1 00:00:00,280 --> 00:00:03,400 Speaker 1: A note before we start. This episode contains mention of 2 00:00:03,520 --> 00:00:11,120 Speaker 1: complex mental illness from the Australian. Here's what's on the front. 3 00:00:11,400 --> 00:00:20,120 Speaker 1: I'm Christinamia. It's Thursday, January sixteenth. Prime Minister Anthony Albanesi 4 00:00:20,200 --> 00:00:23,960 Speaker 1: says strong action should be taken against people who perpetrate 5 00:00:24,000 --> 00:00:28,080 Speaker 1: anti Semitic attacks on Australian synagogues, but he won't back 6 00:00:28,280 --> 00:00:32,120 Speaker 1: mandatory sentences for the offense or convene a national cabinet 7 00:00:32,159 --> 00:00:36,400 Speaker 1: to tackle the nation's antisemitism crisis. That story is live 8 00:00:36,520 --> 00:00:42,760 Speaker 1: right now at the Australian dot com dot au. After 9 00:00:42,920 --> 00:00:47,599 Speaker 1: days of negotiations, Israel and Hamas struck a ceasefire deal overnight. 10 00:00:48,159 --> 00:00:50,440 Speaker 1: You can read all the details about the long awaited 11 00:00:50,479 --> 00:00:53,640 Speaker 1: agreement to end the Middle Eastern conflict right now at 12 00:00:53,680 --> 00:01:02,400 Speaker 1: the Australian dot Com dot aus. Experiencing complex mental illnesses 13 00:01:02,640 --> 00:01:05,880 Speaker 1: could be blocked from specialist psychiatric care in New South 14 00:01:05,880 --> 00:01:10,360 Speaker 1: Wales as hundreds of psychiatrists abandoned the state's flailing mental 15 00:01:10,360 --> 00:01:26,280 Speaker 1: health care system. That's today's episode. Arianne Beaston remembers those 16 00:01:26,520 --> 00:01:31,160 Speaker 1: sleepless nights with her son Henry well he was waking 17 00:01:31,240 --> 00:01:34,920 Speaker 1: up as newborns tend to do every forty five minutes, 18 00:01:35,319 --> 00:01:38,080 Speaker 1: making her return to work after a stint of parental 19 00:01:38,160 --> 00:01:42,360 Speaker 1: leave all the more challenging. But even in those hazy, 20 00:01:42,440 --> 00:01:46,320 Speaker 1: waking moments, Arianne felt like she was living a nightmare. 21 00:01:46,959 --> 00:01:51,000 Speaker 1: She saw dragons everywhere, their apparent hunger for her tiny 22 00:01:51,080 --> 00:01:55,080 Speaker 1: baby burning in their eyes. She doubted if the hands 23 00:01:55,120 --> 00:01:58,440 Speaker 1: attached to the ends of her arms truly belonged to her, 24 00:01:59,160 --> 00:02:02,120 Speaker 1: and she wondered more than once if her blue eyed 25 00:02:02,120 --> 00:02:04,760 Speaker 1: baby was the product of a mix up at the hospital. 26 00:02:05,680 --> 00:02:10,000 Speaker 2: I experienced postpartum psychosis, which is a rare mental illness 27 00:02:10,160 --> 00:02:13,279 Speaker 2: bit effects one to two in every one thousand months. 28 00:02:14,200 --> 00:02:17,600 Speaker 1: Arianne was admitted to a private mothers and baby psychiatric 29 00:02:17,720 --> 00:02:21,400 Speaker 1: unit to help her manage the delusions and hallucinations she 30 00:02:21,600 --> 00:02:23,680 Speaker 1: experienced following the birth of her son. 31 00:02:24,639 --> 00:02:27,679 Speaker 2: It was the only unit of its kind. It was 32 00:02:27,760 --> 00:02:32,320 Speaker 2: critical for me to be a bitt. I was experiencing 33 00:02:32,720 --> 00:02:36,160 Speaker 2: quite severe side effects on the medications I'd been prescribed. 34 00:02:37,400 --> 00:02:40,160 Speaker 1: At the time, no such service was available in the 35 00:02:40,200 --> 00:02:44,720 Speaker 1: public healthcare system. Instead, mothers and babies who couldn't afford 36 00:02:44,760 --> 00:02:48,680 Speaker 1: to take the private route were typically separated during treatment. 37 00:02:49,480 --> 00:02:52,360 Speaker 1: In the years since Arian's son Henry is now a 38 00:02:52,400 --> 00:02:57,520 Speaker 1: thriving teenager. Dedicated perinatal psychiatric health care beds have been 39 00:02:57,560 --> 00:02:59,919 Speaker 1: made available in hospitals across New South Wales. 