It important to say that any success I have enjoyed in my career has, for the large part, come about because I have been ‘in the right place, at the right time, with the right people’. Definitely the right people!
I first became a registered nurse 53 years ago in late 1972. My nurse training, in what could now be described as an ‘apprenticeship’ model, took place almost entirely in hospital settings, with an on-site ‘School of Nursing’. Following my registration, I worked as a charge nurse and clinical teacher. I then obtained a place on what is now regarded as a landmark development in mental health nursing: an 18-month, full-time training course in evidence-based psychological therapies (Gournay, 2000).
The skills that I had acquired then served me well until I eventually retired from clinical practice in late 2023. During this training, I began to appreciate the need to always approach my clinical work with a question about the evidence that supported my treatment intervention.
In 1978, I was appointed to the post of nurse therapist in the psychiatric unit of a general hospital, where I continued to work first on a full- and then on a part-time basis for the next 17 years. In that time, I provided treatment to people with obsessive compulsive disorder, phobic anxieties, health anxiety and some sexual problems. I also developed expertise in the treatment of individuals involved in a range of traumatic events that occurred in road traffic accidents, major disasters, terrorist incidents and theatres of war. I provided psychological treatment to women, and sometimes their partners, in the aftermath of stillbirth and perinatal death.
During this period, I was supported by the NHS to pursue part-time education, obtaining a PhD in psychology, based on the evaluation of treatments for agoraphobia (Gournay, 1989). This research inspired me to continue the pursuit of evidence. I was then able to lead, while still employed in the NHS, a 3-year research programme funded by the Department of Health, together with the late Professor Julia Brooking. It involved an evaluation of the work of community mental health nurses in primary care, employing a randomised controlled trial and an economic evaluation (Gournay and Brooking, 1994; 1995).
During this period, I also decided that the award of a PhD was just the beginning of the education that I required to develop my research career further and I obtained part-time postdoctoral education in epidemiology, health economics and statistics.
Multiple roles
This background enabled me to become the Professor of Mental Health at Middlesex University. It was here that I developed what was the UK's first multidisciplinary master's degree in the mental health interventions that supported the developing network of community mental health teams and crisis intervention services. Throughout the development of this programme I was able to visit, and learn from, innovative services in the USA, Australia and New Zealand, where I formed collaborations that endure to the present.
In 1995, I became the first Professor of Psychiatric Nursing at the Institute of Psychiatry (now the Institute of Psychiatry, Psychology and Neuroscience), King's College London. I took the decision then to ensure that I remained in part-time clinical practice. This connection with the real clinical world, while spending most of my time in academic life, has, in my opinion, been of enormous importance.
Because I became a chartered psychologist and then a practitioner psychologist, I have been asked how I regard myself. Some ask ‘Are you a nurse?’ and sometimes ‘Have you stopped being a nurse?’ For me, the question of a single professional identity fails to appreciate the developments that have occurred in core professions over past decades and an absence of the understanding of the central need for multidisciplinary working.
In addition to continuing to work in two core professions, I am also a chartered scientist and am very active in not only the Royal College of Nursing, to which I was elected as a fellow in 1998, but also as a fellow of the Royal Society of Medicine, where I serve on the Psychiatry Council.
I am also enormously proud to be a Fellow of the Academy of Medical Sciences and an Honorary Fellow of the Royal College of Psychiatrists. My elections to these bodies have, in a sense, become an opportunity for a process of two-way learning and understanding. Apart from what I have learnt from my colleagues from other professional backgrounds, I have also been able to educate colleagues about the rapid evolution of mental health nursing practice (Gournay and Carter, 2021).
Research interests
Since my early research on agoraphobia and then community mental health nursing, I have been able to contribute to research in a wide range of areas of psychiatry and, more generally, health care. This research has included grantfunded studies of acute inpatient care, the testing of models of training, medication management for mental health nurses, evaluations of the treatment of a number of psychiatric conditions, studies of staff stress and being part of groups that have conducted systematic reviews of literature.
At the beginning of my appointment to the Institute of Psychiatry, where I was also Chair of the Academic Board for two years, it became clear that one of my core responsibilities was to set about building an infrastructure of research skills for the future. I have thus supervised many master's and PhD students and obtained Medical Research Council, NHS and other funding for research-training fellowships at preand postdoctoral levels.
Policy development
Over the past 30 years I have become very interested in the matter of comorbidity, namely the combination of mental health problems and alcohol/substance use. In that time, I have worked with colleagues in Australia and have assisted in the development of (Australian) national comorbidity guidelines (Marel et al, 2022). More recently, I took part as a coauthor of a review of research that supported the Australian Federal Government in its response to the COVID-19 pandemic (Bower et al, 2023).
In the UK, I have had input into a wide range of government policy initiatives. This has included chairing the guideline development group for the National Institute for Health and Care Excellence on the short-term management of disturbed/violent behaviour in mental health and emergency settings. This involved the development of a much-needed guideline on the observation of patients at risk in inpatient services.
I have also acted as a special adviser to the UK Joint Parliamentary Committee on Human Rights in respect of its work on deaths in custody (prisons, immigration centres, police stations and inpatient mental health wards) and have been a member of advisory groups for chief nursing officers, ministers and secretaries of state.
International projects
It has been my privilege to take part in a range of international development projects. This began when a nursing colleague, who was leading a programme to develop mental health services in Czechoslovakia following the Velvet Revolution of 1989, asked me to take part in multidisciplinary training initiatives. I was thus, in the first few years, able to observe the transition of services from the Soviet era up to the time of the separation of the Czech Republic from Slovakia.
It was from the mid-1990s onwards that I became involved in several other international development projects, notably one funded by the UK Department for International Development, aimed at developing mental health services in the Sverdlovsk Oblast in Central Russia, the capital of which is Yekaterinburg. My role was one of oversight, necessitating visits to services in both the very cold winter months and the short, hot, mosquito-laden summers.
After this period, I took part in a World Health Organization training programme in the Palestinian territories. In today's very tragic times, I have many fond memories of the Palestinian health professionals who I met then, but also of the Israeli health professionals I have met at international conferences.
In these and other projects across the European Union, and as an external examiner at the Chinese University in Hong Kong and in other countries, I have learnt a great deal. In a recognition of my contribution to international work, I was elected as Psychiatric Nurse of the Year in 2004, by the American Psychiatric Nurses Association.
On many occasions, my international experiences have caused me to reflect on the many good things that we tend to take for granted in health care in the UK.
Stressful, but enjoyable
In my clinical work, I have become aware that professionals such as myself are often not able to address the needs of people experiencing mental health problems. I have therefore served, variously, as a president, patron and trustee of a number of mental health and palliative care charities and contributed to service user-led programmes.
I am now regarded as an expert in matters relating to suicide and post-traumatic stress disorder. Following training in expert witness work, I have provided reports for courts, instructed by solicitors acting for patients and their families, the NHS, His Majesty's Coroners and other sources in the UK and the Republic of Ireland.
My publications include 17 books and monographs, both as author and editor, and I have contributed more than 300 chapters, articles and books, as well as conference papers. The publication of the second edition of my book, written with midwife colleague Dr Brenda Ashcroft, entitled Hope and Healing After Stillbirth and Early Baby Loss, was published in autumn 2024 (Gournay and Ashcroft, 2024).
A number of thoughts came to mind when I learnt that I had received this award. First, my professional life has been both enjoyable and satisfying, although at times somewhat stressful. I have also thought of the many people who have touched my professional life in so many important ways. To all of these individuals, who are far too many to mention here – a very big thank you.