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Welcome to the Oxford Psychiatry Podcast series.

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I'm Charlotte Allen, and today I'm here with Mina Faizal, who is a research fellow and consultant and child and adolescent psychiatry.

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Her research focuses on the mental health of refugees and asylum seeking children,

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and she looks at how to develop services to better meet their needs. Welcome, Mina.

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Thank you for talking to us today.

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Before we talk about your research, could you just tell me a bit about your career so far and why you chose to do psychiatry?

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So I am trained in medicine. I always love medicine.

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And I was always interested in chronic diseases and chronic illnesses.

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I thought I might get into pain, but in my training, I took a year out and I did a degree in social anthropology, OK?

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And at that time I became really interested in different cultural expressions of mental illness.

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And that really started me very curious about social environments and the interplay between cultures,

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societies and biological processes and materials and services, such and such.

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And the party I always thought that I probably would end up in psychiatry because it looked at the

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areas that I was most interested in and busted in a way that I thought was quite fascinating.

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What role does the factors of our everyday lives potentially play?

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A biological processes in our body says a more unusual route into psychiatry.

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Yes, well, I've actually come across many versions of similar anthropological interests, actually.

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So not that's atypical. And the other thing I did a lot of was travel quite a lot.

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So I spent any opportunity that could abroad.

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And so that also, I suppose, further cemented my interest in different cultures,

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expressions of mental illness and kind of all the same illness, the different cultures.

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And and so that started me on my path.

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What training did you have to do after you've finished your medical degree? So that I did.

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I took a couple of years just in general medical subjects, including neurology, accident and emergency things that were quite important.

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And then I started training in psychiatry in Oxford and quite early in my career first when travelling.

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So I went to work in Australia with the Aboriginal population as a psychiatrist in a remote part of Australia.

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And then I I suppose what I have done is I've never rushed my training, so I took an extra year at a lower rate to do what interested me.

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And so having throughout my career, taking years of life possible some different pursuits, different interests.

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I also kind of travelled and I spent a year longer at a lower grade so that I

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could do a year of psychotherapy training and also start my research career.

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That became essential because if I hadn't taken my time, I probably wouldn't have started doing research.

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And what inspired you to start doing research in the first place?

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Well, I was really curious. I love being a clinician. I love clinical work.

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So it was never a desire to be away from that. But that was just so much that I think is an answer and there's so much that needs research doing it.

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So I started off doing part time clinical working part time research, and I continued that for about ten years.

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So kind of completing my high psychiatric training alongside research.

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And how did you find that balance between doing a part time clinical working, part time research?

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It really suited me. So you often feel like you're never doing anything particularly well, but that also kind of keeps everything quite interesting,

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because whenever you do something, it feels like it's a real treat and it's quite new.

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And it suited me because my interests are very clinical and I remain that way.

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And that now my main research interest is in refugee children, but also it's just school based mental health services in general.

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So my research has always been very clinically driven and is now very much in services.

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And I have to provide services and change services and make services responsive to the needs of clinical population.

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But not since you're very much a clinical academic combining both parts.

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Yes, can I say a bit more about the focus of your current research?

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Well, I've been working for many years in refugee,

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looking at refugee children and thinking about how they were not presenting in

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traditional mental health services in the numbers that you would expect them.

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And yet they're all at schools that I was involved in,

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a project that I just decided to provide the of service within the school context rather than the traditional hospital clinic setting.

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And that became quite an interesting area of work because we were working with schools very closely.

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We work in an environment where these young children were spending the majority of their time and they seemed to like to be in a CSA school.

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So we'd have that much if you were in a DNA race for not attending appointment rates.

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And so it just seemed quite important. And teachers wanted to increasingly talk about all children, not just the subgroup, sort of, you know,

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any child that they thought might benefit from some mental health and put of some thinking around their needs within the framework that we can offer.

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And so I spent about 10 years working with refugee children, asking questions, conducting research, trying their baseline levels of inner needs,

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evaluation service before and after, conducting qualitative interviews with refugee children who'd been seen by themselves at school.

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And interestingly, in those interviews, the vast majority of children said they preferred to be seen at school than anywhere else.

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So quite a shift to help mental health services. And usually that's right.

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Yes.

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Yeah, it's actually if you step back and look at countries like the United States of America, they have over 2000 school based mental health clinics.

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And if you go to their psychology conferences, I went recently to one and almost a third of psychiatrists that other psychiatrists call

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themselves schools that identify themselves as somebody who was in the school setting.

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And yet that isn't something we do here. And so I've been working quite closely with lots of health, NHS, Foundation Trust,

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which is a local trust here to develop a model of bringing mental health services into the state funded sector schools.

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And we're just starting that now. So it's come directly out of my research trust,

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but it's a clinical application that's being generalised to children and we're trying to work out how to evaluate that,

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how to properly, how to make the findings useful, you know, for schools and services across the country.

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So that's a great example of how your research is really shaping clinical

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services and shaping clinical practise and having a direct benefit to patients.

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Well, we hope so. We have to see what we have to make sure we evaluate it properly.

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We ask the right questions. You know, it's likely that a proportion of children will much prefer to be seen at school.

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And, of course, the children won't want to see the school.

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But we would hope that actually thinking about education, health shouldn't be two separate things.

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We shouldn't be thinking the schools, the education and the mental health services in the mental health is actually it makes no sense

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to me that mental health services are much better integrated within the education system,

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because what we know is that, you know, mental health assists in your academic of time,

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that if you've got, you know, academic difficulties, that it would be of value to do a full assessment.

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And actually, mental health is integrated fully.

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Part of that is that project keeping you busy for the moment, or have you got other ideas of what you want to do in the future?

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Well, my main my main funding comes to the NIH, where I have a post-doctoral research fellow looking at developing tools,

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psychotherapeutic tools for teachers, teachers and school staff to use with refugee children.

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So that's just the side. And just the bulk of my work is that.

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But actually, I'm hoping that the instruments that I developed, I'm not at all the trial on General Teachers for children so gives me an opportunity

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to immediately extend my research question to make it more generalisable.

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OK, that's great.

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If anybody wants to learn more about your research or if they want to get involved in doing research for the how after they contact you,

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I think the first thing is to encourage anyone who's interested in these kind of questions to contact, you know,

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anyone of us in the department here in Oxford and just to do it, you know, it's hard work, but can be very interesting.

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If you're into some of these kind of questions, you can email us.

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You can look on the websites, either department website or my own website to learn more about the work that's being done in publications where.

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Producing whether they're interested. Thank you very much.

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That's great to hear a little bit about your work with refugee children and good luck for the rest of your search.

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Thank you.