40 00:03:01,200 --> 00:03:05,560 Speaker 2: The Australian Political Guidelines recommend that where possible, moms and 41 00:03:05,639 --> 00:03:09,000 Speaker 2: babies should be admitted together. And what this allows is 42 00:03:09,040 --> 00:03:12,200 Speaker 2: the opportunity for women, where it's safe and where they're 43 00:03:12,240 --> 00:03:15,120 Speaker 2: able to do so, to really bond with their baby, 44 00:03:15,320 --> 00:03:19,560 Speaker 2: to receive help not just around their mental health but 45 00:03:19,639 --> 00:03:24,280 Speaker 2: also new settling and feeding their babies on all of 46 00:03:24,320 --> 00:03:26,919 Speaker 2: those things that can be really, really difficult when you're 47 00:03:26,919 --> 00:03:29,880 Speaker 2: also experiencing a complex mental illness. 48 00:03:30,440 --> 00:03:33,680 Speaker 1: But now New South Wales mothers could be without this 49 00:03:33,919 --> 00:03:37,600 Speaker 1: vital care as some of Sydney's biggest hospitals close the 50 00:03:37,680 --> 00:03:39,440 Speaker 1: few beds they have available. 51 00:03:41,920 --> 00:03:46,040 Speaker 3: First thing to say is that mental health disorders in 52 00:03:46,080 --> 00:03:50,360 Speaker 3: the postpartum period are very common and will be experienced 53 00:03:50,360 --> 00:03:53,680 Speaker 3: by between ten and twenty percent of new mothers. 54 00:03:54,600 --> 00:03:57,080 Speaker 1: Natasha Robinson is the Australian's Health Editor. 55 00:03:57,920 --> 00:04:01,320 Speaker 3: In the most severe cases that can include dug postnatal 56 00:04:01,440 --> 00:04:06,240 Speaker 3: psychosis and relapses of severe conditions like a schizphrenia and 57 00:04:06,280 --> 00:04:11,000 Speaker 3: bipolar and what this requires given breastfeeding is involved, is 58 00:04:11,480 --> 00:04:16,880 Speaker 3: very specialist skills and knowledge as to medication management for 59 00:04:17,200 --> 00:04:20,480 Speaker 3: new mothers, and that's why it's really important to have 60 00:04:20,839 --> 00:04:25,960 Speaker 3: care provided by specialists trained perinatal psychiatrists, of which there 61 00:04:26,000 --> 00:04:29,520 Speaker 3: are very few in New South Wales and everywhere really, 62 00:04:29,560 --> 00:04:31,560 Speaker 3: but in New South Wales there's only sort of less 63 00:04:31,560 --> 00:04:34,799 Speaker 3: than twenty of these specialists that actually exist. 64 00:04:38,560 --> 00:04:42,239 Speaker 1: There are just two mental health units comprising sixteen beds 65 00:04:42,279 --> 00:04:45,200 Speaker 1: in New South Wales where new mothers can be admitted 66 00:04:45,320 --> 00:04:48,839 Speaker 1: with their babies, and those beds are now being capped 67 00:04:49,000 --> 00:04:52,479 Speaker 1: or closed for service altogether as the state's mental health 68 00:04:52,560 --> 00:04:54,800 Speaker 1: care sector spirals into chaos. 69 00:04:55,520 --> 00:05:00,560 Speaker 3: A mental health system already under immense strain and days 70 00:05:00,760 --> 00:05:04,920 Speaker 3: seventy seven percent of the state's public psychiatrists will leave 71 00:05:04,960 --> 00:05:09,840 Speaker 3: their jobs, so there's only in fact four beds open 72 00:05:09,960 --> 00:05:14,680 Speaker 3: at the moment, and the information from psychiatrists within those 73 00:05:14,800 --> 00:05:17,599 Speaker 3: units and across the state from community mental health teams 74 00:05:17,640 --> 00:05:21,040 Speaker 3: is that admissions have been denied out of area. So 75 00:05:21,120 --> 00:05:24,200 Speaker 3: this really leaves people in regional areas in particular, in 76 00:05:24,240 --> 00:05:28,800 Speaker 3: a very bad situation because these units are supposed to 77 00:05:28,839 --> 00:05:30,080 Speaker 3: provide care statewide. 