Presidential Blog


I thought, last week, that the political world could not get any more turbulent. But events in the South of France, in the USA, in Turkey, and even here in the UK, proved me wrong.

A couple of weeks ago I mentioned the importance of leaders in civic society - including the British Psychological Society - stepping forwards in the confusion and, frankly, vacuum of detailed policy-making post Brexit. We’ve previously spoken out on the dangers of xenophobic and hate-filled speech and on the psychological factors associated with flawed political decision-making.

All these issues seem to grow in importance each week. Of course, psychology as a discipline and a profession overlap with others. Sociologists, anthropologists and ethnographers all study society as much as do psychologists. Historians, especially political and military historians, have perspectives that overlap with, inform and are informed by, psychology.

Psephologists and political geographers analyse the human factors associated with political decision-making and survey the views of the voting public. And, of course, since political decisions impact upon all of us in our professional activity, all professions have legitimate interests.

So it’s important to remember that the psychological perspective should accompany other, equally valid, perspectives. We are, as has been said before, stronger together. And it is important that professions and disciplines act in unity. We aren’t the only professional and academic body active in this area - but we are, as you would expect, active.

I am delighted that the BPS is central to discussions by the Academy of Social Sciences (representing, of course, the social sciences) and Science Council (representing the more physical sciences) in their discussions about UK science and professional activity post Brexit. I’m also delighted to have been a co-signatory to an open letter to the new UK prime minister, asking her to confirm the previous government’s commitment to mental health and to ‘parity of esteem’ in the provision of services.

This reshuffle has not produced the dedicated cabinet minister for mental health that we had been calling for, but the release of the NHS ‘Implementing the Five Year Forward View for Mental Health’ plan just a few days into the new cabinet suggests it is still high on the agenda.

We’ve got a whole new cast of political characters to work with and we will be working hard over the coming months to introduce our Society to them and explain the value that psychology can bring to their policies and to the way they make their decisions.

Wed, 20/07/2016 - 12:05

The British Psychological Society is actively engaged in several important policy issues, but two are particularly contentious. They are technically complex and they are personally challenging.

A recent government consultation asked how to implement the replacement of bursaries for nursing and other healthcare students with an expanded system of loans. This change raises complex issues for our discipline.

Our response stressed that “the proposed reform to healthcare education funding falls short of the long-term holistic workforce strategy necessary to achieve the government’s goal of delivering high quality integrated physical and mental health care.”

Given that clinical psychology trainees receive both fees and salaries from Health Education England, any move towards loans as opposed to bursaries would constitute a major threat to our profession. Thus we stated clearly that this support “is vital and must continue”. But this support does not cover all applied psychology, and, as we said in our response “is not sufficient to deliver the progress needed to achieve the government’s goal of significantly improving the psychological health and wellbeing of the population.”

We need to enter into substantive discussions with the Department of Health and Health Education England about the future shape of our professional training. We know that our profession is under review. There are many options – from the discussions held under the New Ways of Working programme, suggestions I have previously made and the opportunities offered by the existing Clinical Scientists route.

One thing that psychologists are good at – trained in – is grappling with difficult issues and forging coherent consensus. In this response we expressed a clear message on behalf of the whole profession that takes us forward with authority. But on a personal level, this was a difficult issue. It was challenging to balance the well-argued concerns of colleagues over the commissioning of clinical psychology training with the opportunity for other applied Divisions to boost the psychological workforce and begin to address structural inequity if they were at least able to access loans to meet their training costs.

One of the reasons I love my profession is that we didn’t just put our head in the sands. We took the bull by the horns, and developed a coherent and authoritative position, which we will develop further in the coming months. Armed with this, we are ready to sit down at the table and try to influence the course of events.

I had to confront a second personal and professional dilemma this past week as on Friday I met with colleagues in the Department for Work and Pensions. Many of my friends have aired grave concerns about DWP policies, arguing that they inappropriately ‘psychologise’ unemployment and locate the problem within the unemployed person.

