What it's like to lead a mental health trust while dealing with depression and anxiety

It took more than 40 years for Lisa Rodrigues to talk about her mental health issues and she hopes her candour will help other leaders who are struggling at the top

It has taken more than 40 years for Lisa Rodrigues to talk about her mental health issues and she hopes her candour will help other leaders who are struggling at the top

A year before she left her position as the chief executive of a mental health trust, Lisa Rodrigues wrote about her depression and anxiety, which began when she was 15 years old. 

‘I’d been secretive about it,’ says Ms Rodrigues, who qualified as a nurse in 1977 at Great Ormond Street Hospital in London. ‘But I thought I’d kept it secret for long enough. It’s about destigmatising.’ 

Writing was cathartic 

Her experiences form part of her newly published book – Being an NHS chief executive: what they never told me or if they did I wasn’t listening. ‘I used to write a weekly blog when I was a chief executive,’ says Ms Rodrigues. ‘At my leaving do, I said I’ll be writing a book. 

‘I expected to get it done in six months but it took four years. It was quite painful and I had to put it down and pick it back up again a few times. But I got there in the end.’ 

'I went off the rails. I stopped sleeping, became quite irrational and found myself unable to do anything. It was a crash'

For Ms Rodrigues, it’s less a management book and more a how-not-to guide. ‘There were a few things I wanted to get off my chest,’ she says. ‘And I have some thoughts that might be helpful to potential leaders and those who work in public services.’ 

When things go wrong at work

Based on different themes, the book includes chapters on when things go wrong at work, whistleblowing, sex and the abuse of power, the 'horrid parts of the job', learning from your mistakes, and leaving your work feeling well. 

Several chapters address mental illness, including stigma and discrimination, suicide as well as depression and anxiety, which Ms Rodrigues calls ‘my old unwelcome friend’. She explores why it was only as she approached retirement that she felt able to share some of her experiences. 

The book covers her decision to ‘go public’ in a magazine article and the aftermath, which included one of her worst depressive episodes. Being open for the first time about her lifelong experience of mental illness was ‘exhilarating and scary’, Ms Rodrigues recalls, but afterwards her world fell apart. 

‘I went off the rails,’ she says. ‘I can’t tell if it was cause or effect, but I stopped sleeping, became quite irrational and found myself unable to do anything. It was a crash.’ 

'I feel truer to who I am'

Despite the difficulties, her decision to disclose her mental health issues was beneficial. ‘Having come out and talked about it and faced who I am, I find I’m easier with myself,’ says Ms Rodrigues, who is also a vice-chair of the Mary Seacole Trust. 

‘I feel truer to who I am. Depression isn’t my normal state of mind, as it’s not most people’s. I’m a joyful person who wants to help others and make my contribution.’ 

While leadership undoubtedly has its attractions, it’s tough, says Ms Rodrigues. ‘It’s amazing, but it’s much harder than you think. When you think you know what you’re doing, you don’t, because you never know what’s going to happen.’ 

'If you see a leader having a hard time, don’t cross over on the other side. One day that could be you'

She urges those who are critical of leaders to be kinder. ‘We judge leaders on such trivial issues – what they look like, their speech, how they reacted in the moment.

‘If you see a leader having a hard time, don’t cross over on the other side. One day that could be you,’ she says. ‘When someone is doing well, everyone is around you, and when it’s difficult they melt away. But that’s when you need your friends.’ 

Loneliness and sleepless nights

She writes about the loneliness of being an NHS leader, ‘never more so than when you are awake at 3am worrying’. The difficulties are exacerbated by being constantly under scrutiny. 

‘Leadership in public services has never been harder with our 24-7 media, including social media, and the anti-public sector rhetoric that appears in most newspapers,’ writes Ms Rodrigues. 

‘We live in a post-fact world. People believe things that are not true, and don’t believe things that are. I’ve had personal experience of this. And it is horrible.’ 

Campaigns for change

Now a life coach and blogger, Ms Rodrigues is passionate about the inequalities faced by those coping with mental health issues. ‘Mental illness can affect anyone,’ she says. ‘I’m lucky in that I have a supportive family, good friends and, despite my difficulties as a teenager, I managed to train as a nurse, which has led to good work. 

‘When I had my last depression, I wasn’t worrying about my house being repossessed or whether I would get any care, because all those things were being sorted out. It’s not the same for all of us,’ she adds. ‘The social impact can be dreadful – and that’s why I campaign these days, because I think we can make it so much better.’  

Mental health has gone from being 13% of the NHS spend to below 12%

Alongside volunteering with the Samaritans, Ms Rodrigues worked with mental health charity Time to Change, chairing a two-year project that reported in July 2016 on the stigma of mental ill health. 

Disparity of esteem

'Despite the government talking about parity of esteem, since 2010 we’ve seen a year-on-year reduction of resources,’ says Ms Rodrigues, who was made a CBE in 2012 for services to the NHS. 

Looking back over her career, which includes 13 years as chief executive of Sussex Partnership NHS Foundation Trust, she says her one regret is that she was unable to make more of a difference. 

‘Commissioners have been told mental health is very important, but they’ve also been told to spend less money,’ says Ms Rodrigues. ‘It’s gone from being 13% of the NHS spend to below 12%. 

‘People are saying it really matters and then doing the opposite. It’s utterly wrong. The solution is simple: they need to put their money where their mouth is – stop talking and do.’  

I pretended to feel OK even when I wasn't 

Extracted from Lisa Rodrigues' book, Being An NHS Chief Executive

I met my first psychiatrist when I was 15 and I’ve had various episodes of mental illness since then. Like a lot of people, I have not always described them as such, even to myself, at the time they were happening.

I have tried to explore why, despite my job running a mental health trust, it wasn’t until I was 58 and approaching retirement that I felt able to share a little of my experiences. And in particular, to be honest about what it was like to be a chief executive who didn’t always feel OK, but felt she had to pretend she was.

I came out via an article, which preceded an apparently sudden, significant depressive breakdown a few weeks later. Was this coincidental? Probably not. Did I get better after this episode as quickly as I led others to believe? Almost certainly not.

Writing this book has been a significant part of my recovery. But like any recovery, it has not been easy. Nor has it been linear. Getting this down on paper has presented a series of horrible hurdles. I have written and thrown out more pages than I have submitted for publication. I have had days when I felt I couldn’t go on. And I have caused myself pain as I poked and prodded in retrospect at my feelings about my life as a leader in the NHS. But writing about my experiences has also been a source of solace and healing.

Lisa Rodrigues is a life coach, blogger and mental health campaigner. To read more about her work or contact her, visit www.lisasaysthis.com

Being an NHS Chief Executive: what they never told me, or if they did I wasn’t listening, published by The Laughton Press, is £10.99 in paperback and £6.99 for Kindle. 

Lynne Pearce is a freelance health journalist 

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