78 00:05:33,480 --> 00:05:36,240 Speaker 1: Arianne is grateful that she was able to access this 79 00:05:36,400 --> 00:05:39,640 Speaker 1: kind of vital health care via the private system, and 80 00:05:39,839 --> 00:05:42,560 Speaker 1: she knows better than anyone why it needs to be 81 00:05:42,600 --> 00:05:45,560 Speaker 1: available to other new mums, no matter where they live. 82 00:05:46,560 --> 00:05:50,400 Speaker 2: Not having access to these units means that women with 83 00:05:50,560 --> 00:05:55,200 Speaker 2: complex perinatal mental illness need to be admitted to general 84 00:05:55,279 --> 00:06:00,760 Speaker 2: psychiatric woards without their babies, which is hugely in an 85 00:06:00,800 --> 00:06:03,800 Speaker 2: already really difficult time and a really vulnerable period for 86 00:06:03,839 --> 00:06:07,560 Speaker 2: these women. So these beds, these units are critical a. 87 00:06:07,839 --> 00:06:13,800 Speaker 3: Save live of course for the most vulnerable people and 88 00:06:13,880 --> 00:06:16,680 Speaker 3: people who can't afford that care, they're left with no 89 00:06:16,800 --> 00:06:21,080 Speaker 3: option and for a long time in all states, including 90 00:06:21,120 --> 00:06:25,680 Speaker 3: New South Wales, these new mums, breastfeeding mums have been 91 00:06:25,720 --> 00:06:30,159 Speaker 3: separated from their babies, so they're admitted to acute wards 92 00:06:30,160 --> 00:06:34,039 Speaker 3: in public hospitals and they're not able to be with 93 00:06:34,080 --> 00:06:36,960 Speaker 3: their baby, which is very very devastating, but it also 94 00:06:37,000 --> 00:06:40,240 Speaker 3: has profound impacts on the entire family and on the 95 00:06:40,279 --> 00:06:44,760 Speaker 3: development of the child. And of course the worst case 96 00:06:44,800 --> 00:06:48,560 Speaker 3: scenario if you can't even access an acute impatient bed, 97 00:06:48,600 --> 00:06:51,320 Speaker 3: and of course all beds will be under pressure. Across 98 00:06:51,320 --> 00:06:54,520 Speaker 3: the New South Wales of these resignations take effect, is 99 00:06:54,560 --> 00:06:57,800 Speaker 3: that mothers can't access inpatient care at all in these 100 00:06:57,880 --> 00:07:01,440 Speaker 3: dire situations, and that posts is a fairly high risk 101 00:07:01,600 --> 00:07:05,080 Speaker 3: to mother and baby. In fact, severe mental health conditions 102 00:07:05,080 --> 00:07:07,599 Speaker 3: in the postpartum period are in fact a leading cause 103 00:07:08,320 --> 00:07:11,840 Speaker 3: of death for these mothers and babies. So the states 104 00:07:11,840 --> 00:07:12,280 Speaker 3: are very. 105 00:07:12,240 --> 00:07:20,480 Speaker 1: High coming up. Why hundreds of psychiatric specialists have handed 106 00:07:20,480 --> 00:07:38,680 Speaker 1: in their resignations, Natasha, You've been covering healthcare for a 107 00:07:38,720 --> 00:07:42,400 Speaker 1: long time as the paper's health editor. Have you ever 108 00:07:42,400 --> 00:07:43,680 Speaker 1: seen anything like this? 109 00:07:44,400 --> 00:07:47,160 Speaker 3: No, I never have, and their state has never seen 110 00:07:47,480 --> 00:07:50,600 Speaker 3: or resignations on mass in these numbers, I mean, they're 111 00:07:50,640 --> 00:07:54,440 Speaker 3: extraordinary numbers. Two hundred and one star specialist psychiatrists making 112 00:07:54,520 --> 00:07:58,200 Speaker 3: up a very large tunk of the workforce, and it 113 00:07:58,320 --> 00:08:02,960 Speaker 3: really is just an indication of how carless the state 114 00:08:03,160 --> 00:08:07,040 Speaker 3: of mental health care is in New South Wales at 115 00:08:07,080 --> 00:08:07,720 Speaker 3: this time. 116 00:08:10,960 --> 00:08:14,080 Speaker 1: By next Tuesday, the state's mental health care system could 117 00:08:14,160 --> 00:08:19,320 Speaker 1: look completely different. More than two hundred psychiatrists, half of 118 00:08:19,360 --> 00:08:22,440 Speaker 1: the state's current cohort, are set to walk away from 119 00:08:22,480 --> 00:08:26,720 Speaker 1: their jobs citing concerns about pay and conditions they say 120 00:08:26,840 --> 00:08:30,880 Speaker 1: are unworkable. Now, with just five days to go and 121 00:08:31,080 --> 00:08:34,720 Speaker 1: no resolution in sight, the state and federal governments appeals 122 00:08:34,800 --> 00:08:39,120 Speaker 1: to doctors to abandon their resignation plans have become more desperate. 