Thread by @coopesdetat

This afternoon I will be tweeting from #RANZCP2021 sessions on mental health workforce, and DV, trauma & substance use. John Allan getting us underway now. @croakeynews will be covering sessions on ADHD, and the MH of veterans and first responders

The psychiatry workforce is ageing, and about 50:50 public vs private says Allan. Stressors include too much work to do with not enough time to do it #ranzcp2021

Just 6 psychiatrists in Australia service very remote regions. SIX! Versus 2,671 in the cities. Significant rural maldistribution #RANZCP2021

The College has made some suggestions to the federal government on addressing these issues #RANZCP2021. Interesting to hear Australia is transitioning to a two-year intern model, with psychiatry angling to become a mandatory rotation

Next up will be Harvey Whiteford, who will be delving into the issue from the @ozprodcom perspective #RANZCP2021

Recs from @ozprodcom on Australia's mental health workforce. Psychiatrists, peer workers, Indigenous MH and nurses were biggest gaps, along with some of the subspecialty areas like child & adolescent, and rural #RANZCP2021

Lower-intensity, community-based services should play a bigger role. Achieve the same outcomes for less cost. Don't always need a psychiatrist. Value of family, carers, peer workers, community support workers #RANZCP2021

The shortfall in state/territory based community ambulatory care. We don't just need new workforce, but to make sure we're properly deploying the workforce we do have. What's the right mix for psychiatrists: consult vs treatment? And is that reflected in funding? #RANZCP2021

The National Mental Health Service Planning Framework has looked at these questions in detail. Greatest shortfall in peer workers, and Indigenous MH workers in urban regions. Addressing these problems will be single biggest determinant of implementing reform #RANZCP2021

Next up will be Ruth Vine #RANZCP2021. Says #COVID19 had a major impact on demand and workforce

Heightened levels of anxiety, stress, depression, burnout. Many contributors including home schooling and lockdowns, not just frontline work. Masking, shields complicating engaging w patients #RANZCP2021

Shift to telepsychiatry was a boon for some, a burden for others. No one had time off, people went without breaks, and demand surged from the general community, esp to EDs and esp by younger people. Hasn't abated, sustained persistent increase says Vine #RANZCP2021

Booming demand. Good that people are seeking help, but how much further does it have to run? #RANZCP2021

Vine says a major complicating factor in workforce discussions is the number of stakeholders and silos, including state and federal, public and private, professional and peer. National MH Workforce Strategy considering this, due out end 2021 #RANZCP2021

Vine says state and territory discussions will be critical to carrying this agenda forward. Emphasises everything on the table now can only be a starting point #RANZCP2021

Now hearing from Alex Cockram, one of Victoria's Royal Commissioners #RANZCP2021

For a broken system, there are expectations of broad-scale and wholesale reform, says Cockram #RANZCP2021

The concept of 'workforce' is itself a contested space. Who does it include? So many adjunct and interfacing roles #RANZCP2021

If we are going to deliver a system that spends time understanding needs and supporting them, providing access to safe restorative settings, listening not judging, we need to think about empathic, recovery-focused partnership, says Cockram. Cultural change needed #RANZCP2021

The workforce itself also crying out for change. Demand pressures, engagement and inclusion, respect and value, risk of burnout, professional development all emerged as themes. Moral injury of short-term, medical models of care #RANZCP2021

Interesting reflections on lived experience as a discipline. How is it stratified? How does it interface with existing pillars of the mental health system? How is its expertise best utilised, and where are its limits? #RANZCP2021

Importance of primary care, and the absolute expertise of some GPs in this space #RANZCP2021

Question time now #RANZCP2021

What are some of the low-hanging fruit? Ruth Vine says amenity of spaces is one. Assistance wth administrative tasks. Cockram says it's starting the discussion around appeal of the job. Whiteford points to value of leadership, role models #RANZCP2021

Hs the College become too rigid around training, competencies, administrative burden of exams for what improvement, asks Vine #RANZCP2021

There is nothing about a reform agenda that says we don't need more resources, says Cockram. We need more bodies, more people. Maybe in different configurations #RANZCP2021

Vine reflecting on the difficulties of mixing public and private practice, in terms of building a capacity in the public system for leadership, quality improvement, tasks other than clinical work #RANZCP2021

That concludes the workforce symposium. Will be back soon with the next session, on DV, trauma & substance use #RANZCP2021