Concern psychiatrist walk-out will trigger mental health crisis

GPs have been warned to prepare to manage an increase in mental health consults and acute cases following the mass resignation of more than half of New South Wales’ public hospital psychiatrist workforce.
 
The proposal follows failed salary negotiations with New South Wales Health, after psychiatrists asked for a 25% pay rise.
 
The Royal Australian and New Zealand College of Psychiatrists (RANZCP) confirmed 200 psychiatrists have handed in their resignation ‘citing patient safety concerns’, which will be ‘effective before the end of January’.
 
NSW Health says it has ‘plans in place to try to manage the impact this will have’ but warned there may be ‘extensive disruption’ to mental health services and the broader public health system.
 
RACGP NSW&ACT Chair Dr Rebekah Hoffman told newsGP although GPs ‘absolutely have the skills to manage patient mental health problems’, the inability of both parties to reach an agreement will trigger a ‘mental health crisis’.
 
‘We know that GPs already see a really large number of mental health patients, but the patient load that we’d be expecting and those that are having significant acute problems will increase,’ she said.
 
‘We’ll be looking at potentially increased numbers of patients who should be in hospital, should be in acute beds as an inpatient, that GPs will be managing in the community beyond a level that they’ve managed before.
 
‘Often that means daily phone calls, daily catch-ups to make sure that they’re safe, and doing that within an already very busy general practice does add significantly to the physical load, but also to the emotional and mental load of being a GP as well.’
 
New South Wales Health Minister Ryan Park said the State Government ‘can’t afford wage increases akin to around $90,000 or 25% for some of the highest paid healthcare workers in our profession and right across the system’.
 
‘We once again say to a psychiatrist; please don’t do this, remain at the table, don’t do this to patients, don’t do this to the healthcare system that I know you love and support, don’t do this to your colleagues who I know you value and trust,’ he said.
 
‘I’m very concerned of the potential impact that this has on other healthcare professionals across the health and hospital system.’
 
Minister Park confirmed the 200 resignations constituted around half of the current workforce in NSW Health and that he wanted psychiatrists to continue negotiations despite the salary increase not being ‘possible for us’.
 
Dr Hoffman describes this response as ‘horrendous’ and effectively blames psychiatrists for the crisis, which she says is ‘absolutely not the case’.
 
‘We wholeheartedly throw our support behind any profession that is working to burn out, and any group of other doctors or otherwise that are working beyond their means, and there’s the capacity to make the change,’ she said.
 
‘We really hope that the State Government does that, and they absolutely have a choice to make here.’
 
Dr Hoffman said the situation also highlights the need for ‘appropriate funding for mental health care for general practice’.
 
‘So that we have the time to be able to do long consults, because mental health consults aren’t quick medicine, they’re really long and complicated consults, and the patient should be reimbursed appropriately for those,’ she said.
 
RANZCP said it first raised concerns about ‘the impact inadequate staffing levels will have for patients and families in the NSW health system’ two years ago.
 
‘The issues impacting our members’ workplaces have not been addressed by Government in that time, which is unfair on patients and impacts psychiatrists’ and trainees’ wellbeing,’ it said.
 
On Monday, Federal Health and Aged Care Minister Mark Butler called for both the New South Wales Government and psychiatrists to ‘get back to the table and to resolve this in the interests of patients’.
 
But with no resolution in sight, Dr Hoffman urged GPs to remember to care for their own mental health during what will likely be a challenging time.
 
‘There’s a number of things that as a GP you can do and that we should be doing,’ she said.
 
‘One is making sure that you have a GP yourself and all doctors, all staff, including psychiatrists and psychologists, need to have a GP and need to have a GP that knows you.’
 
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