123 00:08:39,960 --> 00:08:41,280 Speaker 1: Please don't do this. 124 00:08:42,040 --> 00:08:43,360 Speaker 3: Remain at the table. 125 00:08:44,000 --> 00:08:46,720 Speaker 1: This was the plea made by Minister for Health Ryan 126 00:08:46,840 --> 00:08:51,280 Speaker 1: Park in a press conference this week. We can't afford 127 00:08:52,040 --> 00:08:56,640 Speaker 1: wage increases are kin to around ninety thousand dollars. 128 00:08:58,920 --> 00:09:01,400 Speaker 3: What they're saying is, look, if we give a twenty 129 00:09:01,440 --> 00:09:05,920 Speaker 3: five percent immediate uplifting pay to psychiatrists, then every medical 130 00:09:05,960 --> 00:09:09,240 Speaker 3: specialty is going to be coming to us wanting the same. 131 00:09:09,720 --> 00:09:14,920 Speaker 3: So that is an understandable position. But no other specialty 132 00:09:15,080 --> 00:09:19,640 Speaker 3: has thirty percent of its staff specialist positions vacant at 133 00:09:19,679 --> 00:09:23,120 Speaker 3: the moment. No other specialty has an extraordinary staff exodus 134 00:09:23,400 --> 00:09:28,360 Speaker 3: like this. No other specialty really has experienced the kind 135 00:09:28,360 --> 00:09:34,720 Speaker 3: of spiral of decline that mental health care has amid 136 00:09:35,120 --> 00:09:39,319 Speaker 3: record demand. Given all of that, there would seem to 137 00:09:39,400 --> 00:09:42,400 Speaker 3: be a case that this is a special case. It's 138 00:09:42,440 --> 00:09:44,800 Speaker 3: not just another industrial demand. 139 00:09:46,120 --> 00:09:48,840 Speaker 1: Natasha says. The new South Wales government needs to decide 140 00:09:48,880 --> 00:09:51,840 Speaker 1: if it's actually possible to run the state's mental health 141 00:09:51,840 --> 00:09:55,960 Speaker 1: care system with next to no specialist psychiatrists on their books. 142 00:09:56,600 --> 00:10:01,040 Speaker 3: It seems to be an extraordinary proposition that you could 143 00:10:01,320 --> 00:10:04,319 Speaker 3: do that. It will have knock on effects the government 144 00:10:04,400 --> 00:10:09,920 Speaker 3: is admitting freely and patients will be impacted. So is 145 00:10:09,960 --> 00:10:13,080 Speaker 3: it feasible for a government to wear that and to 146 00:10:13,160 --> 00:10:18,120 Speaker 3: have that on its record. That's for them to decide. 147 00:10:20,920 --> 00:10:23,440 Speaker 1: There's a bit of a misconception that hundreds of special 148 00:10:23,559 --> 00:10:26,800 Speaker 1: psychiatrists in New South Wales are resigning because they're not 149 00:10:26,920 --> 00:10:31,160 Speaker 1: paid enough. In reality, they say years of underfunding and 150 00:10:31,240 --> 00:10:36,240 Speaker 1: under resourcing has created a tinderbox. Doctors are exhausted and 151 00:10:36,280 --> 00:10:39,160 Speaker 1: they're concerned vulnerable patients will pay the price. 152 00:10:40,280 --> 00:10:43,800 Speaker 3: This has been cast by the government as an industrial dispute. 153 00:10:44,080 --> 00:10:47,959 Speaker 3: It's not really an industrial dispute. The reason that they're 154 00:10:48,000 --> 00:10:52,000 Speaker 3: asking for this twenty five percent immediate pay rise is 155 00:10:52,040 --> 00:10:55,800 Speaker 3: to stem the tide of staff from the system, which 156 00:10:55,840 --> 00:10:59,320 Speaker 3: they say is making the system unsafe. They feel as 157 00:10:59,320 --> 00:11:02,800 Speaker 3: if they're now complicit in an unsafe system. They feel 158 00:11:02,880 --> 00:11:08,080 Speaker 3: so desperate and concerned in terms of working within a 159 00:11:08,120 --> 00:11:11,600 Speaker 3: system like that. So this is really the result of 160 00:11:11,800 --> 00:11:16,240 Speaker 3: not just a disparity between the staff salaries that can 161 00:11:16,280 --> 00:11:18,920 Speaker 3: be commanded in the public system versus a private and 162 00:11:18,960 --> 