A road trip to very far north

On Thursday I was lucky enough to get to spend the day with the Community Mental Health Team in Lerwick, who are also based at the health centre. Once a month they have to go and do a couple of visits in the most northerly parts of the Shetland Islands, and it just to happened that they were going while I was on placement, so I was able to tag along for the ride.

We were up early (or at least earlier than normal) and set off to catch the ferry to Yell. This is the first time I’ve been able to see a lot of the mainland as without a car it is quite difficult to get around unless you plan the buses just right. It was amazing to see how sparse the houses became outside of Lerwick, with just the odd cluster here and there. It takes just over half an hour to get to the ferry terminal and the ferry itself over to Yell only takes about 10 minutes. The views from the ferry were amazing, made all the better by the sunny weather and clear skies. We then had to drive through Yell to get to Unst, an island further north. In both Yell and Unst the houses are even wider spread, and it appeared that many of the buildings are either crofts or abandoned houses. After seeing our patient in Unst we got back on the ferry to Yell and drove back down the winding single track roads. The one thing Yell does have is the most bizarre shop I have ever seen, called the Aywick Shop. It sells absolutely everything, from food to clothes to gardening stuff, and it’s a complete maze. Once we found our way back out the shop, we continued on our journey back to the mainland to see another patient.

All the travelling offered a lot of time to talk about how the community mental health team work up here and to see the similarities and differences from back home. Obviously one of the big differences is the amount of travelling the team has to do to reach their patients. While there are mental health nurses based in the more northerly areas, if they aren’t available then it is up to the nurses from Lerwick to cover the areas. Back home there’s at least 4 community mental health teams covering Hampshire. And while I know it’s all to do with population size etc, the remoteness of some of the patients the team up here have to see pose and equally as challenging situation as having a large caseload. More nurses to cover the northern areas would be useful, but I guess aren’t seen as a necessity. The other big challenge the team faces is that there are no acute or inpatient mental health beds in Shetland. If a patient becomes very unwell and needs to be admitted for treatment it requires a huge logistical process to get them over to mainland Scotland by air ambulance. This can cause all sorts of problems if things don’t go to plan, and while it’s no one’s fault, it can mean delays to a patient getting the care they need. This can be so stressful and frustrating for both staff and patient, but I don’t believe there’s an obvious solution to the problem. I would find it interesting to see the statistics for the prevalence of mental health issues in Shetland. In my mind, the isolation some people will face as well as the very dark winters would surely be factors that would cause struggles for many, but I could be wrong. Perhaps that will be some interesting reading for another day.

Today I have been over to Noss, an island that is a nature reserve. It was truly stunning. I will share more about it with you tomorrow, as right now I am off to experience the ‘nightlife’ in Lerwick with some of the other people in my accommodation block. I can’t imagine it’ll be a particularly late night…