The BPS and other organisations have also raised concerns that the DWP considers employment as a clinical outcome, and that the underpinning rationale for these policies was not improving health, but for ideological purposes. We are concerned that people would be coerced into therapy or face sanctions on their unemployment benefit payments if they refused consent.

We continue to scrutinise these policies and insist on the appropriate, ethical, use of psychological theory at all times. The British Psychological Society has argued that staff must not be involved in coercion and must maintain their professional independence as therapists. Claimants’ rights to autonomy and freely-given consent (to, for instance, participation in research trials or therapy) are non-negotiable.

Moreover, employment is not a universally positive outcome for everybody. There must be a clear commitment to appropriate work that includes long-term tailored support or there is a real risk of jeopardising recovery or worsening of mental health problems. Personally I’d go further and argue that employment should only be an outcome if that’s what the client wants.

I have my own opinions, which are guided by my understanding of psychological science, by my professional training and by my values, and which I know I share with my colleagues. Last year, I spoke out about the misuse of such policies but a principled stance is not necessarily the same as simple opposition.

The most important discussions are not easy. They aren't conceptually easy and they aren’t emotionally easy. But they are necessary - we have an obligation to engage and discuss such contentious and difficult issues, not avoid them.

Wed, 13/07/2016 - 13:51


The Chilcot Report into the decision to go to war in Iraq has highlighted the irrationality and psychological vulnerability of our leaders, and how disastrous the consequences can be.

As the fall-out from the EU Referendum left us painfully aware, there are dangers in making decisions under conditions of high emotion, poor quality information and great uncertainty. Coming so soon after Brexit, we are even more acutely aware of the limitations of our politicians.

Sadly, we have become to expect that politicians will act in their own best interests, avoid direct answers and backtrack on their promises. But I had hoped senior civil servants, military commanders and, crucially, the shadowy chiefs of our intelligence services would take the most rational approach to the process of decision-making.

But the Chilcot Report shows that decisions – life-and–death, world-changing decisions – fell prey the same disastrous cognitive biases to which we are all prone. Psychologists have always known that human beings are irrational. The philosopher and proto-scientist, Roger Bacon suggested in 1266 that a principal source of error was our “false conceit of our own wisdom”.

We find it difficult to retain more than a few relevant facts so use rules of thumb - heuristic reasoning - rather than cool logic. Our decisions are distorted by emotions, by the most memorable information, by irrelevancies and by other people. We seek out information that confirms rather than challenges our assumptions. And we seek the company of people who agree with us.

Once a decision has been made, we naturally feel terrible at the thought that we may have made mistakes. The phenomenon of ‘cognitive dissonance’ – and the psychological discomfort it causes - means that we sometimes try to change the facts to make ourselves feel better. Chilcot said Tony Blair had presented intelligence about Iraq’s Weapons of Mass Destruction “with a certainty that was not justified”.

We are cooperative animals. Cooperation has been and remains crucial for our survival. But the nature of human groups means that we form alliances and support our friends in ways that are not always in the best interests of anyone. Political alliances may be of short-term benefit of politicians, but may not always serve the interests of citizens.

But what of irrationality, what of an understanding of flawed human psychology, in this mess? These flaws in human reasoning and in our human relationships all applied in the run-up to the fatal decision on Iraq. Individuals will be blamed, but it’s important that we also understand that psychological biases were at play and to make the necessary changes to legal, constitutional and political processes to improve the quality of decision making and prevent future mistakes.

As with the EU referendum, we should let the lawyers, politicians and civil servants do their jobs. We should actively inform and advise leaders of civil society as they sort out the mess in which we find ourselves. We can offer advice as to how we choose our leaders, form our groups and make our decisions. Above all, we need to choose and select people free, as much as possible, from the conceit of false wisdom.

Wed, 06/07/2016 - 14:00

Last night I attended the Gala Dinner of the Royal College of Psychiatrists held in the magnificent Painted Hall of the Old Royal Naval College, Greenwich. It followed the college’s annual congress in the huge ExCeL centre, with an estimated 3000 delegates. It offers an ambitious goal for what the BPS should aim for.

