Background

Leadership and professional skills in the field of mental health have never been more important. Mental disorders are conditions of major public health importance, which can have severe consequences for both the individuals with lived experience and for those who care for them. Meanwhile, effective treatment options exist to reduce the symptoms of mental disorders and prevent disability.1 However, many individuals with psychiatric disorders have difficulty accessing appropriate mental health services, and one of the most critical factors contributing to this is the stigma surrounding mental health and disorders.1 To increase awareness in the field of mental health, combat stigma, and make mental health services more accessible, it is essential that mental health professionals develop leadership and professional skills that can help in the development of community-based mental health programs that are beneficial for individuals living with mental disorders.

Leadership skills are useful for both individuals in leading roles and professionals who are not in leading positions. Communication skills are at the forefront of these techniques. This includes the ability to listen and understand what others say, to express one’s goals and plans in a way that will arouse the interest and participation of others, and to share information in a way that can be processed adequately. These skills can be learned, practiced, and enhanced.2 Other essential skill sets concern the discovery of those most likely to be involved in the initiative the leader wishes to undertake and to share the vision, as well as the timing of the leader’s action and the ability to assess behavioral trends in a particular group of people and interpret them in the context of the larger environment.

An innovation of Professor Norman Sartorius, referred to by some as “the living legend of psychiatry”,3 created with a view of enhancing the professional skills and leadership qualities of early career psychiatrists (ECPs), the leadership and professional skills development courses have been organized regularly over the past 30 years. Professionals who previously attended the course described this experience as an authentic training and collaboration opportunity.4 The two main goals of this program, which first started in 1994, were to develop the leadership skills of early-career psychiatrists through intensive, interactive courses and to provide continuous support and mentoring to them when needed and possible after these workshops.2 The training program, which Professor Sartorius leads with the support of the Association for the Improvement of Mental Health Programme (AIMHP), a non-profit, non-governmental organization, continues each year in various locations, with the participation of over 2000 ECPs in over 100 countries worldwide to date.4

A Leadership and Professional Skills Course for Early Career Psychiatrists workshop was held in Timisoara, Romania, between 20-22 May 2024. Twenty ECPs from eight European countries participated in the program, organized and assisted by Associate Professor Catalina Giurgi-Oncu and Doctor Ioana Rivis on behalf of the Victor Babes University of Medicine and Pharmacy. The course was led by Professor Norman Sartorius and Professor Sir Graham Thornicroft. As three ECPs from Ireland, Romania, and Turkey who had the opportunity to participate in this experience, sharing a brief report about the course and reflecting on the program’s potential impact on our professional development was considered relevant.

Pre-course application and selection process

Applications for the course were received between February and March 2024. Professor Sartorius and Professor Sir Thornicroft selected 20 ECPs (psychiatry trainees or psychiatrists in their first five years after specialization) through an assessment of their resumés, motivation letters, and recommendation letters. One of the criteria sought was fluency in English, which was assessed through online video interviews during the selection process. The course participants were also provided the opportunity to attend the Romanian National Psychiatry Conference held in Timisoara following the course between May 22 and 25, 2024.

Course setting and content

Professor Norman Sartorius, Professor Sir Graham Thornicroft, Associate Professor Catalina Giurgi-Oncu, and Doctor Ioana Rivis were faculty members in this comprehensive three-day program. The main objectives of the training content were to encourage active participation of all participants to support the development of cooperation skills in a newly founded collaborative environment. This also helped in creating bonds between participants. The course started early in the day and continued until late hours. Various activities were incorporated, including role-playing, group presentations, and brainstorming. Almost all the lessons in the course content were interactive, avoiding the risk of passive learning by ensuring all participants took part in the course, allowing for easier follow-up of long working hours.

The presence of all faculty members in all sessions, eating meals together for three days, and being in the same place throughout the course made it more convenient for participants to receive mentorship from faculty members individually. Each participant sat in a predetermined seating arrangement in the course room, and everyone could make eye contact with each other, to help achieve training goals.

In contrast to other brief trainings in psychiatry, the goal of this course was not to build knowledge but to cultivate specific soft skills necessary for the leadership role a psychiatrist should possess. In all interactive skills courses in the program, such as oral presentations, presenting posters, and managing meetings, constructive feedback was provided, emphasizing not only the content of the presentations but the importance of delivery of the presentation itself. Constructive feedback was actively provided by faculty members and all participants, allowing everyone to gain experience in this area. The course had 24 hours of organized teaching, with many more hours of joint work and discussions in group work to prepare for the following scheduled sessions.

