Vacancies raise concerns around mental health staffing
Concerns have been raised over vacancies in the mental health team with a specialist psychiatrist position advertised for more than 18 months.
Nelson Marlborough Health general manager mental health, addictions and disability support services Jane Kinsey said there were currently 11 vacancies in the mental health service.
Of those, four were in the medical team; an addiction medicine specialist, two specialist psychiatrists and a psychiatry registrar.
The specialist psychiatrist roles for Wahi Oranga, the inpatient mental health unit, had been advertised since October 2018.
There were also vacancies for two clinical psychologists in the community mental health team, a consult liaison psychologist, a registered nurse and three positions for patient support security personnel.
Kinsey said it was not unusual to see vacancies for specialists in mental health services across the country, with the positions attracting overseas interest. Immigration, Medical Council and other professional bodies’ requirements added to the time taken to process applications. Kinsey said the situation had been exacerbated by the restrictions in place for the Covid-19 pandemic.
Staff had been working hard to see more people, with locums and psychiatry registrars working across the mental health service to meet demand.
There had not been a significant spike in inpatient admissions to Wa¯ hi Oranga during the lockdown in May, but there was an impact on how care was provided.
Earlier in the year, Ministry of Health data provided to Stuff shows more than half of the country’s psychiatrists come from overseas.
Of the 634 registered last year, 380 obtained their qualifications outside of New Zealand.
The previous four years followed the same trend, though total numbers rose from 558 in 2015 to 634 in 2019.
Kiwi Health Jobs – a website recruiting medical staff from overseas – had 859 clinical jobs advertised on Friday.
Of those, 154 were in mental health.
Of the 30 clinical jobs advertised with Nelson Marlborough Health, six were in mental health with some advertising for more than one position.
Royal Australian and New Zealand College of Psychiatrists New Zealand national committee (Tu Te Akaaka Roa) chairman Mark Lawrence said the situation in Nelson Marlborough was not uncommon, with many health boards around the country struggling to recruit psychiatrists.
‘‘Our whole medical system is reliant on international medical graduates, we don’t have the capacity to train enough,’’ Lawrence said.
‘‘The issue in psychiatry is that it tends to be a greater proportion . . . 40 per cent of our workforce will be locally trained and 60 per cent will come from overseas; the UK, South Africa, India, Chile, right around the world.’’
Lawrence said psychiatry was also a speciality that was ‘‘much harder’’ to recruit in as it was a challenging area of work.
Anecdotally, he had heard that around the country there were challenges filling psychiatrist positions and the impact of Covid-19 had only added to that.
He knew the Bay of Plenty District Health Board recently had a vacancy for a psychiatrist in Whakatane for more than 18 months which had been filled by a doctor from overseas who was now trying to get into the country.
In a report to the board, chief executive Peter Bramley said staffing of the medical team remained the ‘‘our largest concern’’ within the mental health service.
‘‘Our inpatient services have high occupancy and high acuity, which is difficult for the teams to manage on the back of the huge amount of change and busy service delivery during Covid.’’
At a meeting on Tuesday, board member Jacinta Newport questioned how the staffing issues were being managed.
‘‘If this is a pattern throughout New Zealand and it has been like this in Nelson for some time, would you look at private services coming in and assisting or are you going to upskill GPs or nurse practitioners taking on some of that responsibility,’’ Newport said. ‘‘How are you going to manage this really important service so that the patients get the best outcomes?’’
Bramley said in the last year there had been a ‘‘real challenge’’ in staffing the mental health inpatient unit after a couple of specialists resigned.
‘‘This is true at times in many of our specialist services, you lose one or two from a small team and actually for a season there is a real struggle in making sure there are the right resources to support that service.’’
The service was currently relying on locums which was ‘‘not ideal’’.
Bramley said the staffing gaps had been ‘‘complicated by Covid’’.
In one case, a specialist from South Africa who had accepted a community psychiatry role was currently fulfilling quarantine obligations before starting with Nelson Marlborough Health.