As someone who has occasionally annoyed our psychiatry colleagues through the things they think I may be implying in what they think I’ve written (but which I may not have said or they may not have read), it was interesting - and occasionally challenging - to be a guest at their celebration dinner. But it’s important, especially today.

It’s important because the world shifted under our feet this week. We’ve written a lot about Brexit this week – a joint BPS/EFPA statement, a letter to members and in The Psychologist - and there will be more to come.

We’re responding to the consequences of a decision taken by 33,551,983 UK citizens in conditions of high emotion, poor quality information and great uncertainty. Psychological science tells us that decisions made under such circumstances are dangerous things.

In situations of chaos, complexity and anxiety we use ‘heuristic reasoning’ rather than logic. We are swayed by our initial assumptions and by the most recent, most available and eye-catching information, irrespective of its truth or relevance.

We seek out information that confirms – rather than challenges – our assumptions and the company of people who agree with us. Once we’ve made our decisions, psychological science tells us that we tend to justify our actions with ‘hindsight bias’ and minimise any ‘cognitive dissonance’ with selective recall and attributing blame anywhere but to ourselves.

I’m struck by the fact that everybody that I follow on Twitter seemed to be of one mind. And now, after the decision, all my friends seem to agree with me. We are shocked by apparently perverse decisions, partly because we surround ourselves with people with whom we agree and whom we try to ensure agree with us.

I wrote last week about divisive and even xenophobic rhetoric.

If we are to understand the referendum decision, if we are to understand the psychology of social divisions, and if we are to have any basis for advising society about these important issues of psychology – as I think we must – we should also challenge ourselves.

It’s easy to speak to a mirror, and it’s easy to present your thesis to friends. It’s more challenging to listen to people with different experiences and attempt to engage those of different perspectives. But it’s vital that we are part of that debate. I hope I shall be able to remember that in the weeks to come, and remember to keep my ears open and my prejudices closed.

So last night, I had dinner with my friends in the Royal College of Psychiatrists. And… there was much more on which we agreed than on which we disagreed. As the next steps in this complicated political process become clearer, we will find common ground on which to stand together when action is needed.

Thu, 30/06/2016 - 14:42

Once again, in the horrific killing of MP Jo Cox, we’ve seen violent tragedy strike at honourable and charitable people. Our hearts go out to Jo’s husband Brendan and their children.

As Brendan has said, we should “work every moment of our lives to love and nurture our kids and to fight against the hate that killed Jo.”

We all share, I’m sure, Brendan’s views: “She would have wanted two things above all else to happen now, one that our precious children are bathed in love and two, that we all unite to fight against the hatred that killed her. Hate doesn't have a creed, race or religion, it is poisonous”. As citizens as much as psychologists, we need to review and consider how we work together to combat such hate.

Once again, we do not know the complex motives and reasons for the attack on Jo, just as we do not fully understand the background – political and psychological – of the homophobic attack in Orlando, the Germanwings tragedy or the neo-Nazi violence of Anders Breivik.

But in each case we see considerations of psychological issues – in each case there is a fierce debate as to whether we should locate responsibility within the individual or, alternatively, look to wider, societal, causes.

We need to understand the full background to such tragedies, and that includes the psychological of the perpetrators. But, in that examination, we must ensure that we cast our investigation appropriately broadly; looking not only at the psychology of the individual, and the experiences and motivation of someone who can convince themselves that to do such an act is acceptable and justified, but also the psychology of wider society - the hate and prejudice, misunderstanding and warped political ideology that also must be recognised as contributors to this, and similar, atrocities.

As I have read and watched coverage of this issue, I have been slightly concerned to detect a binary distinction – between ‘mentally ill’ on the one hand and, alternatively and in contrast, ‘politically motivated’ on the other. I do not recognise such a clear distinction.

