Speaker 1: A note before we start. This episode contains mention of
Speaker 1: complex mental illness from the Australian. Here's what's on the front.
Speaker 1: I'm Christinamia. It's Thursday, January sixteenth. Prime Minister Anthony Albanesi
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Speaker 1: the Australian dot Com dot aus. Experiencing complex mental illnesses
Speaker 1: could be blocked from specialist psychiatric care in New South
Speaker 1: Wales as hundreds of psychiatrists abandoned the state's flailing mental
Speaker 1: health care system. That's today's episode. Arianne Beaston remembers those
Speaker 1: sleepless nights with her son Henry well he was waking
Speaker 1: up as newborns tend to do every forty five minutes,
Speaker 1: making her return to work after a stint of parental
Speaker 1: leave all the more challenging. But even in those hazy,
Speaker 1: waking moments, Arianne felt like she was living a nightmare.
Speaker 1: She saw dragons everywhere, their apparent hunger for her tiny
Speaker 1: baby burning in their eyes. She doubted if the hands
Speaker 1: attached to the ends of her arms truly belonged to her,
Speaker 1: and she wondered more than once if her blue eyed
Speaker 1: baby was the product of a mix up at the hospital.
Speaker 2: I experienced postpartum psychosis, which is a rare mental illness
Speaker 2: bit effects one to two in every one thousand months.
Speaker 1: Arianne was admitted to a private mothers and baby psychiatric
Speaker 1: unit to help her manage the delusions and hallucinations she
Speaker 1: experienced following the birth of her son.
Speaker 2: It was the only unit of its kind. It was
Speaker 2: critical for me to be a bitt. I was experiencing
Speaker 2: quite severe side effects on the medications I'd been prescribed.
Speaker 1: At the time, no such service was available in the
Speaker 1: public healthcare system. Instead, mothers and babies who couldn't afford
Speaker 1: to take the private route were typically separated during treatment.
Speaker 1: In the years since Arian's son Henry is now a
Speaker 1: thriving teenager. Dedicated perinatal psychiatric health care beds have been
Speaker 1: made available in hospitals across New South Wales.
Speaker 2: The Australian Political Guidelines recommend that where possible, moms and
Speaker 2: babies should be admitted together. And what this allows is
Speaker 2: the opportunity for women, where it's safe and where they're
Speaker 2: able to do so, to really bond with their baby,
Speaker 2: to receive help not just around their mental health but
Speaker 2: also new settling and feeding their babies on all of
Speaker 2: those things that can be really, really difficult when you're
Speaker 2: also experiencing a complex mental illness.
Speaker 1: But now New South Wales mothers could be without this
Speaker 1: vital care as some of Sydney's biggest hospitals close the
Speaker 1: few beds they have available.
Speaker 3: First thing to say is that mental health disorders in
Speaker 3: the postpartum period are very common and will be experienced
Speaker 3: by between ten and twenty percent of new mothers.
Speaker 1: Natasha Robinson is the Australian's Health Editor.
Speaker 3: In the most severe cases that can include dug postnatal
Speaker 3: psychosis and relapses of severe conditions like a schizphrenia and
Speaker 3: bipolar and what this requires given breastfeeding is involved, is
Speaker 3: very specialist skills and knowledge as to medication management for
Speaker 3: new mothers, and that's why it's really important to have
Speaker 3: care provided by specialists trained perinatal psychiatrists, of which there
Speaker 3: are very few in New South Wales and everywhere really,
Speaker 3: but in New South Wales there's only sort of less
Speaker 3: than twenty of these specialists that actually exist.
Speaker 1: There are just two mental health units comprising sixteen beds
Speaker 1: in New South Wales where new mothers can be admitted
Speaker 1: with their babies, and those beds are now being capped
Speaker 1: or closed for service altogether as the state's mental health
Speaker 1: care sector spirals into chaos.
