Paying it forward: the consultant psychiatrist

John Mulinga started working in mental health after meeting the first consultant in his career who was truly welcoming.

“This consultant wanted to know a bit about me before we started the training, which was quite different to the other roles I’d had,” says Mulinga, who works as a consultant psychiatrist for Lancashire and South Cumbria NHS Foundation Trust.

“I’d never had a time before that when the consultant said, ‘Sit here and let’s just have a chat about who you are, what you want, or how we can best help you.’ But that’s exactly what happened when I started with that psychiatric consultant. At the end of my three month placement my mind was made up to stay.”

Mulinga had wanted to be a doctor ever since being rushed to hospital as a child after drinking from a bottle of what he thought was water—but which turned out to be paraffin. Watching the medical staff as a 5 year old motivated him to pursue medicine as a career throughout his school years in Malawi.

He was one of three students from the southern African country who secured a British Council scholarship to study medicine at Manchester University, arriving in 1979. While it was a big change for a young man who had never left his home country before, he and the other two students supported each other, he recalls. “One of the good things was that there were already a number of Malawians studying in Manchester, so they looked after and supported us as well.”

He has stayed in the north west of England ever since and after four decades in the NHS, two of those as a consultant, he has recently dropped down to a part time role.

During his career Mulinga has specialised in psychiatry for older people and those with substance misuse problems. Caring for older people with mental illnesses, with the opportunity to understand and unpick the impact of their comorbidities and medications, is an area he has found rewarding and stimulating.

Another area of interest has been the misuse of alcohol and benzodiazepines in older people, which can be much harder to pick up than in younger people. “While in younger people you may see problems at work, road traffic accidents, or fights, as older people tend not to be working they are more likely to be drinking at home and may present more with falls, bleeding, or depression,” he says. “Another important area of work has been with the memory clinic, as alcohol can be an important factor in memory problems for older people.”

Alongside his clinical work, Mulinga has been dedicated to supporting junior members of staff throughout his career. This includes preparing resident doctors for their membership of the Royal College of Psychiatrists exams, and, once a consultant, becoming an educational and clinical supervisor.

Supporting international medical graduates who have joined the NHS has also been a focus for Mulinga, and he served as a tutor for specialist, associate specialist, and specialty doctors for three years.

Throughout he has set out to replicate the welcome that he received when he joined psychiatry. “The experience I had with my first consultant in psychiatry stayed with me,” he says. “I try to see if I can make trainees feel welcome—feel that we’re actually interested in supporting them and interested in them. We are all different, but we all have something to contribute. It’s only when we understand our strengths and weaknesses that we can help each other.”

Mulinga spends time talking to new recruits, sharing information about himself and inviting them to do the same. “I ask them what they’ve done, what their aims and goals are, and how they like to do things.”

He says it can be challenging when young doctors rotate into psychiatry and make it clear that they are only there because they have to be, and don’t want to engage. A deeper understanding of mental health can benefit doctors who want to specialise in any area, he says.

Flattening the hierarchy so that less experienced doctors can speak up is also important. “I want us to treat each other as equals,” he says. “I’ll say to them, ‘If you see me do something that you’re not sure about, don’t shy away from asking me why I’m doing it.’ I want to create an atmosphere where people can bring out their best.”