In the opening session, participants were asked to briefly introduce their neighboring partner after receiving information from each other. This activity helped to “break the ice” at the beginning of the three-day journey and gave participants insight into what to pay attention to when introducing themselves and others. The following lessons discussed valuable professional skills such as writing an effective CV and motivation letter, choosing a topic for a research project, digital tools, writing and reading articles, and writing a brief report. Throughout the course, participants were allowed to gain experience and feedback on frequently encountered but hands-on topics such as making an oral or poster presentation, preparing a project proposal, and applying for funding, which required individual and group preparation.

An interesting feature of the course was the role-play activities on various topics. One activity was about fellowship interviews. Three participants who volunteered for the role-play conducted the same interview for a fellowship position at a prestigious university department. Other participants had the opportunity to witness the interviews and share their evaluations and feedback afterward for each participant at the end of the session. Owing to the active participation and performances of colleagues and the feedback session, participants were able to learn how a good fellowship interview should be conducted.

Overall, these activities aimed to improve individual and group communication and solidarity skills, demonstrating numerous roles that ECPs would undertake in their careers. For example, in a role-play activity involving conducting a meeting or session within a specific agenda, participants could collect feedback from each other and faculty members about principles to pay attention to. Similarly, in a practical teamwork session on effectively presenting a project in front of a jury, ECPs would learn what should be prioritized and emphasized in project proposals, including what questions might be encountered to obtain funding. All these experiences also helped the participants gain ideas about what ECPs could bring when interacting with other professionals in mental health and related fields to improve mental health services. Considering that mental health systems are greatly affected by various social, economic, and political factors, both leading such projects and participating as team members play a critical role in improving mental health services and combating stigma. From this point of view, the Leadership and Professional Skills Course was an experience that not only provided technical guidance but also encouraged ECPs to collaborate further.

Discussion

Leadership training in psychiatry is an increasingly significant and often underrecognized topic.5 The Medical Leadership Competency Framework outlines a structure with domains, elements, and competency outcomes that involve demonstrating personal qualities, working with others, managing services, improving services, and setting direction.6 In various ways, ECPs can receive leadership training, including brief training modules, provision of leadership training resources, usually external training programs, or limitedly devoted hours in the psychiatry training curriculum. In the United Kingdom, a variety of leadership and management training, such as the Royal College of Psychiatrists’ Leadership and Management Fellow Scheme, is available for postgraduate medical professionals.7 In the United States, a formal leadership fellowship organized by the American Psychiatric Association selects residents with preexisting leadership experience. However, existing opportunities are either limited to several professionals, require a financial commitment, or are provided in an unstructured and non-standardized manner.8 Thus, there seems to be an unmet need to develop leadership competency in the following generations of psychiatrists, especially in low-resource settings. As a structured, free-of-charge, and sustained training opportunity, this international Leadership and Professional Skills Course might shed light on other schemes to become widespread and accessible to ECPs worldwide.

Our takeaway points

As ECPs from different cultural backgrounds with an interest in improving mental health, we gained insights into the productivity of working together and collaboratively in a supportive environment. This professional experience also provided a platform for future collaborations. Enhancing professional leadership and communication skills is essential to our work lives, especially as psychiatrists. This robust, comprehensive training has taught us that these skills should be continuously developed. We all parted ways from this course with ideas and motivations to further transfer these valuable skills we have learned to our colleagues locally when we return to our workplaces.

Conclusion

As Professor Sartorius said- “Psychiatry is about all of medicine, perhaps much more than medicine, and it needs to be fully integrated with suitable care for people in all ways, at all levels, in public, at work, and in people’s homes, where much work remains to be done.”9 Through what we learned from this leadership and professional skills course, we are instilled with the hope of collaborating on this goal and contributing as best as possible to this purpose.

Declaration of Interest Statement

The authors report no competing interests to declare. The authors declare no conflicts of interest associated with this manuscript.

Acknowledgements

We would like to thank the mentors of this course, Prof. Norman Sartorius and Prof. Sir Graham Thornicroft, as well as all fellow participants and course faculty, who made such an enriching experience possible. Finally, we would like to express our gratitude to Prof. Norman Sartorius, whose invaluable feedback guided us in practicing drafting this manuscript well.

Funding Statement

The authors have no funding to disclose.

Author Contributions

Conceptualization: STK, DSS, CP. Writing -original draft: STK. Writing -review&editing: DSS, CP.