Sad and vulnerable, lonely and confused, angry and alienated people are swayed by hate-filled rhetoric that blames their difficulties on other, different, people and offers them a distorted picture of society. Indeed, it seems pretty clear that sad, lonely, confused individuals are more, not less, susceptible to such messages.

This might make the picture more complex than a typical tabloid leader column, but it does, nevertheless lead to clear conclusions. It is vital and urgent that we put a stop to xenophobic, hate-fuelled, divisive and violent rhetoric in political and public life.

Find out more about my plans for this week.

Wed, 22/06/2016 - 10:47

The world is still in shock after the horrific events in Orlando last weekend, which left many people grieving for their loved ones and many more experiencing loss, distress, confusion and fear. In our statement this week, the British Psychological Society said it was vital to recognise that the attack had targeted the LGBT community.

While any hate attack is an attack on us all, it is important to acknowledge and give voice to the experience, so that we can more effectively support LGBT people who already experience high levels of discrimination and abuse, and, consequently high levels of psychological distress and mental health problems.

After a tragedy like this, society and the media tend to look for simple explanations. And as psychologists, we are often asked to explain why people commit such crimes, and what can be done to prevent them happening again.

It may be superficially attractive to examine the minds (or even brains) of the perpetrators to explain individual events. But our experience and the evidence we produce as psychologists means we have a responsibility to offer a wider picture.

It’s perhaps uncomfortable to accept that we are all, even those of us who commit terrorist hate crimes, products of the events and circumstances that shape our lives. We need to acknowledge that. And we also need to acknowledge that our response to such tragedies must look beyond individuals.

We will never know with any degree of certainty the details of the motivations and thought processes of perpetrators of crimes like these. Indeed we should avoid an undue focus on individual psychology.

But that doesn’t mean we as a society or as a discipline are impotent. It doesn’t mean we’re forced to face the impossible and unwieldy task of ‘changing society’. Excessive focus on individual psychological issues can draw our attention away from more effective solutions.

The Germanwings airline tragedy in 2015 was another disaster ultimately caused by the actions of one individual. It is right that we provide the highest standards of screening, preparation and support for pilots, and we are working with the Civil Aviation Authority and the airline industry to do so. But practical measures, such as enforcing a policy of always having two people in aircraft cockpits, are needed too.

In Orlando, the perpetrator of this crime was apparently armed with a handgun and a powerful assault rifle. As psychologists, we know that strong emotions of anger, fear and hatred are unfortunately commonplace. But this tragedy is a reminder that the combination of these strong emotions and access to deadly weapons is a highly dangerous one.

We should and must play our role in understanding these emotions and supporting the many people who were affected psychologically by this tragedy, but the fact that it was easy for someone to get their hands on deadly weapons is a result of political decisions.

President Barack Obama has called on Congress to reinstate the assault weapons ban as well as pass legislation to make it harder for suspected terrorists to obtain firearms. To quote President Obama: “to actively do nothing is a decision as well”.

Find out more about my plans for this week.

Wed, 15/06/2016 - 16:19

A great deal of my time is devoted either to asking other people to do things for us or, occasionally, telling other people what they should do. When we lobby, we’re asking politicians to change their plans or make decisions in ways that are important to us and to the people we serve.

But this week I’m shifting emphasis to highlight the things we are doing to directly address problems ourselves. The most effective solutions – both those we deliver and those we demand - are those that combine our science and our practice.

Clearly, as psychologists, we can offer psychological therapies, which are vitally important in the campaign to reduce the use of psychotropic medication and can help design and research medication withdrawal programmes. This is central to BPS policy.

I’ve continued to argue for changes to the way we deliver mental health services. I’ve signed pledges aimed at reducing the use of psychotropic medication for people with learning disabilities (see the picture below), chaired a recent All Party Parliamentary Group meeting on the subject and have supported the wider call for action.

Armed with evidence of the links between social deprivation, psychological issues, mental and physical health problems and social challenges, we can offer leadership and examples of best practice in service delivery. This week we launched a guide for commissioners of specialist services for mothers, explaining not only how psychological expertise can be incorporated, but that evidence shows it’s what new mothers want.

