Dr Henrietta Bowden-Jones (MD Neuroscience and Mental Health 2005) is Director of the National Problem Gambling Clinic in London, which is part of the Central and North West London NHS Foundation Trust (CNWL). Henrietta founded the clinic in 2008 and it is the only NHS treatment centre in the UK. She also teaches at Imperial where she is Honorary Clinical Senior Lecturer in the Faculty of Medicine.

Henrietta was recently elected President of the Medical Women’s Federation (MWF) having been Vice President from 2014 to 2016. She will take up the role in May 2018. Hear Henrietta’s thoughts on her upcoming Presidency at the MWF, her association with Imperial and how she is running the only NHS treatment centre for addiction in the country.

You were featured in Medical Women’s Federation (MWF) 100 years of medical women book. Tell us about that... 
The book was published to celebrate the 100th anniversary of the MWF. Imperial had two women featured in the book – myself and Anne Lingford-Hughes. I had no idea that I would be featured in the book so it was a real surprise! There were an enormous amount of people who got in touch after that. I don’t know how they even got hold of the book! Clearly Imperial has a brand and people use it to link up and relate to and to judge quality.

You have quite a long association with Imperial. How did it all start?
I was born in Italy and grew up there and did my undergraduate degree in Italy at Pavia University. Whilst studying there, I knew that I was interested in the UK side of things because of my father’s side of the family. I did quite a long period of time during my psychiatric training as an undergrad within Imperial at Charing Cross Hospital on the psychiatric wards. My association with Imperial started early!

Whilst I was a Senior House Officer working at the Chelsea and Westminster Hospital, I found out one day that Imperial had a research grant and I remember thinking “if I got that I wouldn’t have to do any clinical work for six months!” More seriously, the idea of a research grant was an exciting one to me, one that I had not, in the past, considered applying for. So when I heard about this, I wanted to go for it to prove a point to myself that I could do it. It became a personal challenge.

During the first phase of full time research I worked for six months looking at Orbitofrontal cortex impairment in patients with alcohol dependency. I was trying to predict who would do well in treatment and who would relapse, something I was able to do from the subjects’ neuropsychiatric computerised tests. I loved it so much and it was going so well that I changed supervisor and went for a full academic – Professor Eileen Joyce, who was then at Imperial and later moved to Queen’s Square. I turned the project into a full MD so I could do it properly over a few years rather than the six months. I am just so lucky to have belonged to that generation where we had that opportunity to work clinically whilst still do half of the week as funded researchers. It was very good fun!

I have kept up the clinical research aspect throughout my career, often in wonderful collaborations with Imperial colleagues such as Professor Anne Lingford-Hughes and other times with MRC grants shared with Cambridge University. I have a couple of lectures that I teach at Imperial – one is on Neuroscience and another on behavioural addiction. Every time I give a lecture, a huge amount of the students come and talk to me and some write papers for me and do placements at the clinic. They are, as you would imagine, forward thinking and good at planning and interacting. They really are interested.

How did the clinic come about?
It all really stemmed from the work I was doing during my training at Imperial. That’s how I ended up doing what I am doing now and I could only dream of a career like this. There are over half a million problem gamblers in the country but there is only one NHS Consultant psychiatrist and one NHS treatment centre and it is the National Problem Gambling Clinic, which I set up ten years ago.

Are you still involved with the clinic today?
I am heavily involved with every aspect of the clinic’s running and find myself happily jumping from one role to another. One morning I can be helping out with research and in the afternoon, I can be running a teaching session and later still, seeing patients for psychiatric reviews and assessments. It’s a bit like a surgeon…you have to do the hands-on stuff to keep up to date with everything – you can see the trends and how people are reacting to treatments. You really need to follow it. I feel I am constantly in need of more time at the clinic, particularly in the weeks when media work or meetings with politicians take up precious hours.

I founded the clinic in 2008 after being offered money for a match funded pilot project with NHS and the Responsibility in Gambling Trust both committing for one year initially. I spent much of 2007 preparing all the protocols and learning from international colleagues who had set up similar projects in the US and in Australia to make sure it would hit the ground running and be successful. In the summer of 2008, we started seeing patients. I initially thought I would see 30 people a year but actually we were inundated and we quickly expanded to receive 700- 900 patients a year.

It sounds like you are very busy! Are there plans for a second clinic?
This year, there are plans to open a second NHS problem gambling clinic, this one will be in the north of the country and will run along identical protocols, I am excited about having other colleagues come on board. The dream of having a central hub with other NHS clinics across the country seems to be closer than ever.

How do you convince young people to become involved in your area of work? How will that change when you become President of the MWF?
Over the course of the past ten years I have found myself nurturing an increasing number of young people, both men and women with significant potential in whom I felt ready to invest time and energy in the hope they may eventually decide to remain in my area of work.

This has been immensely rewarding, there are trainees now all over the world who still keep in touch and who continue to maintain an interest in behavioural addictions after their time at the clinic. I have not focused on female trainees only as I feel gender is not in this case relevant, it has been more about trying to take up each and every one of the young people who have sought me out for mentoring and nurturing their development. I have however, found myself at times needing to really convince some of my female trainees to take up opportunities and to put themselves forward for positions they may not have had the self-confidence to apply for. This is a common factor which we see across specialties in medicine with female medics for example not applying for clinical excellence awards despite being eligible.

In my role as future president from May 2018 (currently president-elect) at MWF I really want to focus a bit more on how to make people feel good about putting themselves forward, leading rather than being led, coming up with ideas and following their career dreams. I think you need to be encouraged and the more you are presented with opportunities the more you might take them.

Another strand to educate people is your outreach work. You’ve been involved at the Imperial Fringe…what was that like?
I love those events! I think they are fundamental, not just for society or for people to be captured and educated and brought in, but also for us! After 20 years of doing this, you’d end up getting burnt out if you didn’t have these extra things like the Fringe and the outreach work we do. Some of the most exciting events have been just down the road…

When I gave a Ted Talk at the RGS four years ago I ended up receiving a grant from someone in the audience who represented a well-known science charity! It paid for three years of my research and allowed me to publish three textbooks. I always try say yes to invitations to speak, not only at the various medical schools and universities but also to a wider public. Recently I was speaking at the Donmar Warehouse to a large audience of sixth formers brought together by a charity helping people choose their careers.

Some of the most wonderful patients and staff have arrived knocking on the door of my clinic because they’ve seen the Ted Talk or seen one of my interviews with a patient in front of a live audience.

Has the Imperial name helped you?
Tremendously! I can tell you now and this is really important…ten years ago when I was trying to persuade people to let me open the National Problem Gambling Clinic, that this would be the leading evidence-based centre in the UK to treat this illness…If I hadn’t had the Imperial doctorate and therefore the credibility scientifically, I don’t think people would have given me the same opportunities. Secondly, when my trust did give me the chance and when I started receiving funding, over and over again the reason I think I got the funding was because I came with a badge of quality that was Imperial – the medical training, the teaching, the academic meetings at Imperial. 

It works the other way too! When I’m deciding who to give my time to, I will see and I will look and I will take my pick and definitely when it’s Imperial I will say yes. That’s the network! I have Imperial students at the clinic – I’ve got one now actually! It’s really nice that it comes full circle – some Imperial students have won prizes and competitions working at the clinic and have thrown themselves into the life of the team and the patients. I am often contacted after one of my talks at Imperial, there are always two or three students who ask to visit the team meeting and then offer to stay and help or come in during the holidays to get clinical experience. There is a huge amount of work to be done and I can give it out if people want it!