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The University of Southampton

Inaugural Lecture series: Seeing through a glass darkly

Published: 31 January 2020
Julia Sinclair
Julia Sinclair

Professor Julia Sinclair will present her Inaugural Lecture entitled Seeing through a glass darkly in which she will discuss the complex interactions between illness and pathways through health systems, which have a significant impact on patient outcomes. She will focus on alcohol use and suicidal behavior, and how simple things, when consistently implemented, may be very effective. Here Professor Sinclair talks about her career, her current research area and what inspires her.



Name: Julia Sinclair

Position: Professor of Addiction Psychiatry

Research field: Alcohol Use disorders

What is your current research focus?

Integrating the assessment of alcohol use across health systems and understanding the barriers that prevent this, to better identify and manage patients with alcohol use disorders and their complications to improve clinical outcomes.

Why did you decide to focus your career on that particular area of research?

I first became interested in the hidden harms of alcohol consumption as a house officer in 1994, when managing elderly patients in acute alcohol withdrawal following elective hip replacement surgery.

The situation was no better during my training in a range of psychiatric settings: despite alcohol use disorders being the most common co-morbidity for many mental health conditions (as well as being the cause of death for most patients with liver disease) it was rarely recorded in admission assessments.

The negative impact on patient outcomes due to the absence of an integrated health system approach has been a significant motivator for my research, teaching and training roles over the past 20 years.

What have been your biggest ‘eureka’ moments in this field?

Realising that having a robust evidence base for effective treatment of alcohol use disorders is necessary but not sufficient for people to be provided with the cost-effective services they need.

To improve outcomes for people in this field we need to see the same societal and political changes that have occurred in the tobacco field over the past twenty years; and that the way to do this is by working strategically and collegially, across disciplines, to develop consensus and take people with you, one step at a time.

How would you describe the rate of progress in your research field that you’ve witnessed?

Sadly, addiction treatment services in the UK have been cut by 25 per cent in the last eight years, and many have moved outside the NHS. This has had a considerable impact on patients’ lives and on the ability to conduct research and encourage the next generation. In evolutionary terms, clinical research in the alcohol field in this country is somewhat primitive! However, this presents opportunities to develop the evidence base using different research methods and finding solutions that fit with our society.

How has the role of women in scientific research changed during the course of your career?

As the first female Professor of Psychiatry within the Faculty of Medicine at the University of Southampton, I am part of that change. When I qualified as a consultant in 2000, I was based in Oxford and needed to join a ‘peer group’ as part of the appraisal requirements for clinicians: my ‘peer group’ consisted of 12 male professors, another female consultant and me. I am not sure how much that has changed.

Since being in Southampton I have been encouraged by senior male colleagues, and without Professor Rob Read goading me into applying for promotion with the words ‘don't you want to be a role model for other women?’ I would not have done so!

More globally Addiction science has a better track record with some very impressive women in the field: though many of my role models have been highly respected as clinicians, researchers and teachers but have not chosen (or been encouraged and supported as I have) to be officially recognized as leaders in their field.

What would you say are the aspects of your work of which you are most proud?

Teaching medical students and junior doctors has been such a significant part of my career, and the part that has enabled me to work as a team with other colleagues, students and patients to produce some innovative developments which have helped Southampton Faculty of Medicine be so successful in encouraging the next generation of psychiatrists.  The ‘changing minds’ project within the psychiatry attachment was an innovative way of encouraging students to challenge their unconscious biases about mental illness; redeveloping our curriculum to enhance students experience and, working with refugee doctors in Oxford to benefit from their skills within the NHS.

What excites you most about the future of your research field?

As a society, our relationship with alcohol is changing, and the possibility to target and personalize behaviour change techniques is developing along with digital technologies. This has implications for medical student teaching, the ability to deliver behaviour change interventions at scale as well as directly to the public. However, the human factors remain important, as stigma and prejudice towards people with alcohol use disorders remain a significant barrier to timely and appropriate health interventions.


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