We are launching guidance on the management of disclosure of historic child sexual abuse for psychologists, and those who employ them, who must respond to these complex and challenging situations. Both of these pieces of work are practical examples of how psychologists can help remind us all of the social context and social determinants of our mental and psychological wellbeing.

We have solutions for many of the challenges on which we are asked to comment. Our research evidence and practical experience can provide a framework through which these problems can be understood. And I am confident that our colleagues and those policy makers we advise value our contributions. We’re also in the latter stages of preparing responses to the two government consultations I mentioned last week.

My main concern is that we still struggle to get our message about the value of psychology across to the general public. I’m sure there’s an element of ‘Catch 22’ here; as our work becomes ever more widely appreciated by the general public, and discussed in the media, it’s inevitable that we’ll get better at speaking to those audiences. The onus is on us to showcase what we do and communicate clearly with all our audiences.

Things are improving - when I first set out in this career 25 years ago, people didn't really know what psychologists are or what we do. But now, partly thanks to all those members who regularly engage with the media, psychologists are introduced to viewers and listeners in the confident (and correct) belief that the audience is (now) aware of our work. And that, I think, is good news.

Find out more about my plans for next week.

Wed, 08/06/2016 - 10:48

We are always actively seeking members’ input to a great number of live consultations on policy issues related to psychology. Right now, two are particularly worthy of mention.

 In April, following the comprehensive spending review and significant further pressure on public spending in health and social care, the UK government announced that: “From 1 August 2017, new nursing, midwifery and allied health students will no longer receive NHS bursaries. Instead, they will have access to the same student loans system as other students.” That means  nursing and other healthcare students will soon be required to take out loans to fund their training.

The Department of Health has launched a consultation on how to implement this change and we are seeking our members’ views on how to respond. We are deeply concerned about the possible impact on these students, and therefore on the ability of the health and social care systems to deliver the services upon which we all rely.

Although student loans are now the norm in England and Wales, this is not the case across the UK as a whole. I remain committed to the idea that free, universal, education is an ideal of any civilised society. More importantly, for these particular students, the prospect of tens of thousands of pounds of additional debt at the end of training will have a negative impact on the future of these professionals and the patients in their care.

Our response is likely to stress the unwelcome nature of these changes for the overall delivery of psychological health care. Providing the best standards of care requires many different types of healthcare professionals working together in multi-disciplinary teams – any negative impact to one part of the system will have a knock on effect.

Currently, training for Clinical Psychology and some other mental health professions (including psychological therapists in the IAPT programme and child psychotherapists) that are funded indirectly by Health Education England are unaffected.

We are cautiously reassured that psychologists have been spared from the effects of these reforms for now. This move reflects the recognition that psychologists in training deliver invaluable services to the NHS… much like our junior doctor colleagues.

At the same time, a different arm of the political octopus – the House of Commons public accounts committee (not, technically, an arm of Government, but holding government to account) – has announced a call for evidence on the topic of ‘improving access to mental health services’.

The public accounts committee noted various positive steps taken (or announced) in this area: clear commitments from the prime minister and the Department of Health to improve mental health services, for ‘parity of esteem’ between physical and mental health, and, therefore clear access and waiting time standards.

The committee has raised concerns, following a rather sceptical report by the National Audit Office that said the cost of improving access to psychological therapies (IAPT), early intervention in psychosis and liaison psychiatry services could be 25 per cent higher than clinical commissioning groups have spent in the past and that their budgets may not stretch.

The British Psychological Society will be making a written submission to the Committee. Our view is likely to be that it is not only welcome but necessary, to follow through with these ‘Parity of Esteem’ commitments. People have a right to expect the NHS to provide NICE-recommended care whether in the field of physical or mental healthcare.

Investment in health and social care is not only a moral imperative and necessary for a well-functioning society, but it also represents value for money. Psychological health, particularly preventative and early intervention services, represents a clear net saving to the public purse in the avoidance of higher, future, costs.

