Victorian psychiatrist trainees have sounded the alarm over a reduction in government funding for junior doctors in mental health wards, warning it will have “severe consequences”.
Having junior doctors completing mandatory stints in public hospital psychiatry wards was a recommendation by Victoria’s landmark mental health royal commission to tackle workforce shortages. The state has a target of 70% of junior doctors doing a psychiatrist stint, and has funded some of these positions since 2021.
But a letter from psychiatry registrars at St Vincent’s hospital in Melbourne said junior doctor positions in its mental health department would be cut from 17 to four next year, due to a funding shortfall.
Medical sources have confirmed to Guardian Australian that from next year the state’s health department will require public hospitals to fund 25% of the junior doctor positions on psychiatric wards. Previously, the department had fully funded the positions.
The letter to the state’s mental health and health ministers said the reduction in junior doctor positions in the wards would drastically impact the ability for staff to make “timely diagnoses” for patients and ensure there was appropriate follow-up care.
“Many patients with psychiatric illness die from preventable physical health illnesses due to barriers in accessing care,” the letter said.
“As a result, it is likely that our patients will experience a greater number of preventable deaths.”
The registrars argued the reduced funding was at odds with the royal commission’s recommendation and would lead to greater burnout among existing staff due to increased workload.
Simon Stafrace, the Victorian chair of the Royal Australian and New Zealand College of Psychiatrists, called on health services and the department to work together to ensure junior doctor placements in psychiatry were supported.
“With these additional positions, there has absolutely been an uplift in interest in psychiatry,” he said.
The Department of Health said it had worked to ensure the target of junior doctors completing a psychiatry rotation could be maintained in 2024.
“These rotations are important for improving the mental health literacy of our future healthcare workers as we build a more diverse, multidisciplinary and sustainable workforce so Victorians can access the best care and support,” a spokesperson said.
A Melbourne-based psychiatrist at a different public hospital, who requested anonymity, said hospitals were not warned that the funding would be reduced when the reform was implemented after the royal commission.
“We then have to take money from other areas and all our money is budgeted for. There is no wriggle room,” the psychiatrist said.
“Free-market economics just doesn’t make sense in a public health system. Where do we get the money from?”
Guardian Australia understands some hospitals will be able to make up the shortfall of funding to maintain the number of positions.
The state’s peak psychiatry body has previously said staff shortages remained a major barrier to implementing the royal commission’s reform. The inquiry, which tabled its final report in 2021, concluded the state’s mental health workforce was overworked and resourced, leading to “serious shortages”.
The royal commission’s interim report, published in 2019, recommended that by 2023 all junior doctors undertake a psychiatry rotation. The inquiry said early and positive experiences of psychiatry exposure could help increase the number of doctors who choose to specialise in the field.
A spokesperson for the Victorian government said there was no change to the target of junior doctors completing psychiatry rotations.
“We’re investing heavily in our future workforce as we build a stronger, better connected and more responsive mental health system in Victoria.”
But the opposition’s mental health spokesperson, Emma Kealy, said the decision was at odds with the royal commission’s recommendation to urgently build up the state’s mental health workforce.
“It will make it even harder for Victorians to get the urgent mental health support they need.”
Crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; Kids Helpline 1800 55 1800; MensLine Australia 1300 78 99 78; Beyond Blue 1300 22 4636
