Research — 25 May 2018

Queensland’s regional and rural mental health patients, in particular, are still struggling to access specialist help under an ongoingg national shortage of practising psychiatrists.

Royal Australian and New Zealand College of Psychiatrists president Dr Kym Jenkins said there were roughly two psychiatrists per 100,000 people in regional and rural Queensland.

Access to psychiatrists in rural and regional Queensland may be difficult.
Photo: Gabriele Charotte 

In contrast, city centres are likely to see a ratio of about 18 psychiatrists per 100,000 people.

Such a shortage meant practising psychiatrists were under pressure to juggle both public and private health system work according to their own practice needs, she said.

The problem is not limited to Queensland but is being felt across the country as both the college and the federal government actively tries to make psychiatry a more attractive profession.

“It means that we don’t have an equitable mental healthcare system across the nation,” Dr Jenkins said.

Patients reported feeling the strain in research published last week by a life insurance company, with more than a third of respondents said they felt it was difficult to find the right mental health treatment.

More than 70 per cent of respondents were also concerned about the cost of mental healthcare, and less than half felt there were long wait times to access treatment.

Dr Jenkins said wait times were reliant upon how many psychiatrists were available if they were working in the public or private system and upon the types of treatment being administered.

According to data from Queensland’s Office of the Chief Psychiatrist reported across 2016-17, nearly 100,000 people were seen in the public mental health system, with 24,000 admissions to specialist mental health units.

A Queensland Health spokesperson said mental health referrals in the public system were predominantly made by phone, through the statewide mental health triage and referral service 13 MH CALL.

“Upon mental health services receiving a referral, an initial triage and intake is conducted by a mental health practitioner to determine whether the person has a mental health related problem and to determine the most appropriate service response,” the spokesperson said.

“This includes a risk assessment process to ensure a rapid service response for those people identified as requiring immediate or urgent follow-up.”

Royal Australian College of General Practitioners Queensland deputy chairman Michael Clements said the specialist shortage was not just in regional Queensland but Brisbane as well.

A practising GP in Townsville, Dr Clements said when referring patients, doctors needed to match patient personality and needs with the appropriate specialist but that wasn’t always possible.

“Some of the members in the RACGP are telling us they’re having referrals rejected by private psychiatrists who are overwhelmed or have sub-specialised,” Dr Clements said.

“I’ve certainly had cases of my patients being rejected by private psychiatrists and the public system.

“There have been concerns for sometime time, months and months, maybe years, that there is restricted access to even private psychiatrists.

“That’s a sign of a system that is overwhelmed and in need of funding.”

Dr Jenkins agreed that the mental healthcare system was underfunded, and said fresh approaches needed to be examined to better manage psychiatrist workloads and patient access.

She said issues around psychiatrists closing their books to new patients or refusing referrals went back to the type of practice each psychiatrist ran, their workload and whether they were working in private or public practice or a combination.

But, she said, the shortage was slowly showing signs of improving as efforts to attract more graduates into the field continued.

A national psychiatry interest forum set up to encourage medical students and doctors who had not yet specialised to consider psychiatry had about 2000 members, far exceeding the expected 200 or so.

Dr Jenkins said while not all of those members might specialise in psychiatry, having such interest shown was a big step forward and raised awareness about the importance of the profession.

While efforts to increase the numbers of trained psychiatrists continues, Dr Jenkins said it was still estimated that in five years Australia would be about 175 psychiatrists short.

“Mental health today is bigger than psychiatrists but we also need to be more creative in the models of care we provide,” she said.

“Greater models of shared care and more utilisation of mental health care workers on the ground.

“We’ve had a multidisciplinary team approach for mental health for a long time now, but in private practice, it’s a lot more difficult than it is in public practice to negotiate how that team works.”

This piece by  Lucy Stone was first seen on ‘Brisbane Times‘, 22 May 2018. 

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