Psychiatry staff hard to attract in the provinces

By BRIDGET CARTER

Mental health services in provincial areas are critically short-staffed, with some operating on just half the number of psychiatrists and nurses they require.

Some health workers are also claiming that Government funding specifically tagged for mental health is being spent elsewhere.

The Mental Health Commission is now checking on how the country's district health boards are spending this money.

Commissioner Jan Dowland, who is in Whangarei today and tomorrow, said two staff members had claimed that Northland's mental health services were in crisis and that money was being spent incorrectly.

She said money was specifically allocated for mental health and the commission had to ensure it was going into the right areas.

"In some places it is, and in other places there is a suggestion that it might not be.

"It's very hard to make sure everything is going where it is meant to when you have so many competing demands."

Health boards have problems with mental health services, mainly involving recruitment.

Dr Margaret Honeyman, clinical director of mental health in Northland and chairwoman of the Royal Australian and New Zealand College of Psychiatrists, said the shortage of psychiatrists was critical in places such as Hawkes Bay and Southland.

Gisborne had only one fulltime and one part-time psychiatrist, half as many as the area needed.

For two months Northland was five psychiatrists short, leaving it also with half the required number.

Dr Honeyman said that during that time, she was doing the work of two psychiatrists at Northland Health while carrying out her management duties.

"I was working extremely long hours and feeling very stressed and under pressure."

Northland's community care nursing team is also short-staffed. Another four nurses are needed to fill all 14 positions - and the region needs another four occupational therapists.

Dr Honeyman said that part of the problem was that community care required more staff than hospital care.

Psychiatrists were in short supply everywhere except Wellington and Christchurch, she said, which meant existing psychiatrists had to take on bigger caseloads.

"It may mean patients are seen less frequently by psychiatrists."

Northland Health general manager David Meates said that by November the region should be only two psychiatrists short.

He said the number of patients had been high this year.

"Our mental health services go through periods of time when the pressures are on."

Many nursing positions were filled by graduates who took time to get up to speed.

"The difficulty is we expect them to run at full steam immediately."

Jan Dowland said Northland mental health staff had also alleged that Maori mental health caseloads were twice as big as they should be and that staff were under pressure. These claims would be investigated this week.

Meanwhile, the deputy director of mental health at the Ministry of Health, Dr Anthony Duncan, says he expects to get up-to-date figures within the next few months on how many more psychiatrists the country needs.

Further reading:
Feature: Our sick hospitals