Speaker 3: A mental health system already under immense strain and days
Speaker 3: seventy seven percent of the state's public psychiatrists will leave
Speaker 3: their jobs, so there's only in fact four beds open
Speaker 3: at the moment, and the information from psychiatrists within those
Speaker 3: units and across the state from community mental health teams
Speaker 3: is that admissions have been denied out of area. So
Speaker 3: this really leaves people in regional areas in particular, in
Speaker 3: a very bad situation because these units are supposed to
Speaker 3: provide care statewide.
Speaker 1: Arianne is grateful that she was able to access this
Speaker 1: kind of vital health care via the private system, and
Speaker 1: she knows better than anyone why it needs to be
Speaker 1: available to other new mums, no matter where they live.
Speaker 2: Not having access to these units means that women with
Speaker 2: complex perinatal mental illness need to be admitted to general
Speaker 2: psychiatric woards without their babies, which is hugely in an
Speaker 2: already really difficult time and a really vulnerable period for
Speaker 2: these women. So these beds, these units are critical a.
Speaker 3: Save live of course for the most vulnerable people and
Speaker 3: people who can't afford that care, they're left with no
Speaker 3: option and for a long time in all states, including
Speaker 3: New South Wales, these new mums, breastfeeding mums have been
Speaker 3: separated from their babies, so they're admitted to acute wards
Speaker 3: in public hospitals and they're not able to be with
Speaker 3: their baby, which is very very devastating, but it also
Speaker 3: has profound impacts on the entire family and on the
Speaker 3: development of the child. And of course the worst case
Speaker 3: scenario if you can't even access an acute impatient bed,
Speaker 3: and of course all beds will be under pressure. Across
Speaker 3: the New South Wales of these resignations take effect, is
Speaker 3: that mothers can't access inpatient care at all in these
Speaker 3: dire situations, and that posts is a fairly high risk
Speaker 3: to mother and baby. In fact, severe mental health conditions
Speaker 3: in the postpartum period are in fact a leading cause
Speaker 3: of death for these mothers and babies. So the states
Speaker 3: are very.
Speaker 1: High coming up. Why hundreds of psychiatric specialists have handed
Speaker 1: in their resignations, Natasha, You've been covering healthcare for a
Speaker 1: long time as the paper's health editor. Have you ever
Speaker 1: seen anything like this?
Speaker 3: No, I never have, and their state has never seen
Speaker 3: or resignations on mass in these numbers, I mean, they're
Speaker 3: extraordinary numbers. Two hundred and one star specialist psychiatrists making
Speaker 3: up a very large tunk of the workforce, and it
Speaker 3: really is just an indication of how carless the state
Speaker 3: of mental health care is in New South Wales at
Speaker 3: this time.
Speaker 1: By next Tuesday, the state's mental health care system could
Speaker 1: look completely different. More than two hundred psychiatrists, half of
Speaker 1: the state's current cohort, are set to walk away from
Speaker 1: their jobs citing concerns about pay and conditions they say
Speaker 1: are unworkable. Now, with just five days to go and
Speaker 1: no resolution in sight, the state and federal governments appeals
Speaker 1: to doctors to abandon their resignation plans have become more desperate.
Speaker 1: Please don't do this.
Speaker 3: Remain at the table.
Speaker 1: This was the plea made by Minister for Health Ryan
Speaker 1: Park in a press conference this week. We can't afford
Speaker 1: wage increases are kin to around ninety thousand dollars.
Speaker 3: What they're saying is, look, if we give a twenty
Speaker 3: five percent immediate uplifting pay to psychiatrists, then every medical
Speaker 3: specialty is going to be coming to us wanting the same.
Speaker 3: So that is an understandable position. But no other specialty
Speaker 3: has thirty percent of its staff specialist positions vacant at
Speaker 3: the moment. No other specialty has an extraordinary staff exodus
Speaker 3: like this. No other specialty really has experienced the kind
Speaker 3: of spiral of decline that mental health care has amid
Speaker 3: record demand. Given all of that, there would seem to
Speaker 3: be a case that this is a special case. It's
Speaker 3: not just another industrial demand.
