatry as a medical student because of lots of things. It was very well taught, and it was the first time I'd met consultants who knew the names of their patients."

Psychiatry attracts 'a certain type', he says. "They tend to be a bit older - I always tell people psychiatry is medicine for grown-ups. I did the running around, 'Quick nurse, give me the needle', and all that stuff, up in Newcastle. It was interesting, but I didn't want to spend my life doing that."

He was chiefly influenced by Anthony Clare, the presenter of 'In the Psychiatrist's Chair' on TV and radio. "It was his book, Psychiatry in Dissent, that really switched me on. Because it was about really interesting things which got me excited. The intellectual battles, the issues, and that's still the case to this day."

The process of reviewing of the Mental Health Act has proved the accessibility of his profession, he says. "We've had a huge engagement programme. We've learned a lot."

An initial report was issued earlier this year and the final version will be published in December. Simon can't share the findings, but the interim document found people with serious mental illness were suffering neglect and discrimination when they had been detained for treatment. In 2017 Theresa May said the 'flawed' legislation was causing too many people to be locked up.

"We've flagged some things that clearly we're going to do, because when we do detain people it's the only bit where the state takes away your liberty when you haven't committed a crime," says Simon. "We therefore have to do it for a reason and that reason has to be to help people. I think we need to rebalance, to remind ourselves that it is the most severely mentally ill that are the greatest challenge."

The recommendations are going to carry funding implications. Is there an appetite to spend more?

"That's the $64,000 question - it's going to more than $64,000, I can tell you that now. We don't know. This report could be shelved. Others have, in this area. You've got to land the report at the right time to the right audience. We have to make a good case, get a consensus, have the service users and charities with us, make sure it doesn't become a political football - it's a lot to do. It's a big task."

Mental health is on the agenda generally. Research has suggested the number of university students trying to access support has soared.

"Every generation always thinks things are getting worse, that's just a characteristic of life," says Simon. "Usually the rates of most mental health problems have been static since we've been recording them. That's still the case now, but what we have definitely seen is a massive increase in demand. There's been a fivefold increase in people at university going to seek help."

There is a real rise in mental health problems among women aged 18 to 24, he says. "It's gone up from 18 per cent to 26 per cent over a period of about seven years. That might not sound very much, but it's a lot. I don't know what that's due to, and I don't think anyone else does. Everyone has their pet theory and it's very important we take a careful look at what this is before we leap to conclusions. We could just as easily make things worse."

Previous work by Simon in areas like psychological debriefing has shown the risk of doing more harm than good. "The trained counsellor appearing at the scene of a disaster turned out not to be a good thing. Maybe it was just too early. Maybe it's not a good time to ask 'What was it like seeing your wife get blown to bits by a terrorist bomb?' Maybe it gets in the way of what comes naturally - the instinct is to talk to your mates. And then your family, and your colleagues. And we, the professionals, are very low down on the list."

His life today sounds pleasant. As long as he is delivering the goods academically at King's his bosses are happy - he hasn't filled out a holiday form in 30 years.

But it hasn't all been plain sailing. He stopped studying ME, or chronic fatigue syndrome, years ago, after suffering a backlash from a faction of sufferers who believed the illness was a purely physical condition. His research, carried out with colleagues, found combining cognitive behavioural therapy with light exercise brought about a full recovery in a third of patients.

Simon doesn't regret researching the syndrome - "Absolutely not, I'm quite certain we did a lot of good" - but thinks changes could have been made. "We spent too much time with people we agreed with and not enough with people we didn't agree with. We believed the evidence would speak for itself, and it didn't."

The impact on his life endures. "It's not been pleasant. It's a difficult area for me to talk about. I would describe it as stalking, unpleasant ways of people trying to interrupt your career, incite hostility, threats."

By contrast his work on military health has been the 'most satisfying and enjoyable' part of his career. When Gulf War Syndrome, characterised by mysterious symptoms like fatigue, pain and breathing problems, emerged among veterans in the early 1990s, he showed soldiers' health had been affected by serving in the conflict, which meant they could access war pensions.

"We never really found out what it was. We found out all the things it wasn't."

Simon is director of the King's Centre for Military Health Research and a trustee of the charity Combat Stress. "It takes quite a while before they trust you because you're a civvy. When you go out to watch them on deployment they make bloody sure you know how useless you are. The best they will say of you is you're 'not a bad boffin'. I got to like them."

He feels he has 'come full circle' with the Mental Health Act review. "I haven't been dealing with the problems of severe mental illness for most of my career. I realised I'd lost touch with quite a bit of that, and I've got it back now."

Simon, 61, is married to Dr Clare Gerada, former chair of the Royal College of General Practitioners - and yes, they do talk about work at home. "Some of it is the usual gossip, but psychiatry and general practice are very close actually. It's about a third of their work. They're on the frontline, they have to cover everything."

They have two grown-up sons - one is a human rights lawyer and the other a social worker in child protection, 'probably the hardest job there is', says Simon.

If there is a thread running through his own working life, it is a simple one.

"Not being bored. I'm terrified about being bored."

‘Thank God there wasn’t YouTube’

Professor Sir Simon Wessely believes psychiatry has been on a learning curve since he was a trainee doctor 40 years ago.

"The kind of views that would go around in the doctors' mess - looking back, I'm sometimes quite ashamed of some of the stuff that went on, some of the banter and the way we described certain groups of patients. This was standard across medicine. 

"If you played back some of the junior doctors' entertainments - I used to write shows and scripts - you would be embarrassed. Thank God there wasn't YouTube."

But some things were better then - even, in a way, the very long hours. "It does mean we had those really strong social networks that get you through adversity. That's gone."