Psychiatrists 'on the edge' as care crisis worsens

CASE STUDY; Day of danger for a stressed doctor

By 8am on Friday, Dr Martin Deahl, a consultant psychiatrist at Homerton and Bart's hospitals, London, is in his office.

An hour later he is on his round of the acute ward. "We have 17 beds and 29 people needing them," he says. "Last year I admitted 460 people, all seriously disturbed ... People have to leave as quickly as they can, to make room for a more disturbed person."

He skips lunch to go straight to the emergency clinic, pursued by patients and relatives.

A schizophrenic patient has stopped taking his medication and is "going berserk in the community". "I'm physically too busy to do anything about it, so I have to send a junior doctor down to find this 6ft 6in huge guy ... [who] abuses drugs and is very dangerous when he is ill."

Dr Deahl is now 15 minutes late for a case conference for a patient who self-abuses. "When I turn up late it seems as if I'm not taking her case seriously."

Driving through London in heavy traffic, he is late for another meeting, this time with a schizophrenic and a council housing officer who is threatening to evict him because of complaints from the neighbours: "If this man is evicted ...he stress will lead to a breakdown, putting him back on the ward, and when he gets out he will have nowhere to live."

Dr Deahl leaves at around 6.30pm - nearly 11 hours after he started out. "I'm 39, and I already know my retirement date: 29 September 2014. That says something about morale, if you know it off by heart," he says.