One in two psychiatrists in New South Wales public hospitals are threatening to quit their jobs in protest over chronic understaffing and uncompetitive wages.
One hundred and forty-five of the country’s 295 paid psychiatrists have now submitted letters of resignation to their union, threatening to formalize their departure unless the NSW Government comes up with a plan to recruit and retain more staff.
Pramudie Gunaratne, the NSW president of the Royal Australian and New Zealand College of Psychiatrists (RANZCP), said doctors were not taking the move lightly.
“There are so many psychiatrists who are committed to the public sector, and they want to continue working in the public sector,” Dr. Gunaratne said.
“But it’s absolutely demoralizing when you can’t provide the care you’re trained to provide because the system is under-resourced.
“I think it really shows how serious and how pressing the problems are in our public mental health system.”
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The Australian Salaried Medical Officers Federation (ASMOF), the doctors’ union, previously told the Industrial Relations Commission it would not request resignation letters from psychiatrists as part of its campaign.
However, they kept pouring in.
Nicholas Spooner, the NSW president of ASMOF, said psychiatrists were suffering “moral injury and burnout” and many believed dismissal was the only way to get the government’s attention.
He said the possible layoff of half the workforce would put pressure on the entire hospital system.
“People are not going to stop coming to the hospital with their acute mental health problems,” Dr. Spooner said.
“So the emergency departments would be terribly overwhelmed.
“And because the emergency situation would be under pressure, that means the rest of the hospital would be under pressure too.”
Nicholas Spooner says psychiatrists suffer from ‘moral injury and burnout’. (Supplied: Central Coast Local Health District)
Patients struggle with ‘revolving door’ of psychiatrists
According to ASMOF, a third of specialist psychiatric positions in hospitals across the state are unfilled, with a heavy reliance on temporary or local staff.
The labor shortage has been a source of frustration for Sharon Grocott, whose 26-year-old daughter Amber was diagnosed with schizophrenia after hearing voices and becoming increasingly paranoid during the COVID-19 pandemic.
“(We would) be in an emergency situation for 12 hours, with no place to sit, (with) Amber in full-blown psychosis, in dire distress,” she said.
“They don’t have psychiatrists to do the assessment, so there’s no one to actually see you.”
Sharon Grocott says the shortage of psychiatrists has been a source of frustration since her daughter Amber’s schizophrenia diagnosis. (Delivered)
Once admitted, Ms Grocott said her daughter would often be treated by a “revolving door” of local psychiatrists who had little knowledge of her medical history.
“Every time you came in for an appointment there was a different psychiatrist,” she told the ABC.
“You had to repeat your health story. You had to start over every time. It was exhausting.”
Dr. Gunaratne said the shortage of psychiatrists meant the bar was being raised.
“Unless someone is acutely and seriously ill, he or she simply cannot access our public mental health system, which is a huge problem,” she said.
“We know that the sooner you intervene with a mental health problem or any health problem, the more likely you are to get better outcomes.”
Psychiatrists are paid better in other states
According to ASMOF, public hospital psychiatrists working in other states and territories can earn up to 30 per cent more than those in NSW.
Depending on their experience level, they could earn up to $80,000 more by moving interstate, the union said.
Dr. Spooner said the union’s nearly year-long campaign for better wages was directly related to employee retention.
“It’s not a money grab. We feel like we have to find a way to ensure that the workforce comes back,” he said.
“(Psychiatrists) do not have the resources with which they believe they can provide the critical elements of patient safety to do their work.”
Government ‘very aware of pressure’
Mental Health Minister Rose Jackson says the government is taking the issue seriously. (ABC News: Adriane Reardon)
Mental Health Minister Rose Jackson said the government recognized the “world-class care” provided by the state’s community psychiatrists.
“We are acutely aware of the pressures placed on this workforce. We are listening to the concerns of psychiatrists,” she said.
“We take these issues seriously and want to see a resolution.”
Ms Jackson said the Government has identified 15 recommendations to improve workplace satisfaction, and has already commissioned a ‘gap analysis’ of service delivery and demand, which will be completed by the end of the year.
A recent RANZCP survey found that four out of five trainee psychiatrists did not want to remain in the NSW public system.
“This is the result of decades of neglect,” said Dr. Gunaratne.
A chronic shortage of psychiatrists meant that doctors who chose to resign could easily find work in private practice, she said.
Ms Grocott’s own experience of mental health has influenced her work as head of mental health charity WayAhead.
She said the issue was less about doctors’ pay packages and more about patient safety.
‘It affects families, it affects carers (and people) with mental health problems.
“It affects their quality of life.”