Disillusionment amongst clinical staff experiencing repeated change.

OBJECTIVE: To describe disillusionment amongst the clinical community as a result of repeated ideological and organisational change and to suggest a road map forward. CONCLUSION: Despite knowing that change can be disruptive, it will likely remain a constant and necessary feature of organisational life. Various approaches, including the development of a personal sphere of influence and knowing when to resign, are considered.

Silent reflections remain unheard.

OBJECTIVE: To consider the contribution of non-clinical factors in the rising rate of mental health presentations and explore the associated silence within the psychiatric profession. CONCLUSION: Medicalisation, concept creep and group think, alongside societal demand and expectations, have collectively contributed toward a distorted view of mental health and illness. Equitable service provision has been hindered by the silence of important perspectives.

Long COVID - Can we deny a diagnosis without denying a person's reality?

OBJECTIVE: The aim is to consider Long COVID not as a new clinical entity but as another example of a disabling, historical phenomenon. CONCLUSIONS: A triad of polymorphic symptomatology, an elusive pathophysiological explanation and a hostile defensiveness has appeared throughout history. The reluctance to consider these contextually may delay early intervention and appropriate patient care.