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A Day in The Life of a Psychiatric Liaison Nurse

An interview with Niall Donaghy, Psychiatric Liaison Nurse


Can tell us a bit about yourself?

Well Hello you! I’m Niall Donaghy and I’m Psychiatric Liaison Nurse.  What is that you may say?! Well, it’s a lovely job that at its core bestows on me the privilege of caring for people. 

I’m based in the Accident and Emergency part of the hospital and I provide mental health assessment support, signposting and also advocate for people with issues relating to mental health.  

What does an average day at work look like for you?

The average day consists of assessments that have been requested by the hospital’s medical teams, I’m usually in A&E but also have patients on the physical health wards.

As I work in a psychical health hospital and the majority of patients I see have had no prior contact with mental health services. So, it’s my job to do an assessment that takes into account the biological, psychological and social (biopsychosocial) needs of the patient.


In a single day, I can see a patient that’s self-presented to A&E with depression and suicidal ideation, a ward patient that requires support coming to terms with a cancer diagnosis and round it off see a third patient in A+E that’s come in due addiction issues, homelessness or even torture.


How has this changed with the coronavirus crisis? 

The entire mental health service delivery model has undergone a radical redesign due to Coronavirus. This has led to the establishment of mental health assessment centres that move patients out of A&E thus limiting Coronavirus exposer, to assessment centre that can draw from a wealth of mental health specialists such as psychiatrist and psychologists.   


Since the lockdown started, we’ve also seen a steady increase in people attending the emergency department for support. Especially in the field of addiction and domestic violence.  


How are you able to currently provide your services safely?

With the use of PPE equipment!


What are some of the big challenges of this work?

Time! Due to the nature of biopsychosocial assessments, it can take up to 2 hours to complete an assessment, let alone starting to document it and action the referrals to mental health services. Due to this, we work long hours, at least 14.5 hours a day.


What are some of your favourite things about your work?

What I cherish most about my job is that it puts me in the privileged position to be able to care and support people who are experiencing moments of crisis and difficulty.  After sitting with a patient and discussing their issues, it is a wonderful thing to be able to say, this is how we’re going to help and be able to offer some hope and guidance.

What made you want to go into this profession?

When I was a teenager, I was invited to a friend’s house after school for the usual watch TV, talk about boys etc.  When I got to their house, I could tell there atmosphere and that their parent had been experiencing some issues with their mental health.  My friend also explained that their older sibling was being thrown out of university due to illness and this had added to their parents’ stress levels. 


We sat in the living laughing at the television when the parent burst into the room and threw the yellow pages (a large phone book in the 00s) that they had been holding at the wall, it hit it with thud they then screamed and burst into tears.


At that moment I saw a stranger emerge from the kitchen that was able to calm the entire situation down and expel the tense atmosphere, they whisked the parent into the kitchen using kind and compassionate language and ensured everyone felt safe and at ease.  This person was a community mental health worker and I was in awe of them.  It emboldened in me a want to support people in the darkest moments and to provide a guiding light.


As someone who is LGBTQ+, have you always felt supported at work?

As an LGBTQ+ person, I wear a rainbow Lanyard with pride and am privileged to work in an organisation with a thriving and motivated LGBTQ+ network that supports in members.  Yes, homophobia is something I’ve experienced from patients, but because I feel support by my workplace, I can challenge it and hold constructive conversations to educate.

Niall (right) with his boyfriend, Josh 


How does your identity impact your work?

Being LGBTQ+ has allowed me to have more in-depth insight into the issues affecting my community, thus when I come across LGBTQ+ patient I’m better equipped to provide support. I’m also more aware of local charities and institutions and what they can offer directly.

What advice would you give to someone who is supporting a friend or loved one who is struggling with their mental health?

Listen and only offer advice when directly asked.


If they’re coming to you to talk about their mental health its likely something they’ve struggled with for months, if not years. Try to highlight their strengths and how well they’ve done to manage things so far.  Ensure they’re feeling safe and don’t be afraid to ask a question such as “are you having thoughts to end your life”, you can never make some-one feel suicidal, but you can challenge them to see how they’re feeling.

If the answer is yes, they are experiencing suicidal thoughts consider supporting them to get help through calling 111 or hope line on 08000684141. 


If this is not helpful google your local Metal Health NHS trust for your area and call their “single point of access line” which is 24/7 service staffed mental health professionals that can refer directly to mental health services such as Home treatment teams or local community mental health teams for immediate support dependant on need.


Over the last few years we have seen an increase in conversations around mental health, what else would you like added to the conversation?

It heartening to see the conversation increasing around mental health, but working in this sector still highlights to me the amount of stigma that exists with “medical overshadowing”. This is when a patient is diagnosed with a mental health condition and then their physical health complaints are discounted and not taken seriously due to this mental health label.  I find myself having to advocate for these patients regularly to receive treatment.  To counteract this, we need to increase education for physical health professionals on mental health issues.  


We can also seek to normalise mental health by talking about our own mental health struggles and highlighting to people, “its ok not to be ok”. 


As someone who works in mental health, what are some things you do to look after your own mental health?

Self –care is paramount, set aside an hour a day just for you. Set an alarm on your phone to prompt you as to when hour beings.  Then Put down the phone and turn off the computer, focus on you.  Do something for yourself, I LOVE FACE MASKS! But what do you like? You don’t have self-care activity planed just start by setting the alarm and see what happens.

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Zoe Schulz

Thanks for sharing Niall! Loved this 🌈

Marie Vaughn

Excellent information in there! I learned something from "Ensure they’re feeling safe and don’t be afraid to ask a question such as “are you having thoughts to end your life”, you can never make some-one feel suicidal, but you can challenge them to see how they’re feeling." Thank you for that!