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The Maudsley Blog

Story Series: Mary Yates

2020 is the International Year of the Nurse and Midwife, a time to reflect on the skills, commitment and expert clinical care that nurses and midwives bring, and the impact they make on the lives of so many. Here Mary Yates talks about her nursing career.

"I am Mary Yates, Nurse Consultant for Health Promotion and Wellbeing.

"I grew up on a small farm in a typically large and loving family in rural Ireland. Getting to school involved a four-mile cycle and a two-hour bus ride each day. At the end of the school day I had to wait for an hour before the bus ride home. Whilst others used this time to get their homework out of the way I was always curious and took the opportunity to find other things to do in and around the school community. One such activity was volunteering in a centre for people with learning disability, next door to the school. This experience gave me the insight and confidence to embark on a career in nursing. 

"I trained as a nurse in Dublin. It was a thorough programme, with weekly tests and a lot of fun. As a student learning disability nurse, I had placements in a psychiatric hospital, a children’s hospital, a school, a day centre and residential services. I loved it all. After graduation, I worked as a staff nurse in Dublin, before joining a group of friends in London. It was an instinctive move that proved just right for me. I settled well to working in Bromley’s children’s services. My friends returned to Dublin within one year, but I was thriving, enjoying new challenges and more responsibilities.

"When the chance to do post-graduate mental health nurse training came along I grabbed it, the bespoke 18-month programme involved hospital and community placements. For my elective placement, I chose to work in MIETS, a national and specialist unit for people with co-morbid complex learning disability and mental health needs at Bethlem Royal Hospital. I absolutely loved Bethlem, the beauty of the grounds (270 acres of woodland and meadows) and the prospect of working with the best experts in the field was wonderful. It was 1988, and my placement ended too quickly but I vowed to be back.

"As a mental health nurse, I worked in acute psychiatry and then spent a few years in a first-class day hospital. During this time, I continued to study in the evenings - cognitive analytical therapy, group therapy, and quality improvement. I got a year-long secondment working as a research nurse on the HoNOS programme with the Royal College of Psychiatrists. 

"Back in the Day Hospital after my secondment ended I began to look for other openings in my career and was thrilled to get a post in Denis Hill Unit, a medium secure unit at Bethlem Royal Hospital. It was 1995, and by this time I had started a master’s degree in mental health studies. Working alongside leading experts in forensic psychiatry I further developed my clinical, teaching and research skills. I also published several papers and spoke at numerous conferences.

"Almost ten years of my career was dominated by collaborative work to expand the forensic services at Bethlem. During the long campaign, I was personally targeted by some local residents who mounted objections. Throughout this period, I developed negotiation and conflict resolution skills. I was also able to work with architects, planners and commissioners. I was at the forefront of communication about the project with local and national media. When River House finally opened in 2008 I transferred to the Team Leader post in Spring ward, a female medium secure service. It was a real sense of achievement.

"When I was later appointed to the Matron role for forensic and learning disability services, it felt like a perfect fit for me given my qualifications and experience. I thrived in the job, and continued to grow in confidence. I developed a keen interest in physical health and focused on what we could do to close the premature mortality gap for people with serious mental illness. Whilst I was busy researching this question, the answer came to me from an unexpected source – a conversation with a patient.

"'Tom’ was transferred from Broadmoor hospital to River House as part of his recovery journey. He had stopped smoking whilst in Broadmoor and told me he had relapsed to smoking on admission to River House because “it was impossible not to”. He opened my eyes to see that staff were facilitating 19 cigarette breaks per day. He said we were helping patients to develop preventable disease and die young. In his view recovery was not possible in such a place.

"This conversation changed my life because it triggered my determination to make sure that comprehensive smoke free policies are implemented in all mental health services and care is provided in an environment that is conducive to optimal health and wellbeing.

"Although I had read many books and research publications, none had such a powerful impact on me. I now try to make sure everyone understands tobacco dependence is a chronic relapsing but treatable condition – it is the leading global cause of avoidable disease and premature mortality. If we focus on routinely treating tobacco dependence every day with every smoker, I am convinced we can build back a fairer society.

"I feel very fortunate that I came to SLaM – it is a place where continuous quality improvement is the norm and I’ve been able to thrive both personally and professionally in this historic place with great people to support me. I dedicate every day in my work to my late brother Johnny, who tragically died at age 24 by suicide following a battle with bipolar illness."

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