Urgent need to address country Victorian psychiatrist shortage as suspension uncovers shortcomings

There is 1 psychiatrist for every 100,000 people in rural Victoria, compared with 17 per 100,000 in Melbourne. Picture: DARREN HOWE
There is 1 psychiatrist for every 100,000 people in rural Victoria, compared with 17 per 100,000 in Melbourne. Picture: DARREN HOWE

THE growing gap between psychiatry services available in cities compared with rural areas in Victoria is hurting country communities and measures need to be taken to reverse the trend, the body representing Australian psychiatrists believes.

The suspension of a country Victorian psychiatrist for six months from August further highlighted the fragile nature of rural Victorian psychiatry.

Former Castlemaine psychiatrist Dr Robert Proctor was found to have committed two breaches of professional standards for having sex with a former patient in the 1990s.

His 70 clients in Ballarat, Swan Hill and Horsham will need to be transferred to other services during his suspension.

The issue was addressed by VCAT senior member Elisabeth Wentworth, who imposed the penalty on Dr Proctor. She noted the impact it was likely to have on his patients.

“There is a dearth of psychiatrists willing to service the area he practices in as is evidenced by the fact that Dr Proctor has been unable to get another psychiatrist to share his workload,” she said.

“Dr Proctor is performing an important community service, which will likely not be able to be replicated given the unique nature of his transport.”

The World Health Organisation recommends there should be 10 psychiatrists per 100,000 population. In rural Victoria, the figure is 1 to 100,000, compared with 17 in Melbourne.

Dr Richard Newton, chair of the Royal Australian and New Zealand College of Psychiatrists Victoria branch said it was not uncommon that when one psychiatrist moves out of a rural area, the “whole service feels it”.

“One person leaves, and the service feels so under stress that everybody is no longer able to keep on top of the workload that they’ve got because they’re all working essentially in an enormously stretched service,” he said.

“It means that primary healthcare providers such as general practitioners carry an enormous load of mental health care in rural and regional areas. 

“And of course so too do the public mental health service systems which are already understaffed and under-resourced, and extremely busy.”

Dr Newton said having proper resources for country psychiatric clinics would ensure a safe environment for practitioners, which would in turn attract more psychiatrists.

“There are trainee positions available in a number of regional centres. Recruitment into those services continues to be difficult, and retaining those people in those centres is also an issue,” Dr Newton said.

“One of the common reports we hear from rural and regional areas is that once people achieve their qualification, then they tend to move out of those services.

“It’s not just about attracting them to work there, it’s also about retaining them and providing them with the kind of conditions and support that they need to stay there and do their job.”