3 Jul 2017

Figures reveal under-staffing of mental health sector

From Nine To Noon, 9:08 am on 3 July 2017

New information shows the extent of the country's shortage of psychiatrists and mental health workers.

Figures released to Nine to Noon showed there were 55 vacancies for psychiatrists in the country's hospitals, nearly 100 unfilled nurse positions in acute mental health wards and just under 40 unfilled jobs in crisis assessment teams in mid-May.

The areas worst hit by the shortage include West Coast, Hawke's Bay, Tairawhiti, Counties Manukau and Waitemata.

College of Psychiatrists chair Dr Mark Lawrence said the country was heavily reliant on foreign psychiatrists to supplement an ageing workforce.

The college was training 170 psychiatrists a year, he said.

"There are 700 psychiatrists working in the field and 59 percent of those are overseas-trained doctors. So we rely heavily on our overseas-trained specialists to boost our workforce."

In 2016, 34 of the 39 psychiatrists (87 percent) entering the workforce were international medical graduates.

The other pressing concern was that the average age of psychiatrists was about 50, compared to 45 years in other specialties, Dr Lawrence said. That meant in 15 years, half the workforce could potentially be coming up for retirement.

In addition, many qualified psychiatrists were leaving for Australia and it was not an attractive specialty to medical students.

"The nature of the work is very challenging, so it's not going to suit everyone, and we can all appreciate that. But there's also false perceptions that working in mental health is unsafe. There's also the perception and stigma that's associated with working with people with mental illness, which is more of a cultural, societal issue," he said.

Nurses Organisation mental health section chair Gina Soanes said nurses continually told her they were under pressure.  

"There's the expectations that they are always on doing overtime and things like that and the turnover puts a lot of pressure on them. People want to do the best for the work and their patients, but the pressure is too much for them sometimes," she said.

Dr Lawrence said there were three key areas of psychiatry that were very vulnerable and needed to be addressed - addiction, old age and young people.

"We don't have enough addictions specialists and with the new Substance Addiction Compulsory Assessment and Treatment Act that's going to be rolled out next year, it's going to be a huge challenge to meet the demand that this is going to cause," he said.

"As our population is ageing and we're living longer, the challenges are with age-related, cognitive problems such as dementia.

"And the other end of the age spectrum is in youth. We know that the youth suicide rates in New Zealand is one of the highest in OECD countries. There needs to be greater impetus for child and adolescent specialists leading the way in the challenges there."

The Ministry of Health's Health Workforce New Zealand Agency was set up eight years ago to lead a sector-wide response to the workforce challenges but Ms Soanes said her impression was that attempts to recruit and retain staff were limited.

The ministry declined to comment.