00:11:23,720 Speaker 3: also interstate it's also about decades of underfunding a mental healthcare, 163 00:11:23,760 --> 00:11:27,360 Speaker 3: which we've of course covered very extensively recently in the 164 00:11:27,400 --> 00:11:29,880 Speaker 3: Australian I think it's fair to say it is at 165 00:11:29,960 --> 00:11:32,600 Speaker 3: rock bottom at the moment. The system is on its 166 00:11:32,640 --> 00:11:37,239 Speaker 3: knees and it's really the morale that is just so 167 00:11:37,240 --> 00:11:41,720 Speaker 3: so bad in this system. They're feeling just battered and 168 00:11:41,800 --> 00:11:47,360 Speaker 3: bruised within the system. It's exhausting. The culture in public 169 00:11:47,400 --> 00:11:49,960 Speaker 3: health systems across the country is in a very bad way. 170 00:11:51,160 --> 00:11:54,520 Speaker 1: The need for specialized mental health care doesn't disappear just 171 00:11:54,520 --> 00:11:58,560 Speaker 1: because the assistance is no longer there. So where does 172 00:11:58,600 --> 00:12:00,240 Speaker 1: this saga end? 173 00:12:00,640 --> 00:12:04,280 Speaker 3: The reality is that most of these specialists that are 174 00:12:04,320 --> 00:12:08,080 Speaker 3: handed in their resignations do not want to resign. These 175 00:12:08,120 --> 00:12:11,080 Speaker 3: are people who are committed to the public system. They're 176 00:12:11,080 --> 00:12:14,800 Speaker 3: committed to the most vulnerable patients. They wouldn't be in 177 00:12:14,960 --> 00:12:19,280 Speaker 3: psychiatry if they weren't altruistic, if they weren't committed to 178 00:12:19,640 --> 00:12:24,360 Speaker 3: care of some of the most disadvantaged people in our country. 179 00:12:25,000 --> 00:12:27,680 Speaker 3: A lot of them don't actually know where they're going 180 00:12:27,760 --> 00:12:28,040 Speaker 3: to go. 181 00:12:29,400 --> 00:12:32,600 Speaker 1: There are options for psychiatrists outside the New South Wales 182 00:12:32,720 --> 00:12:37,439 Speaker 1: public system. There's academic or local work, private opportunities as 183 00:12:37,440 --> 00:12:41,040 Speaker 1: well as work in other states and territories, but redeploying 184 00:12:41,120 --> 00:12:44,640 Speaker 1: them as visiting medical offices or locums could end up 185 00:12:44,640 --> 00:12:47,800 Speaker 1: costing the state just as much, if not more than 186 00:12:47,840 --> 00:12:49,520 Speaker 1: the pay rise they've requested. 187 00:12:50,440 --> 00:12:53,640 Speaker 3: But the reality is that by not having these people 188 00:12:54,440 --> 00:12:58,640 Speaker 3: attached to the public system as permanent employees who are 189 00:12:59,240 --> 00:13:03,320 Speaker 3: working not only on behalf of patients who they know, 190 00:13:04,240 --> 00:13:08,880 Speaker 3: with colleagues that they know, but also contributing to the 191 00:13:08,920 --> 00:13:14,199 Speaker 3: positive culture and the promotion of safety unsafe systems within 192 00:13:14,559 --> 00:13:19,240 Speaker 3: those public hospitals. If we lose all of that, it's 193 00:13:19,280 --> 00:13:22,400 Speaker 3: a tragedy. It's very concerning for the safety of patients 194 00:13:22,559 --> 00:13:25,400 Speaker 3: is going to have knock on effects right throughout the system. 195 00:13:25,440 --> 00:13:28,360 Speaker 3: But of course, in something like perinatal psychiatry, child and 196 00:13:28,360 --> 00:13:32,560 Speaker 3: adolescent psychiatry, the whole system is under threat because there's 197 00:13:32,559 --> 00:13:35,600 Speaker 3: not very many of these specialists psychiatrists, So what on 198 00:13:35,640 --> 00:13:36,880 Speaker 3: earth are they going to do. 199 00:13:43,320 --> 00:13:47,520 Speaker 1: Natasha Robinson is The Australian's Health Editor. You can read 200 00:13:47,559 --> 00:13:50,439 Speaker 1: all her reporting and analysis on the state of Australia's 201 00:13:50,440 --> 00:13:53,840 Speaker 1: mental healthcare system anytime at the Australian dot com dot 202 00:13:53,840 --> 00:14:01,320 Speaker 1: au