Parody Not Specified Profile picture
May 17, 2021 28 tweets 16 min read Twitter logo Read on Twitter
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

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More from @coopesdetat

May 18, 2021
Greatly looking forward to the next two sessions at #RANZCP2021 on Maori and Aboriginal and Torres Strait Islander mental health, feat Helen Milroy (WA Australian of the Year and Australia's first-ever Indigenous MD), Allister Bush, Mark Lawrence & Wiremu NiaNia
First up Palyku woman Helen Milroy, paying respects to elders. Will be speaking about complexities in Aboriginal MH #RANZCP2021
How do cultural perspectives cross over with illness experiences? Milroy sharing some examples #RANZCP2021
Read 62 tweets
May 18, 2021
Will be tweeting in a thread below from the joint @ranzcp-JSPN symposium on patient rights next #RANZCP2021
Our first speaker Neeraj Gill #RANZCP2021
Gill setting the scene #RANZCP2021
Read 23 tweets
May 17, 2021
Our first keynote at #RANZCP2021 today will be from Carole Warshaw, director of the US National Center on Domestic Violence, Trauma & Mental Health
Warshaw talking emergence of trauma theory and how powerful it was for survivors - DV not a psychiatric condition but has many MH and substance use related effects. Reframing #RANZCP2021
Coercive control at the heart of DV, physical violence may be a threat to enforce but not always most prominent aspect, says Warshaw. Like being in a hostage situation, aided and abetted by systems - legal, migration and medical #RANZCP2021
Read 29 tweets
May 17, 2021
Final session today is on the interplay of DV, substance use, trauma & MH. Chaired by @DrWilliams, with @ManjulaOConnor, Sathya Rao & Carole Warshaw; @croakeynews is at the veterans and first responders MH stream #RANZCP2021
First up is @ManjulaOConnor, on gender, social power & restrictive norms, leading to disparities and inequities #RANZCP2021
Gender is a system defining men and women in opposition and distributing power accordingly, privileging masculinity says O'Connor #RANZCP2021
Read 24 tweets
May 17, 2021
Back on deck at #RANZCP2021, tweeting from a session on the @ozprodcom inquiry into mental health. Discussions chaired by Harvey Whiteford from @QCMHR, who was associate commissioner. @CroakeyNews will be covering the session on aged care
Intros to Whiteford. First psychiatrist ever appointed to the @WorldBank, first advisory psychiatrist to the federal government. Will be talking to us about the @ozprodcom inquiry and last week's federal budget #RANZCP2021
Inquiry spanned 18 months from Oct 2018 to June last year, with report released in Nov. Was the biggest @ozprodcom inquiry ever, 1300 submissions from a spectrum of stakeholders, says Whiteford #RANZCP2021
Read 31 tweets
May 16, 2021
We'll be hearing from @kgelber next on hate speech and its consequences. A problem she says is increasing in prominence and scope #RANZCP2021
Gelber talks about the mainstreaming in modern politics of hate speech and its threat to democracy
#RANZCP2021. Political leaders including Trump engaging directly in these discourses. Australia not immune. Scale of problem is huge
Hate or the presence of hate or dislike is not the key determinant of hate speech - discrimination is, says @kgelber. Hate speech is an act of discrimination that you carry out with your words. Doesn't have to be vituperative or epithet-laden #RANZCP2021
Read 26 tweets

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