WEBVTT - Mums and bubs left behind

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<v Speaker 1>A note before we start. This episode contains mention of

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<v Speaker 1>complex mental illness from the Australian. Here's what's on the front.

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<v Speaker 1>I'm Christinamia. It's Thursday, January sixteenth. Prime Minister Anthony Albanesi

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<v Speaker 1>says strong action should be taken against people who perpetrate

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<v Speaker 1>anti Semitic attacks on Australian synagogues, but he won't back

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<v Speaker 1>mandatory sentences for the offense or convene a national cabinet

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<v Speaker 1>to tackle the nation's antisemitism crisis. That story is live

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<v Speaker 1>right now at the Australian dot com dot au. After

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<v Speaker 1>days of negotiations, Israel and Hamas struck a ceasefire deal overnight.

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<v Speaker 1>You can read all the details about the long awaited

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<v Speaker 1>agreement to end the Middle Eastern conflict right now at

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<v Speaker 1>the Australian dot Com dot aus. Experiencing complex mental illnesses

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<v Speaker 1>could be blocked from specialist psychiatric care in New South

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<v Speaker 1>Wales as hundreds of psychiatrists abandoned the state's flailing mental

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<v Speaker 1>health care system. That's today's episode. Arianne Beaston remembers those

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<v Speaker 1>sleepless nights with her son Henry well he was waking

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<v Speaker 1>up as newborns tend to do every forty five minutes,

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<v Speaker 1>making her return to work after a stint of parental

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<v Speaker 1>leave all the more challenging. But even in those hazy,

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<v Speaker 1>waking moments, Arianne felt like she was living a nightmare.

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<v Speaker 1>She saw dragons everywhere, their apparent hunger for her tiny

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<v Speaker 1>baby burning in their eyes. She doubted if the hands

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<v Speaker 1>attached to the ends of her arms truly belonged to her,

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<v Speaker 1>and she wondered more than once if her blue eyed

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<v Speaker 1>baby was the product of a mix up at the hospital.

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<v Speaker 2>I experienced postpartum psychosis, which is a rare mental illness

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<v Speaker 2>bit effects one to two in every one thousand months.

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<v Speaker 1>Arianne was admitted to a private mothers and baby psychiatric

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<v Speaker 1>unit to help her manage the delusions and hallucinations she

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<v Speaker 1>experienced following the birth of her son.

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<v Speaker 2>It was the only unit of its kind. It was

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<v Speaker 2>critical for me to be a bitt. I was experiencing

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<v Speaker 2>quite severe side effects on the medications I'd been prescribed.

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<v Speaker 1>At the time, no such service was available in the

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<v Speaker 1>public healthcare system. Instead, mothers and babies who couldn't afford

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<v Speaker 1>to take the private route were typically separated during treatment.

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<v Speaker 1>In the years since Arian's son Henry is now a

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<v Speaker 1>thriving teenager. Dedicated perinatal psychiatric health care beds have been

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<v Speaker 1>made available in hospitals across New South Wales.

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<v Speaker 2>The Australian Political Guidelines recommend that where possible, moms and

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<v Speaker 2>babies should be admitted together. And what this allows is

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<v Speaker 2>the opportunity for women, where it's safe and where they're

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<v Speaker 2>able to do so, to really bond with their baby,

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<v Speaker 2>to receive help not just around their mental health but

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<v Speaker 2>also new settling and feeding their babies on all of

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<v Speaker 2>those things that can be really, really difficult when you're

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<v Speaker 2>also experiencing a complex mental illness.

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<v Speaker 1>But now New South Wales mothers could be without this

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<v Speaker 1>vital care as some of Sydney's biggest hospitals close the

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<v Speaker 1>few beds they have available.

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<v Speaker 3>First thing to say is that mental health disorders in

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<v Speaker 3>the postpartum period are very common and will be experienced

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<v Speaker 3>by between ten and twenty percent of new mothers.

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<v Speaker 1>Natasha Robinson is the Australian's Health Editor.

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<v Speaker 3>In the most severe cases that can include dug postnatal

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<v Speaker 3>psychosis and relapses of severe conditions like a schizphrenia and

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<v Speaker 3>bipolar and what this requires given breastfeeding is involved, is

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<v Speaker 3>very specialist skills and knowledge as to medication management for

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<v Speaker 3>new mothers, and that's why it's really important to have

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<v Speaker 3>care provided by specialists trained perinatal psychiatrists, of which there

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<v Speaker 3>are very few in New South Wales and everywhere really,

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<v Speaker 3>but in New South Wales there's only sort of less

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<v Speaker 3>than twenty of these specialists that actually exist.

