The shortage of psychiatrists is causing months-long waiting lists in the private sector and vacancies in the public sector

A shortage of psychiatrists in New Zealand means waiting lists to see a specialist in private practice stretch to more than a year.

Meanwhile, in a public system overflowing with patients in need of help, one in five psychiatrist positions is vacant.

This creaking system, in which some psychiatrists reported high levels of burnout, led the Royal Australian and New Zealand College of Psychiatrists to express concerns that the government had failed to keep National’s pre-election promise to fund more training posts.

However, Mental Health Minister Matt Doocey said he was working on a plan to address the workforce shortage and the promise to provide more training places would be fulfilled.

The college’s chair, Dr Hiran Thabrew, practices in the public sector in Auckland and sees first-hand the effects of high-pressure mental health and addictions services.

“Every evening when I’m on duty, I have to make decisions about who to admit and who not to admit to the inpatient unit, knowing that there are usually only one or two beds available because all the others are occupied,” Thabrew said.

“I also know that there are gaps in our squad, which means people have to take extra shifts or try to arrange replacements in some way.”

The college was disappointed that this year’s budget did not include funding for much-needed additional training places, but Thabrew expressed gratitude to the minister for engaging with members about the issue.

However, delaying the urgent removal of shortages made the situation worse.

“This increase was not intended to increase the overall number of psychiatrists, but was actually intended to help sustain it over the coming decade or two.

“We are an aging workforce, with 20 percent of our workforce over the age of 65. People are retiring. People are burning out and leaving public service due to current labor shortages.”

Thabrew said the number of mental health and addictions workers has not kept up with the huge increase in people seeking such services.

Psychiatrists had to make difficult calls about patient visits or length of stay in hospital, which led to other problems, so investment in manpower was crucial, he added.

“It’s a worthwhile investment considering mental health problems cost the country $12 billion a year, or 5 percent of GDP.

“What we are asking for in terms of money to train more psychiatrists is a small drop in the ocean.”

But it would make a big difference, he said.

Emeritus professor Dr Sarah Romans is a psychiatrist in private practice and has found the demand to be too great to keep up.

“I’m now pre-retired and don’t take any referrals anymore, but at my peak when I was taking referrals from GPs my waiting list was 15 months.”

This is significantly longer than the six to eight weeks considered the maximum desired wait time.

Romans said she was lucky because she was in private practice, so she could let people know she had a waiting list and concentrate on doing the right thing with the patients she could see.

However, psychiatrists in public practice do not have this luxury, she added. She felt sorry for them as they struggled with burnout.

Just last week Control point told how the issue led to the departure of the Kāpiti Coast’s only public sector psychiatrist.

Romans says some people have had to wait many months to seek help after receiving a referral from their GP.

“People do wait extremely long times because they are desperate to see someone with additional knowledge and skills, but when very long waits in the private sector are followed by a refusal from the public sector, patients get really upset and angry.

“Their families are often very worried about them, and such long waiting times can jeopardize their acceptance for work. This places a huge burden on families.”

There was no data available on the number of psychiatrists in private practice, which makes a big difference, Romans said.

Doocey said he remained committed to increasing the number of places in psychiatric training “by about a third”.

“We know that we currently have approximately 37 places for psychiatric registrars. I want to increase this number by a third, and we have also promised to increase the number of clinical psychology internships.”

Control point Doocey asked when that would happen.

He said: “I am currently working on developing New Zealand’s first mental health and addictions workforce plan. It’s hard to believe we didn’t have a specific plan for the mental health and addictions workforce.”

This was something the auditor general demanded.

“I want to plan how we can support our mental health professionals, such as psychiatrists, to increase retention, how to support the migration of better-skilled workers and ultimately how to train more of our local workforce,” Doocey said.

Doocey said he wanted to reduce vacancies and retain workers who now felt they had no choice but to move overseas.

“We want to work with people who are not leaving necessarily by choice, but with those who feel they have no choice but to leave due to things like pay rates and of course the burnout factor where they are covering too much free roles.”

Doocey said he has asked officials to quickly develop a staffing plan.