Clinical psychiatrist

Born: June 4, 1952;

Died: April 9, 2020.

DAME Denise Coia, who has died peacefully after a brief illness at the age of 67, was a clinical psychiatrist and leader in the field of mental health whose work was internationally recognised.

Among the tributes paid to her was one observation that her "extraordinary contribution to psychiatry and medicine in Scotland [was] unparalleled" and another that she had been "one of Scotland’s truly great public servants".

She served as Vice President of the Royal College of Psychiatrists, Chair of the Royal College of Psychiatrists in Scotland and Principal Medical Officer in the Scottish Government, and was also one of the pioneers of specialist community mental health services across Glasgow.

An only child, Denise Assunta Coia was born in Glasgow on June 4, 1952, and was brought up in Milngavie, where her parents, Joe and Jill, ran a fish and chip shop. She attended Notre Dame High School then studied medicine at Glasgow University.

It was in Glasgow that she met her future husband Archie Macdonald, who was originally from Benbecula and worked as a marine engineer with Caledonian MacBrayne. They married in 1977.

Early in her medical career she switched from obstetrics - which she had described as “boring” - to clinical psychiatry. Her career as a consultant psychiatrist was largely based in the Gorbals, at the time one of the most deprived communities in Glasgow. It was there that she developed her lifelong commitment to improving the mental health of the most vulnerable and disadvantaged in society.

As the Chair of the newly-formed Healthcare Improvement Scotland (HIS), she tenaciously, skilfully built a strong and internationally respected organisation that was focused on driving improvements in the quality of healthcare.

She was also not shy in asserting the organisation’s independence from government and ministers, through the publication of some hard-hitting hospital inspection reports. She drew admiration and respect from all quarters for her personal courage and straight talking. She had a formidable intellect and enjoyed robust debate but was always ready to see the other side of a well-argued case.

She also found interesting metaphors to express her thoughts and was often open and candid in doing so.

Fearing that without reform, the NHS could consume infinitely more resources, she took the opportunity, in a HIS public annual review meeting with the government, to warn ministers about a possible parallel with the fate of the world’s only seven-masted schooner, the Thomas W Lawson.

In simply adding more masts to compete with steamships, the Lawson had not kept pace with the revolution in maritime trade. It ultimately failed and sank in a storm. Denise’s message was abundantly clear - there was a need for the NHS to redesign and change with the times to survive.

Denise was appointed a Dame Commander of the Order of the British Empire in 2016. She was elected a Fellow of the Royal Society of Edinburgh in 2018.

She took considerable interest in medical education and in supporting the development and training of junior doctors. She chaired the GMC Scrutiny Quality Scrutiny Group overseeing the quality of postgraduate and undergraduate medical training in the UK. With Professor Michael West, she also led an extensive review in 2019 into the mental well-being of medical students and doctors, entitled Caring for Doctors, Caring for Patients.

Throughout her career, and especially in her later years, she championed the mental health of children and young people. She passionately believed in investing more in child and adolescent mental health services, and was therefore a natural choice to chair the Scottish Government/COSLA Taskforce on Children and Young People’s Mental Health. She also served as Convenor of Children in Scotland in her last few years.

In her typically energetic and inclusive way, she initiated a huge listening exercise across Scotland and relished the chance to talk to hundreds of people but, most importantly, children, young people and families. Her response when hearing excuses about service failures was that she was listening to what children and young people were telling her and under her watch, the failures they had experienced would not be repeated.

Even with all her achievements, she remained firmly down to earth. She brought joie de vivre, laughter and a wonderful sense of humour - always with a sparkle and not without a hint of mischief and self-deprecation. She loved socialising and catching up across her wide network of friends and colleagues - and particularly enjoyed exchanging news. This was still evident even in the weeks before her health finally deteriorated. She was always planning the next coffee or lunch.

Denise had a passionate interest in art. In Glasgow’s European City of Culture year in 1990 she established an exhibition from her mental health centre base of art work by those who had suffered from mental ill health, and by their carers.

She is survived by her beloved husband and their two sons – Alexander, a paediatric surgeon in London, and Andrew, an interventional radiologist in Oxford, both of whom graduated in medicine from Oxford University – and three grandchildren.

Dr Linda J. Watt