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<v Speaker 1>There are just two mental health units comprising sixteen beds

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<v Speaker 1>in New South Wales where new mothers can be admitted

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<v Speaker 1>with their babies, and those beds are now being capped

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<v Speaker 1>or closed for service altogether as the state's mental health

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<v Speaker 1>care sector spirals into chaos.

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<v Speaker 3>A mental health system already under immense strain and days

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<v Speaker 3>seventy seven percent of the state's public psychiatrists will leave

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<v Speaker 3>their jobs, so there's only in fact four beds open

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<v Speaker 3>at the moment, and the information from psychiatrists within those

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<v Speaker 3>units and across the state from community mental health teams

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<v Speaker 3>is that admissions have been denied out of area. So

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<v Speaker 3>this really leaves people in regional areas in particular, in

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<v Speaker 3>a very bad situation because these units are supposed to

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<v Speaker 3>provide care statewide.

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<v Speaker 1>Arianne is grateful that she was able to access this

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<v Speaker 1>kind of vital health care via the private system, and

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<v Speaker 1>she knows better than anyone why it needs to be

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<v Speaker 1>available to other new mums, no matter where they live.

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<v Speaker 2>Not having access to these units means that women with

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<v Speaker 2>complex perinatal mental illness need to be admitted to general

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<v Speaker 2>psychiatric woards without their babies, which is hugely in an

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<v Speaker 2>already really difficult time and a really vulnerable period for

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<v Speaker 2>these women. So these beds, these units are critical a.

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<v Speaker 3>Save live of course for the most vulnerable people and

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<v Speaker 3>people who can't afford that care, they're left with no

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<v Speaker 3>option and for a long time in all states, including

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<v Speaker 3>New South Wales, these new mums, breastfeeding mums have been

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<v Speaker 3>separated from their babies, so they're admitted to acute wards

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<v Speaker 3>in public hospitals and they're not able to be with

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<v Speaker 3>their baby, which is very very devastating, but it also

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<v Speaker 3>has profound impacts on the entire family and on the

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<v Speaker 3>development of the child. And of course the worst case

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<v Speaker 3>scenario if you can't even access an acute impatient bed,

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<v Speaker 3>and of course all beds will be under pressure. Across

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<v Speaker 3>the New South Wales of these resignations take effect, is

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<v Speaker 3>that mothers can't access inpatient care at all in these

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<v Speaker 3>dire situations, and that posts is a fairly high risk

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<v Speaker 3>to mother and baby. In fact, severe mental health conditions

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<v Speaker 3>in the postpartum period are in fact a leading cause

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<v Speaker 3>of death for these mothers and babies. So the states

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<v Speaker 3>are very.

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<v Speaker 1>High coming up. Why hundreds of psychiatric specialists have handed

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<v Speaker 1>in their resignations, Natasha, You've been covering healthcare for a

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<v Speaker 1>long time as the paper's health editor. Have you ever

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<v Speaker 1>seen anything like this?

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<v Speaker 3>No, I never have, and their state has never seen

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<v Speaker 3>or resignations on mass in these numbers, I mean, they're

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<v Speaker 3>extraordinary numbers. Two hundred and one star specialist psychiatrists making

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<v Speaker 3>up a very large tunk of the workforce, and it

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<v Speaker 3>really is just an indication of how carless the state

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<v Speaker 3>of mental health care is in New South Wales at

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<v Speaker 3>this time.

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<v Speaker 1>By next Tuesday, the state's mental health care system could

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<v Speaker 1>look completely different. More than two hundred psychiatrists, half of

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<v Speaker 1>the state's current cohort, are set to walk away from

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<v Speaker 1>their jobs citing concerns about pay and conditions they say

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<v Speaker 1>are unworkable. Now, with just five days to go and

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<v Speaker 1>no resolution in sight, the state and federal governments appeals

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<v Speaker 1>to doctors to abandon their resignation plans have become more desperate.

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<v Speaker 1>Please don't do this.

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<v Speaker 3>Remain at the table.

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<v Speaker 1>This was the plea made by Minister for Health Ryan

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<v Speaker 1>Park in a press conference this week. We can't afford

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<v Speaker 1>wage increases are kin to around ninety thousand dollars.

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<v Speaker 3>What they're saying is, look, if we give a twenty

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<v Speaker 3>five percent immediate uplifting pay to psychiatrists, then every medical

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<v Speaker 3>specialty is going to be coming to us wanting the same.

