Workforce shortages are risking patient care in the bush, 9 in 10 rural psychiatrists say

Ninety-four per cent of Australia’s psychiatrists that practice in regional, rural and remote locations say workforce shortages are negatively impacting patient care, with 8 in 10 reporting that workforce shortages are contributing to burnout in psychiatry.

A new nationwide survey of 1269 psychiatrists conducted by the Royal Australian and New Zealand College of Psychiatrists (RANZCP), has highlighted the pressures mounting on psychiatrists working in the bush, as 74 per cent reported experiencing multiple symptoms of burnout. It has also revealed that 33 per cent of psychiatrists based in regional, rural and remote parts of the country are considering leaving the profession in the next five years. 

Of the 294 psychiatrists surveyed in these areas: 

  • 83 per cent said they experienced reduced work satisfaction and loss of motivation to work and 76 per cent said they felt exhausted and drained all the time in the past three years. 
  • 77 per cent said they observed an increase in the symptoms of burnout amongst colleagues in the past three years. 
  • 86 per cent said workforce shortages and inadequate staffing are contributing to burnout amongst psychiatrists, followed by under resourcing of the mental health system (82%), workloads and increasing complexity of mental health presentations (69%)
  • 78 per cent said adequate staffing levels would contribute to their job satisfaction as psychiatrists, followed by having enough resources and time to genuinely help patients (77%)

Previous AIHW data has indicated that there are as few as zero psychiatrists in many very remote parts of Australia, causing a big gap in mental health service delivery for communities in the bush. 

RANZCP Chair of Rural Psychiatry Dr Matthew Coleman said that the findings have shone light on the severity of the workforce shortage crisis in country Australia.

“Around one in five Australians will experience a mental health condition, but in rural areas, the rates of suicide, self-harm and emergency admissions for mental illness increase with how remote you live.

“For some of the most vulnerable people in the bush, accessing essential mental health care can even be impossible. Help is too far away, costly, delayed due to long wait times or simply unavailable. 

“There is a critical and chronic shortage of psychiatrists in Australia. Not only are there not enough, but they are also unevenly distributed. 

“Only 14% of Australian psychiatrists work rurally, but 29% of the population – around 7 million people – live in regional, rural and remote areas. 

“Rural psychiatrists are under increasing pressure to do more with less. Ultimately, it’s the community that will pay the price. Something has to change. 

Dr Coleman said the Federal Government needed to urgently bridge the gap and ensure that every Australian, regardless of their postcode, receives the timely and affordable care they need.

“We need targeted and sustainable Commonwealth investment in attracting, training, retaining and uniformly distributing psychiatrists in rural Australia. 

“Per capital spend on mental health services in regional and rural communities is lower than in the cities, despite glaring evidence that they are at higher risk of suicide and mental health disorders. 

“We’re calling on Jim Chalmers, the Treasurer and Mark Butler, the Minister for Health, to invest in bolstering the mental health workforce in Australia’s in every corner, not just cities. 

“In the next Federal Budget, we’re expecting to see investment to improve the psychiatry and mental health workforce in country Australia. 

“Bad mental health is bad for the economy. The Productivity Commission estimated that disability and premature death due to mental ill-health, suicide and self-inflicted injury costed the economy $151 billion in 2018-19. 

“Getting Australians, the help they need, when and where they need it from a skilled and well supported workforce, can go a long way in prevention and early intervention into mental health conditions. 

"With affordable and timely access to mental healthcare, rural communities can live their lives meaningfully and to their fullest,” Dr Coleman said. 

Ahead of the Federal Budget in May, the RANZCP is calling on the Federal Government to:

Attract 

  • Invest $7.06 million to fund the Psychiatry Interest Forum program for a further 6.5 years to attract the next generation of psychiatry trainees.   

Train 

  • Invest an additional $24.85 million to expand the Psychiatry Workforce Program to support an additional 45 trainee and training supervisor posts.   
  • Increase Specialist Trainee Program (STP) funding by $5.52 million over three years to fund additional training placements in private hospital settings in 2025-2027 to ease pressure on consultant psychiatrists and enable private hospital beds to be used to appropriate capacity.   
  • Invest $225,000 over three years to support Directors of Training and administration staff to ensure additional training posts have adequate oversight and support.   
  • Introduce a new funding stream to support the establishment of new psychiatry trainee placements in private psychiatric practices.   
  • Invest $6.95 million to extend the Military and Veteran Psychiatry Training Program from 2025 to 2028.  

Retain

  • Improve working conditions by:   
    1. Introducing a new psychiatry MBS ‘complex care’ item for assessment, support, and management of people with complex mental health presentations and/or circumstances   
    2. Increasing the MBS rebate for psychiatry services to 100% of the schedule fee from the current 85%, and increase the MBS billing provision for psychiatry trainees, so they can bill at 60% of the consultant psychiatrist rate.   
  • Support collaboration across the mental health workforce by investing $11 million each year for three years to train nurses to become accredited mental health nurses.

View the RANZCP’s full pre-budget submission

About the survey

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) surveyed members across Australia in December 2023 to get their views on the impact of workforce shortages on their wellbeing, job satisfaction and patient care.

The survey received responses from 1269 psychiatrists that highlighted the severity of the workforce shortage crisis. Over 90 per cent of respondents believed psychiatry workforce shortages negatively impact patient care and 82.05 per cent of respondents said workforce shortages are contributing to burnout in the profession.

RANZCP 2024 Workforce Survey Report



For all other expert mental health information visit Your Health in Mind, the RANZCP’s consumer health information website.

ENQUIRIES: For more information, or to arrange an interview call Dishi Gahlowt on +61 437 315 911, or email media@ranzcp.org.

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org.

In Australia: If you or someone you know needs help, contact Lifeline on 13 11 14 or www.lifeline.org.au or the Suicide Callback Service on 1300 659 467 or www.suicidecallbackservice.org.au.

In New Zealand: If you or someone you know needs help, contact Lifeline NZ on 0800 543 354 or www.lifeline.org.nz or the Suicide Crisis Helpline on 0508 828 865 or www.lifeline.org.nz/suicide-prevention.

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