(NEW) How can conditions be improved for psychiatrists working in the public sector?

 

Psychiatrists working in the public sector are under significant pressure, with mental health services stretched under increasing demand. Associate Professor Susanna Every-Palmer and Dr Rees Tapsell provided insights into this situation at RANZCP Congress 2022, outlining psychiatrist perspectives and suggestions for how conditions for psychiatrists can be improved.

The impact of COVID-19 has placed an increasing strain on mental health services. During lockdown in New Zealand, people with past mental health diagnoses were at an increased risk of experiencing distress than those without a previous diagnosis. This situation has not improved as lockdowns have lifted.

A recent survey of New Zealand psychiatrists and registrars sheds light on the impacts that this situation has had on psychiatrists.

The psychiatrists surveyed indicated that demand has increased, and mental health services are under strain.

Of those surveyed, a large proportion said that the configuration and resourcing of mental health services in New Zealand was not fit for purpose. They reported that services are disjointed, and the flow of services can be confusing for consumers to navigate. Inadequate staffing and lack of inpatient beds were cited as major issues affecting specialist mental health services.

Inadequate access to care was highlighted, with 85% of survey respondents indicating that patients cannot always access the care that they need due to resourcing constraints.

Many psychiatrists were concerned about high levels of burnout and issues with staff retention, with burnout causing a vicious cycle: staff leave due to burnout, which creates more work and more potential for burnout in those that remain.

These results are in line with an Association of Salaried Medical Specialists (ASMS) survey conducted in 2021, which found that 45% of psychiatrists would leave their current job if they could, 35% reported high levels of burnout, and 85% reported that the mental health service they work for was not well-resourced.1

In order for the current situation to improve, the health care system needs to be focused on patient need, based on epidemiological research, rates of service use, and equity goals. An improvement in working conditions is also needed in order to retain staff. A change in training approaches, with closer partnerships between educators and employers, could help to provide incentives for psychiatry trainees and help to ease staffing issues.

Suggestions for managing burnout included fostering a healthy organisational culture, redesigning mental health systems so that they function more effectively, and minimising bureaucracy.

Individual interventions to combat burnout could include maintaining a reasonable workload and providing appropriate support to psychiatrists, such as administrative and academic supports.

Advocacy could also be improved via better strategic direction. Independent comment and critique of government policy development is needed, and the attention of politicians needs to be better captured in order to effect much needed change for public sector psychiatrists.

Our correspondent’s highlights from the RANZCP 2022 symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.

AU-HLU-0035. May 2022

References

  1. Association of Salaried Medical Specialists, Health Dialogue 2021; 18:1-42.