The BPS has a stronger influence if we respond in one unified voice. If you wish to add to our discussions please contribute by emailing the Society consultations address or contact me directly. 

Find out more about my plans for next week.

Wed, 01/06/2016 - 15:07

The cliché is that we should fix our own oxygen masks before helping others. Working in a therapeutic profession is a privilege, but there are good, even self-serving, reasons to ensure that those professionals changed with helping others are properly protected.

Many of us have been concerned by apparent pressures on junior doctors and proposals to require young people entering nursing and other professions to take out loans to fund their training. And there are pressures on the ‘psych’ professions, too.

A short time ago, we reported on the findings from the joint British Psychological Society and New Savoy Partnership staff wellbeing survey. This revealed worrying apparent increases in staff stress since a similar survey in 2014, with 46 per cent of psychological professionals surveyed reporting depressed mood and 49 per cent reporting feeling they are a failure. Seventy per cent of the 1348 people surveyed said they were finding their job stressful. More details of the survey, and the results, can be found in a detailed paper.

I’m delighted that the BPS, in collaboration with the New Savoy Partnership and with the support of Public Health England, launched a Charter for Psychological Staff Wellbeing and Resilience. But we also have a responsibility to act.

So, on 21 June, at the BPS London Offices, we’ll see the next stage in this process, when Jamie Hacker Hughes (Vice-President of the BPS) and Jeremy Clarke (Chair of the New Savoy Conference) will launch a Collaborative Learning Network to share best practice on practical measures to improve staff wellbeing.

We have an obligation to our colleagues and to those who use our services to ensure that our workplaces are compassionate and safe. We need to use our skills to facilitate accountable autonomy, reflective practice, participation in decision-making, staff engagement and creation of a non-discriminatory ethos, where difference and diversity are meaningfully sought alongside work-life balance. These are valuable for us as employees, but they are also vital if we are to have compassionate and empathic services.

Find out more about my plans for next week.

Wed, 25/05/2016 - 11:13

I had the great pleasure to be in York on Saturday, marching in support of colleagues calling for proper investment in mental health services in the city. It is ridiculous, in one of the wealthiest nations on earth, to be fighting for the most basic of social services. But the march and rally were great, and I am heartened by several elements of the day. 

The local people, and media, were welcoming and positive and there was strong support from local and national politicians. I was delighted to be shoulder-to-shoulder with colleagues from Psychologists Against Austerity and sharing the speakers’ platform with the local MP Rachel Maskell and Len McClusky from Unite.

Having been a clinical psychologist for 25 years, I was delighted to hear the message that psychological health is a matter for everyone -  one-in-one, not ‘one-in-four’ - and that our psychological health (and therefore mental health services) is intimately linked to social circumstances and the economic, political and material health of civic society. That message needs to be repeated and clarified - hence my visit to Channel 4 on Tuesday, to attend a meeting discussing media portrayals of mental health problems – but I think it’s getting across. I was delighted, for example, that Alistair Campbell has started talking about mental health as an issue that touches ‘one in one’, not just ‘one in four’ of us. For me, this is a welcome recognition of our shared humanity and common psychology.

Otherwise, issues around work and psychology have dominated my email inbox and Twitter account this week. We’ve seen reports of psychologists themselves issuing ‘zero-hours contracts’, and unpaid intern posts for people wanting to enter professional psychology careers. Is this a growing trend that BPS Members and other readers of the blog would like to share their views on?

We’ve also seen increasing discussion of the impact of Work Capability Assessments, the DWP’s in-work progression trial and sanctions in our benefits system. We’ve seen sexism in the workplace and we’ve seen further discussion of the importance of maintaining the psychological health of workers in the NHS.

So… two questions (for the comments section below, perhaps):

  1. What are readers’ views on psychologists issuing zero-hours contracts or contracts for unpaid interns?
  2. Is the time right for a British Psychological Society Presidential Taskforce on ‘Work and Psychology’?

Find out more about my plans for next week.

Wed, 18/05/2016 - 11:21

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