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<v Speaker 3>So that is an understandable position. But no other specialty

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<v Speaker 3>has thirty percent of its staff specialist positions vacant at

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<v Speaker 3>the moment. No other specialty has an extraordinary staff exodus

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<v Speaker 3>like this. No other specialty really has experienced the kind

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<v Speaker 3>of spiral of decline that mental health care has amid

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<v Speaker 3>record demand. Given all of that, there would seem to

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<v Speaker 3>be a case that this is a special case. It's

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<v Speaker 3>not just another industrial demand.

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<v Speaker 1>Natasha says. The new South Wales government needs to decide

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<v Speaker 1>if it's actually possible to run the state's mental health

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<v Speaker 1>care system with next to no specialist psychiatrists on their books.

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<v Speaker 3>It seems to be an extraordinary proposition that you could

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<v Speaker 3>do that. It will have knock on effects the government

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<v Speaker 3>is admitting freely and patients will be impacted. So is

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<v Speaker 3>it feasible for a government to wear that and to

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<v Speaker 3>have that on its record. That's for them to decide.

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<v Speaker 1>There's a bit of a misconception that hundreds of special

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<v Speaker 1>psychiatrists in New South Wales are resigning because they're not

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<v Speaker 1>paid enough. In reality, they say years of underfunding and

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<v Speaker 1>under resourcing has created a tinderbox. Doctors are exhausted and

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<v Speaker 1>they're concerned vulnerable patients will pay the price.

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<v Speaker 3>This has been cast by the government as an industrial dispute.

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<v Speaker 3>It's not really an industrial dispute. The reason that they're

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<v Speaker 3>asking for this twenty five percent immediate pay rise is

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<v Speaker 3>to stem the tide of staff from the system, which

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<v Speaker 3>they say is making the system unsafe. They feel as

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<v Speaker 3>if they're now complicit in an unsafe system. They feel

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<v Speaker 3>so desperate and concerned in terms of working within a

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<v Speaker 3>system like that. So this is really the result of

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<v Speaker 3>not just a disparity between the staff salaries that can

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<v Speaker 3>be commanded in the public system versus a private and

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<v Speaker 3>also interstate it's also about decades of underfunding a mental healthcare,

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<v Speaker 3>which we've of course covered very extensively recently in the

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<v Speaker 3>Australian I think it's fair to say it is at

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<v Speaker 3>rock bottom at the moment. The system is on its

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<v Speaker 3>knees and it's really the morale that is just so

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<v Speaker 3>so bad in this system. They're feeling just battered and

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<v Speaker 3>bruised within the system. It's exhausting. The culture in public

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<v Speaker 3>health systems across the country is in a very bad way.

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<v Speaker 1>The need for specialized mental health care doesn't disappear just

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<v Speaker 1>because the assistance is no longer there. So where does

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<v Speaker 1>this saga end?

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<v Speaker 3>The reality is that most of these specialists that are

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<v Speaker 3>handed in their resignations do not want to resign. These

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<v Speaker 3>are people who are committed to the public system. They're

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<v Speaker 3>committed to the most vulnerable patients. They wouldn't be in

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<v Speaker 3>psychiatry if they weren't altruistic, if they weren't committed to

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<v Speaker 3>care of some of the most disadvantaged people in our country.

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<v Speaker 3>A lot of them don't actually know where they're going

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<v Speaker 3>to go.

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<v Speaker 1>There are options for psychiatrists outside the New South Wales

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<v Speaker 1>public system. There's academic or local work, private opportunities as

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<v Speaker 1>well as work in other states and territories, but redeploying

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<v Speaker 1>them as visiting medical offices or locums could end up

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<v Speaker 1>costing the state just as much, if not more than

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<v Speaker 1>the pay rise they've requested.

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<v Speaker 3>But the reality is that by not having these people

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<v Speaker 3>attached to the public system as permanent employees who are

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<v Speaker 3>working not only on behalf of patients who they know,

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<v Speaker 3>with colleagues that they know, but also contributing to the

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<v Speaker 3>positive culture and the promotion of safety unsafe systems within

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<v Speaker 3>those public hospitals. If we lose all of that, it's

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<v Speaker 3>a tragedy. It's very concerning for the safety of patients

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<v Speaker 3>is going to have knock on effects right throughout the system.

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<v Speaker 3>But of course, in something like perinatal psychiatry, child and

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<v Speaker 3>adolescent psychiatry, the whole system is under threat because there's

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<v Speaker 3>not very many of these specialists psychiatrists, So what on

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<v Speaker 3>earth are they going to do.

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<v Speaker 1>Natasha Robinson is The Australian's Health Editor. You can read

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<v Speaker 1>all her reporting and analysis on the state of Australia's

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<v Speaker 1>mental healthcare system anytime at the Australian dot com dot

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<v Speaker 1>au