After nine years at the helm of the county's mental health trust Pat Holman has mixed feelings about her retirement.Sarah Hall talks to the out going chief executive of the Norfolk and Waveney Mental Health Trust about her achievements, regrets and the changes in mental health services.

After nine years at the helm of the county's mental health trust Pat Holman has mixed feelings about her retirement.

Sarah Hall talks to the out going chief executive of the Norfolk and Waveney Mental Health Trust about her achievements, regrets and the changes in mental health services.

When Ms Holman embarked on her nursing career 33 years ago she saw a vulnerable man with severe mental health problems walking around the grounds of an asylum - semi-naked, confused and embarrassed.

While the image haunted her it is one she has kept with her throughout her career and it galvanised her to change mental health services and ensure the thousands of people like this particular patient are made to feel more safe and secure.

'It is a story I always tell and an image I always carry with me' she said. 'It is exactly what I wanted to change about mental health and the image I never wanted to come across again.

'I started in 1979 when there were asylums and institutions. Mental health was not openly talked about and people were pushed behind walls and kept away from the general public.

'Now I see a totally different image - people are looked after in the community as much as possible, they are more integrated and community services are much more accessible.'

Ms Holman, now 56, started her career as a mental health nurse in Bristol and worked in Dorset and Brighton and her last position before her Norfolk post was as director of mental health services in Suffolk.

Her frustration at services and her desire to improve the mental health environment for patients gave her the drive to eventually become chief executive of the Norfolk and Waveney Mental Health Trust, which currently cares for almost 18,000 people.

During her time in post she says the biggest change is in attitudes to mental health and considers one of her biggest achievements as helping to provide round-the-clock care for patients from multi-disciplinary teams catering for 'all aspects' of mental health.

The trust has come under repeated criticism for years for closing inpatient units which care for people with dementia in favour of 'care in the community' but Ms Holman said the public have now 'come round' to that way of thinking.

She said: 'The last resort now is a hospital or care home. My biggest goal has been to keep people with their families and out in the community wherever possible. I would say one of my biggest achievements is to open up services so they are available 24 hours a day.

'Mental health is just like any other physical illness and should be accepted in this way. I think we have achieved quite a lot in this area. We are certainly getting there with the elderly now.'

Earlier this year Norfolk's first NHS provided psychiatric intensive care unit (PICU) opened at Hellesdon Hospital. The unit provides mental health care in a specialist environment in a peaceful and calm setting and designed for the highest standard of patient safety, privacy and dignity.

The state of the art building has been described as Ms Holman's 'legacy' and something she says is not only one of her biggest achievements but a 'very far cry' from the horrendous image which propelled her to improve mental health services all those years ago.

Last year the trust also gained foundation status which means people have more of a say in the running of services with less 'top-down' power.

However Ms Holman said there is an area which she still believes needs a great deal of improvement and if she was in post for another couple of years she would work hard to achieve.

'I would like to see more done with children and young people,' she said. 'It is important to get people who can communicate with youngsters to help them more.

'We need more youth workers and people who can communicate with young people and to let them know there is such a strong link between being physically healthy and mentally well.

'And also to let them know if is normal o ask for help without them being stigmatised at school or other social environments

'Because it is okay to have mental health problems.'

Ms Holman, who lives near Fakenham with her landscape photographer partner Steve Barker, plans to go to Portugal immediately after her last day and at some point in the near future has plans to take part in voluntary work.

She will be succeeded by Aidan Thomas who is currently chief executive of NHS West Essex.