Consultants need good support systems to deal with the stress of their everyday work (Reference Holloway, Szmukler and CarsonHolloway et al, 2000). Mentoring in the form of regular meetings with an experienced colleague has been proposed as one way of supporting both specialist registrars who become consultants and more senior consultants (Reference Roberts, Moore and ColesRoberts et al, 2002; Reference DeanDean, 2003; Reference DosaniDosani, 2006). In the west of Scotland there are ‘transitional groups’ where senior specialist registrars and newly appointed consultant psychiatrists meet with a consultant psychotherapist and an organisational consultant to discuss work-related issues (Reference Wilkie and RaffaelliWilkie & Raffaelli, 2005). The groups are based on a waiting list and do not cover the whole of Scotland. Recognising the need to provide additional systems of support across the whole of Scotland, the Scottish Section of Child and Adolescent Psychiatry established a mentoring scheme in 2000.
Child and adolescent psychiatry mentoring scheme in Scotland
The scheme aims to offer a mentor to all newly appointed, as well as established, consultant child psychiatrists. Two national panellists on each consultant appointment committee meet with the candidate who, following the job interview, has been offered the consultant post to explain the scheme and provide a list of mentors they can contact. The scheme is also advertised at annual meetings of the Scottish Section of Child and Adolescent Psychiatry, with further information provided on request by the coordinator of the mentoring group. Currently, there are eight senior consultants who act as mentors, all volunteers and coming from all parts of Scotland. They work in a different health board area to that of their mentee and arrange meetings or telephone discussions with them on work-related issues as often as the mentee requires and usually for no longer than a year.
Mentors themselves meet annually to provide a support network and discuss difficult issues that have emerged during mentoring; these discussions are strictly confidential and all references to mentees are anonymous. The problems that have emerged included clinical issues such as the management of unusual or particularly difficult cases, strategic planning, service delivery and relations with colleagues or within teams. These last two issues are the most commonly discussed and cause the greatest concern.
Since the mentor/mentee relationship is strictly confidential, it was impossible to find out whether all newly appointed consultants have a mentor and whether the scheme was universally known. Consultants who had come from training schemes outside of Scotland, such as locums, often had weak links to the local consultant community and frequently worked in challenging posts. Some consultants had problems finding a mentor within reasonable travelling distance as most mentors were based in the west of Scotland. We conducted an audit of the mentoring scheme at the beginning of 2007 to investigate mentees’ satisfaction with it and suggestions for improvement.
Mentoring survey
We sent a questionnaire to all consultant child psychiatrists in Scotland in February 2007, asking about the year of their appointment to the consultant grade, use of mentoring, whether they were satisfied with the scheme and their ideas on how it could be improved. Altogether 69 questionnaires were sent and 44 returned, giving a return rate of 64%. Responses were anonymous and information on non-responders was not available, precluding an evaluation of possible bias in the results.
Results
Since the start of the mentoring scheme in 2000, 21 respondents became a consultant and 15 used the scheme (Table 1). The other six said they had not been aware at the time of their appointment that such a scheme existed, but all but one had used an informal mentor.
Table 1. Use of and satisfaction with mentoring scheme according to date of appointment to consultant grade1
| Date of appointment | Number of consultants appointed | Used mentor from scheme | Happy with mentor from scheme | Not happy with mentor from scheme | Used informal mentor outside of the scheme |
|---|---|---|---|---|---|
| Consultant before 2000 | 23 | 4 | 4 | 0 | 162 |
| Consultant 2000-2001 | 3 | 3 | 3 | 0 | 2 |
| Consultant 2002-2004 | 9 | 6 | 6 | 0 | 53 |
| Consultant since 2005 | 9 | 6 | 6 | 0 | 6 |
There were no negative comments and mentoring was very highly valued by all who had used it (Box 1), including the four respondents who were already established consultants at the time the scheme originated in 2000 and used a mentor from the scheme.
Respondents’ suggestions on how the scheme could be improved were: more information about the scheme at the time of appointment, written details of how the mentor/mentee relationship was expected to operate, greater availability of potential mentors (including better geographical spread) and recognition in job plans for dedicated time for mentoring (Box 2).
Box 1. Views about the mentoring scheme
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• ‘Invaluable perspective of more senior colleague’
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• ‘Help in understanding responsibilities/systems/team dynamics’
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• ‘Crucial to bounce ideas about team and personal development off a trusted, more experienced colleague. Has stopped me making some big mistakes!’
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• ‘Meetings with mentor helped adjust thinking to a more long-term strategic way’
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• ‘Unbiased listening ear with very useful advice’
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• ‘Objective experienced impartial viewpoint invaluable – reduced anxiety of new post’
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• ‘It has been extremely useful to have someone more senior and outwith the local situation to discuss situations with – it has been extremely supportive’
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• ‘Reassurance/encouragement. Information as to what is happening in the profession as a whole’
Box 2. Suggestions on how to make the scheme better
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• ‘Tell people about it!’
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• ‘Dedicated time off for mentoring’
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• ‘Make more mentors available’
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• ‘Written info/suggestions sent prior to starting’
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• ‘Information about scheme could be given at interview’
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• ‘More accessible list of potential mentors’
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• ‘A greater number of mentors outwith the west of Scotland’
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• ‘Written info operationalising role/expectations of mentor/mentee relationship’
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• ‘Would be useful to be sent a list of mentors [with information on] how to contact them’
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• ‘Acceptance (by management) of more face-to-face mentoring’
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• ‘Dedicated time off for mentoring so I don't have to steal time from other things – should have protected time for this’
Discussion
Having a supportive colleague can lead to better job satisfaction and lower the job stress (Reference Rathod, Roy and RamsayRathod et al, 2000; Reference Littlewood, Case, Gater and LindseyLittlewood et al, 2003). Initiatives providing support for consultant psychiatrists have included stress-busting groups (Reference Murdoch and EaglesMurdoch & Eagles, 2007) and trainee/consultant transition groups (Reference Wilkie and RaffaelliWilkie & Raffaeli, 2005). Mentoring is another way of providing support and has included everything from having a trusted older colleague to talk matters through, to intensive support during particularly stressful periods in a newly appointed consultant's professional life.
It has been difficult to make mentoring universally available in Scotland and a third of respondents who had been appointed since the start of the scheme had not used it. Furthermore, some consultants had problems finding a mentor from outwith their immediate peer group but still within manageable travelling distance. Recruiting mentors has been difficult as mentoring is time consuming and most mentors need colleagues willing to cover for time spent mentoring. Formal recognition within job plans for both mentor and mentee would improve availability of mentoring. Better publicity, greater availability of potential mentors and clarity about what could be expected from a mentoring relationship would all improve the scheme.
Conclusion
Mentoring for consultant child psychiatrists is strongly recommended and can provide invaluable support at the time of stepping up from a senior trainee to the consultant position. It can also be of great benefit to well-established consultants. However, a shortage of experienced consultants willing to become mentors and difficulties in making mentoring readily available across all areas of Scotland have limited the scope of the scheme.
Declaration of interest
The authors are all mentors on the Scottish child psychiatry mentoring scheme.
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