Being a chief executive is a wonderful job for those with a well-developed sense of responsibility.

I read somewhere that more leaders are firstborn children than any other family position and I can understand why. As the first child, you are automatically expected to take responsibility for your siblings. If, like me, you are the first child and also a girl, this gets amplified, although my brothers would say it just made me bossy.

As chief executive, the key aspects of my job are building a reputation and relationships externally, while developing excellent services and strong teams internally. The trick is to do all four at the same time.

We are being tested by our work on applying to become a foundation trust – it is forcing us to look at areas where we are weakest with greater scrutiny. The sign of a great company is apparently the ability to spot mistakes and put them right before your competitors find them – this is proving to be interesting.

In the NHS, we are rightly expected to get things right 100 per cent of the time, and yet we work in a high-risk business, none more so than mental health. And who are our competitors – are they the big private providers, who are being very friendly these days? Or the non-statutory organisations, whom we have traditionally worked with in close partnership, ensuring greater plurality than in other parts of the NHS? Or GPs, who, under practice-based commissioning, have the ability to commission themselves to do aspects of our current work and make a profit from it? Answers in an e-mail please.

One of the privileges of this job is that I feel proud of what we do. We help people to be the best that they can be, and this mirrors my personal values. We support people who are often at the bottom of the heap, who are not necessarily the most media friendly, and who suffer from some of the worst possible stigma and discrimination.

I have always been interested in marketing and communications, and our FT application is enabling me to see how we might use a set of business skills that were previously less than honed to get our anti-stigma messages across. So I now feel less guilty about watching The Apprentice and Dragon’s Den.

As I write, I am thinking about another recent TV programme, Love’s Farewell. Hats off to the producer and the couple concerned for tackling such a sensitive subject with dignity and truth. I hope the furore about ITV advertising the programme showing the point of death, when it occurred off camera, will disappear, because this is a distraction. Alzheimer’s is a killer disease and it is on the increase. One in nine of those reading this will get it, and the longer you live, the higher your chances. Yet it attracts little research money, there is a paucity of specialist services, and a lottery about who pays for care.

When my mother’s father died of cancer aged 49, their loss was tinged with shame – his children were not even allowed to mention what had killed him. Nowadays we run Races for Life to raise money for cancer research, we screen for many cancers, we know about prevention, there are national standards for treatment, and specialist services for those who cannot be cured. Please let’s not wait 60 years to bring Alzheimer’s and other dementias out of the shadows – people need help now. And I am not even going to mention NICE guidance.

Writing an article like this means I have put my head above the parapet, and said things that not everyone will agree with, but that goes with the territory. Peter Brock, the Australian motor racing champion said: 'Bite off more than you can chew, and then chew like hell.' It’s a good motto for people who like taking responsibility.