Uncharted territory

Abstract

The Royal College of Psychiatrists' Strategic Plan 2015–181Royal College of PsychiatristsStrategic plan 2015–18. Royal College of Psychiatrists, London2015http://www.rcpsych.ac.uk/pdf/Strategic%20Plan_Le1254_5FINALWEBSITE.pdfGoogle Scholar outlines its vision “to improve the lives of people with mental illness through patient-centred care” and is supported by the values of professionalism, fairness and inclusion, research and innovation, ethical practice, lifelong learning, and multidisciplinary working. I suggest that to implement its vision fully, the College needs to develop and establish a broader set of values with the inclusion of coproduction. This change would enable more effective evidenced-based and values-based decision making and practice in mental health care. Just as we need evidence-based medicine because of the increasing complexity of the evidence underpinning medical decision making, so increasingly do we need values-based medicine because of the increasing complexity of the values underpinning medical decision making.2Fulford KWM Values-based practice: a new partner to evidence-based practice and a first for psychiatry?.Mens Sana Monogr. 2008; 6: 10-21Crossref PubMed Scopus (78) Google Scholar Clincians practising psychiatry undoubtedly have values by which they operate and adopt on a regular basis, but to date these values have not been fully articulated, codified, or explained in how they relate to each other. The Royal College of Psychiatrists in Wales, UK, has developed Core Values for Psychiatrists CR2043Royal College of PsychiatristsCR204. Core values for psychiatrists.http://www.rcpsych.ac.uk/usefulresources/publications/collegereports/cr/cr204.aspxDate: September, 2017Google Scholar and a Core Values Framework,3Royal College of PsychiatristsCR204. Core values for psychiatrists.http://www.rcpsych.ac.uk/usefulresources/publications/collegereports/cr/cr204.aspxDate: September, 2017Google Scholar which seek to address this need for clarification. The hope is that these core values will influence professional identity,4Richards V Parity begins at home.Lancet Psychiatry. 2015; 2: 1051-1052Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar the curriculum, training, clinical practice, and assessment, and aid patient-health recovery outcomes. The Core Values Framework enhances the delivery of the 12 principles outlined in the Royal College of Psychiatrists Code of Ethics CR186.5Royal College of PsychiatristsCR186. Good psychiatric practice: code of ethics.http://www.rcpsych.ac.uk/usefulresources/publications/collegereports/cr/cr186.aspxDate: March, 2014Google Scholar It provides context to understand the attributes and skills indicated in the Royal College of Psychiatrists' Good Psychiatric Practice guidelines CR154,6Royal College of PsychiatristsCR154. Good psychiatric practise (third edition).http://www.rcpsych.ac.uk/usefulresources/publications/collegereports/cr/cr154.aspxDate: May, 2009Google Scholar and it also reflects the requirements detailed in the General Medical Council's Joint Statement of Professional Values.7General Medical CouncilGood medical practise.http://www.gmc-uk.org/guidance/good_medical_practice.aspDate: 2013Google Scholar To illustrate the complexity of the values and dynamics in the consulting room, Simon Wessely commented in his President's blog on the overuse of treatments, tests, and diagnoses, “Are we doing too much?”; “To add to this dilemma, patient expectations are increasing, and there is often an onus on psychiatrists to ‘do something’ at each consultation.” I responsed to this blog saying that I thought the over-riding aim of most patients is to engage in a genuine dialogue with their clinician and address the question of how to move towards recovery and their own aspirations, not to access the newest test or treatment. The integration of a values-based and evidence-based approach in psychiatric practice, in my view, is a more secure and sustainable approach. The questions that will arise from this approach are the ones that we should be addressing, and out of that conversation should naturally follow the valid aims of Choosing Wisely8Malhotra A Maughan D Ansell J et al.Choosing wisely in the UK: the Academy of Medical Royal Colleges' initiative to reduce the harms of too much medicine.BMJ. 2015; 350: h2308Crossref PubMed Scopus (103) Google Scholar and Prudent Healthcare,9NHS WalesHealth and care standards. Welsh Government.http://www.wales.nhs.uk/governance-emanual/health-and-care-standardsGoogle Scholar and the informed use of diagnoses and resources. Core Values for Psychiatrists is a timely document that underpins key reports from the Royal College of Psychiatrists. Its application could strengthen the fabric of mental health care and have a positive effect on processes and outcomes for both clinicians and patients. Initiating and developing a substantive and collaborative piece of work with the Royal College of Psychiatrists has been, for me, a rewarding journey of trust and coproduction. Uncharted territory? Hopefully navigation in the current UK psychiatry landscape will be enhanced by the signposts developed in the Core Values Framework. I declare no competing interests.