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. 2024 Jan;58(1):82-91.
doi: 10.1177/00048674231170572. Epub 2023 Apr 25.

Not heading in the right direction: Five hundred psychiatrists' views on resourcing, demand, and workforce across New Zealand mental health services

Susanna Every-Palmer  1   2   3 , Marion L Grant  2 , Hiran Thabrew  2   3   4 , Oliver Hansby  1   2   3 , Mark Lawrence  1   2   3 , Matthew Jenkins  2   3   5 , Sarah Romans  1   2
Affiliations

Not heading in the right direction: Five hundred psychiatrists' views on resourcing, demand, and workforce across New Zealand mental health services

Susanna Every-Palmer et al. Aust N Z J Psychiatry. 2024 Jan.

Abstract

Objective: To explore the views of psychiatrists (including trainees) regarding the current state and future direction of specialist mental health and addictions services in Aotearoa New Zealand.

Methods: Psychiatrists and trainee psychiatrists (registrars) in Aotearoa New Zealand were surveyed in August 2021. Of 879 eligible doctors, 540 participated (83% qualified and 17% trainee psychiatrists), a response rate of over 60%. Data were analysed quantitatively and with content analysis.

Results: Psychiatrists thought specialist mental health and addictions services had been neglected during recent reforms, with 94% believing current resourcing was insufficient, and only 3% considering future planning was heading in the right direction. The demand and complexity of on-call work had markedly increased in the preceding 2 years. Ninety-eight percent reported that people needing specialist treatment were often (85%) or sometimes (13%) unable to access the right care due to resourcing constraints. The pressures were similar across sub-specialties. A key theme was the distress (sometimes termed 'moral injury') experienced by psychiatrists unable to provide adequate care due to resource limitations, 'knowing what would be a good thing to do and being unable to do it . . . is soul destroying'. Recommendations were made for addressing workforce, service design and wider issues.

Conclusion: Most psychiatrists in Aotearoa New Zealand believe the mental health system is not currently fit for purpose and that it is not heading in the right direction. Remedies include urgently addressing identified staffing challenges and boosting designated funding to adequately care for the 5% of New Zealanders with severe mental health and addiction needs.

Keywords: New Zealand; health policy; health services need and demand; mental health; psychiatry workforce.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
How often patients/service users are unable to access the right mental health care at the right time because of resourcing constraints reported by specialty area.
See this image and copyright information in PMC

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