Comparing the systems: working and studying overseas

Traveling for a year between school and starting university or between finishing university and starting work was and is not that unusual nowadays (the gap year). Traveling the world with a backpack or inter railing around Europe staying in hostels is a romantic and exciting idea. I myself spent a long 7 week summer inter railing around Italy with a friend in 2001. Lira was still the local currency and I was a young and carefree student, happy to survive on a diet of cheap bread, with an endless summer holiday that needed filling. Holidaying in a place is, however, a far cry from living it. In 2005 I moved to Melbourne and lived and worked and studied there. I was there for 5 years in total and I worked as a speech and language therapist for almost all of that time. I also did my Masters over there – through Flinders University.

Living and working in Melbourne – which is in the state of Victoria (Australia has six states- New South Wales, Western Australia, South Australia, Queensland, Tasmania and Victoria) was a great experience in all different ways. I worked at two large health networks over that period – Dandenong Hospital, part of Southern Health, and Royal Park Hospital, part of Melbourne Health. I worked across inpatient neuro-rehabilition, outpatients and homebased neuro-rehabilitation. My favourite was working in people homes. I got to meet so many people within the local community. I met Greek, Italian, Croatian, Lebanese, North African, Vietnamese and Chinese migrants. I met one pound poms who had famously traveled here by boat in the 50s, I met Australians who had been there for generations descended from explorers. I met a survivor of the Tiananmen Square Massacre in China and Australian indigenous people who were living in Melbourne. Working in another culture is a great experience. Not least that I got to understand the different social and political systems.

The health service in Victoria works differently to here. It is a public-private partnership. The unions negotiate the terms of employment for the health care professionals within the state. And each state is different. Consequently the networks employ everyone on these same terms- which are renegotiated every four years. Being a union member or representative as an allied health professional is usual in Victoria. In general patients are able to access acute and hospital care with no immediate costs to them. But to see a GP, or to have some non-acute services (e.g. maternity scans) you had to pay and then submit for a rebate through the Medicare system. If you didn’t have the means you could go to certain GP services who bulk billed the Medicare system, but this was not usual. Most of my friends had private healthcare and received tax rebates in compensation for this.

As a therapist working in an inpatient setting I was able to provide services in much the same way as I had done previously. Although in some outpatient and community settings we charged attendees a small nominal fee per week and we “sold” them the thickeners we prescribed. Selling thickener was a little tricky- occasionally I had to ask myself if someone was refusing to buy it because they didn’t have the money, because they didn’t have capacity or because they were making an informed decision not to follow my recommendations. As a therapist I was also happy to provide a much more evidence based and consistent service- I had annual leave cover when I went on leave and I had less constraints on the intensity and length of services I provided. We applied for funding to set up groups and delivered innovative multidisciplinary interventions for people with dementia.

I applied to do a masters in Clinical Rehabilitation at Flinders University and was able to complete the qualification via distance learning- much of the higher education post undergrad is delivered in this way over there. On this course we learnt a bit about delivering all types of services, even about telepractice to rural and remote settings. I found this a useful course to develop my clinical and research skills. I learnt about research methods and statistics. I completed a project supported by a local neurologist who acted as a mentor and celebrated my desire to undertake research.

When I returned to the UK I brought with me knowledge of a different approach to healthcare commissioning and delivering education. There are pros and cons to both the UK and Australian models. Neither are perfect but I certainly feel better off for having experienced both. Working and studying in Australia afforded me experiences that boosted my confidence and expanded my horizons. I wouldn’t hesitate to do it again. But, for now I am happy to be back in the UK, in London, at UCL.

Mental health in academia: my mental fitness strategies

It is increasingly recognised that people in higher education and academia are at particular risk of mental health issues yet often feel unable to speak about these issues for fear of losing face and being considered incapable of doing their jobs or finishing their studies. This issue isn’t of course particular to academia, there are many industries where speaking up about mental health issues may impact on the persons professional reputation and perceived skills. In fact broadly speaking mental health issues are still frequently a stigmatised issue in our society.

But we are getting better at this. Slowly. There is more money being invested in health care services and research, albeit not enough. People are more willing to share their personal experiences both with employers and colleagues, as well as with friends. I was recently at a conference where the lead academic speaker for the day from the hosting department shared her rationale for becoming interested in disability. This revolved around her own mental health and a very personal experience with depression and suicidal thoughts. This was also an extremely successful and impressive individual, who spoke eloquently and emotionally on both disability and mental health. What a breath of fresh air.

I confess I cannot say I have experienced any mental health issues myself as an academic. I  have been a bit up and down  at various points in my life though – and this is probably very normal (e.g. during my time as an undergrad studying at UCL when I was struggling with grades, friends and various social challenges; oh and when I got pregnant and neither my husband or I were employed, we had just moved countries and were living on my parents couch). These experiences have helped me understand myself. These experiences have helped me identify where my threshold is and what maintains my mental fitness.

Mental fitness is a term someone mentioned to me just yesterday- they were suggesting that mental fitness is a term we could use to describe how we keep ourselves mentally well and healthy. We discussed that actually we all have to work at this. That mental fitness requires work, specific strategies and that these are different for each person. Not all that dissimilar to physical fitness. For me my mental fitness regimes includes:

  • Exercise: I love to run. Or do any kind of exercise. I suspect that is why i found pregnancy so difficult. For a long period I couldn’t run during my pregnancy. I now run about 2-3 times a week, and sometimes I swim or ride my bike or even do some yoga. Without making time for these i notice I can’t concentrate on writing or reading quite so well, I get fidgety and my husband would suggest that I also get very angry! So even when I have too much work on- I still prioritise this. As I know that Ill work better for having been for a run.
  • Family and friends: I do not feel guilty for spending time with them. I make sure that when I spend time with my family I am present. with them. Equally, I do not feel guilty about not spending time with my family when I am working. Although if I am honest I feel guilty about both- but i try to keep a balance in terms of time This seems to balance the guilt so it doesn’t entirely overwhelm me.
  • Doing work that I feel is important: I have found that choosing work that feels valuable and worthwhile makes me feel like I have purpose. Sometimes when I am bogged down with something technical and tricky such as an ethics application or statistics or IT issues I find attending a support group, giving a presentation really helpful. Speaking to SLTs and people with PPA who will hopefully benefit from my work makes it worth it.
  • Getting work done: I also find I have a few strategies to make me feel like I am getting something done. Both clinical and academic work can sometimes feel like your wading through an endless bog of sticky mess, you turn another corner and there is another mile ahead of you with no end in sight. So I have learnt to highlight the things I do get done so I feel a sense of achievement. I have to do lists with every small or large activity listed. On a daily basis I tick of what I have achieved and carry over ongoing tasks. This makes me feel like I am actually making progress and not sinking into a pit of despair.
  • Prioritising: I really like to write blogs. I really like doing presentations. I really enjoy networking. So I prioritise them alongside the harder stuff. I make sure every hard piece of work I do I reward myself or prioritise the work I feel I am better at. Even if it isn’t as ‘valuable’ or as ‘important’- it is important to me.
  • Diet coke: For those who know me well they will also know that I drink a lot of diet coke. I do so love diet coke, It makes me ever so happy. And although I know it could perhaps be bad for me- I drink it. And I love it. It provides me with quality of life. So my last tip is enjoy the odd sin! Even if my mum, my children and lots of friends and colleagues suggest it might be bad for me I feel no shame and no guilt when I crack a can in a meeting or a talk. Diet coke makes me feel better when nothing else can!