“I’ve had several instances where I’ve known I needed care,I know I’m getting more and more sick and developing an episode. But I couldn’t access help in the private system because of the unavailability of psychiatrists,long wait times or the financial costs,so I ended up in hospital,and by then my life had already been left in ruins,” she said.
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The public hospital wouldn’t always take her. On a few occasions,she was turned away because she wasn’t unwell enough. Only when she was severely ill could she be admitted to an inpatient facility.
“I struggled to stay in university,struggled to stay in a job,had problems in my relationships. Thanks to being one of the lucky few who now has access to high-quality,regular psychiatric care,my life has transformed,” she said.
“[But] we shouldn’t have to wait until people become acutely ill,for them to be able to access psychiatric care at an affordable cost. It does a lot of damage to their lives.”
RANZCP president Dr Elizabeth Moore said going without help meant people’s issues became more complex and harder to treat. “It puts lives at risk,” she said.
“Ask any psychiatrist in the country and they will tell you that wait lists are piling up and people are turning up in emergency departments with complex presentations of mental conditions.”
Dr Astha Tomar,director of clinical services at youth mental health organisation Orygen,said psychiatric care in Australia depended on where someone lived and how deep their pockets were,“and that’s not fair to someone who may be going through the most vulnerable time of their life.
“The only thing a psychiatrist can do is suggest someone goes to an emergency department,and even then you’re not sure they’ll get the care they need,” she said.
“There’s so much that can be done in this space,and we have not made the investment. To the credit of governments,they are looking at new ways of working,but they still have a long way to go.”
The psychiatrists’ letter calls for workforce investment that draws more people to the profession,trains high-quality practitioners and retains the current workforce by preventing burnout.
“This must be underpinned by high-quality national data that tells us what is needed,where,when and how. We write to you from the front line of this crisis,asking for help,” the letter says.
It also says there should be a new Medicare psychiatry item for complex cases.
Butler said his government was committed to reforming the mental health system,and had spent more than $200 million on workforce initiatives.
“The government acknowledges there are challenges in the current supply and distribution of the mental health workforce and the associated impact this has on service delivery,particularly in regional,rural and remote areas,” he said.
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Asked about the government’s delays responding to the Better Access review,he said a mental health reform advisory committee had been established to guide the government’s response,given the complexity of issues.
“Since its establishment,the advisory committee has met five times and considered a range of issues – from how to make services more accessible and affordable,to the best way to deliver low-intensity services through to comprehensive,multidisciplinary care for people with severe and complex needs,” he said.
“The government will continue to work with the sector and people with lived experience of mental illness to progress reform.”