Speaker 1: Natasha says. The new South Wales government needs to decide
Speaker 1: if it's actually possible to run the state's mental health
Speaker 1: care system with next to no specialist psychiatrists on their books.
Speaker 3: It seems to be an extraordinary proposition that you could
Speaker 3: do that. It will have knock on effects the government
Speaker 3: is admitting freely and patients will be impacted. So is
Speaker 3: it feasible for a government to wear that and to
Speaker 3: have that on its record. That's for them to decide.
Speaker 1: There's a bit of a misconception that hundreds of special
Speaker 1: psychiatrists in New South Wales are resigning because they're not
Speaker 1: paid enough. In reality, they say years of underfunding and
Speaker 1: under resourcing has created a tinderbox. Doctors are exhausted and
Speaker 1: they're concerned vulnerable patients will pay the price.
Speaker 3: This has been cast by the government as an industrial dispute.
Speaker 3: It's not really an industrial dispute. The reason that they're
Speaker 3: asking for this twenty five percent immediate pay rise is
Speaker 3: to stem the tide of staff from the system, which
Speaker 3: they say is making the system unsafe. They feel as
Speaker 3: if they're now complicit in an unsafe system. They feel
Speaker 3: so desperate and concerned in terms of working within a
Speaker 3: system like that. So this is really the result of
Speaker 3: not just a disparity between the staff salaries that can
Speaker 3: be commanded in the public system versus a private and
Speaker 3: also interstate it's also about decades of underfunding a mental healthcare,
Speaker 3: which we've of course covered very extensively recently in the
Speaker 3: Australian I think it's fair to say it is at
Speaker 3: rock bottom at the moment. The system is on its
Speaker 3: knees and it's really the morale that is just so
Speaker 3: so bad in this system. They're feeling just battered and
Speaker 3: bruised within the system. It's exhausting. The culture in public
Speaker 3: health systems across the country is in a very bad way.
Speaker 1: The need for specialized mental health care doesn't disappear just
Speaker 1: because the assistance is no longer there. So where does
Speaker 1: this saga end?
Speaker 3: The reality is that most of these specialists that are
Speaker 3: handed in their resignations do not want to resign. These
Speaker 3: are people who are committed to the public system. They're
Speaker 3: committed to the most vulnerable patients. They wouldn't be in
Speaker 3: psychiatry if they weren't altruistic, if they weren't committed to
Speaker 3: care of some of the most disadvantaged people in our country.
Speaker 3: A lot of them don't actually know where they're going
Speaker 3: to go.
Speaker 1: There are options for psychiatrists outside the New South Wales
Speaker 1: public system. There's academic or local work, private opportunities as
Speaker 1: well as work in other states and territories, but redeploying
Speaker 1: them as visiting medical offices or locums could end up
Speaker 1: costing the state just as much, if not more than
Speaker 1: the pay rise they've requested.
Speaker 3: But the reality is that by not having these people
Speaker 3: attached to the public system as permanent employees who are
Speaker 3: working not only on behalf of patients who they know,
Speaker 3: with colleagues that they know, but also contributing to the
Speaker 3: positive culture and the promotion of safety unsafe systems within
Speaker 3: those public hospitals. If we lose all of that, it's
Speaker 3: a tragedy. It's very concerning for the safety of patients
Speaker 3: is going to have knock on effects right throughout the system.
Speaker 3: But of course, in something like perinatal psychiatry, child and
Speaker 3: adolescent psychiatry, the whole system is under threat because there's
Speaker 3: not very many of these specialists psychiatrists, So what on
Speaker 3: earth are they going to do.
Speaker 1: Natasha Robinson is The Australian's Health Editor. You can read
Speaker 1: all her reporting and analysis on the state of Australia's
Speaker 1: mental healthcare system anytime at the Australian dot com dot
Speaker 1: au