Abstract
Dr Murray Patton
We are often reminded that good things don’t come easy, and in psychiatry we see this on a daily basis. For each successful recovery there are hours of therapy, medication and clinical treatment that the broader community never see. And for many there is just as much effort for less successful outcomes. It is our commitment to our patients and their long-term health that enables us to keep persisting despite the presence of sometimes devastating obstacles to health and wellbeing.
Similar obstacles can be present in many areas of our professional lives. The bio-psycho-social model that is core to psychiatry is complex and often difficult for people who are not medically trained to understand. So too are many psychiatry treatments such as psychotherapy and electroconvulsive therapy (ECT). It is part of the College’s work to tackle these difficult topics and make explicit the impact of poor policy or inadequate funding. Sometimes the impact of these is felt by our patients which can be distressing. More often poorly thought out processes and protocols mean that psychiatrists waste valuable time filling out forms and filing paperwork, which distracts from our main priority of patient care.
This type of advocacy often goes unnoticed as it is day-to-day College business to seek to influence the government protocols which shape psychiatry practice. Most recently the College has met with the Australian federal Department of Health to discuss the Medicare rebates for electroconvulsive therapy (ECT) which are currently comparatively low for a highly sensitive and time-consuming practice. Since the cessation of the incentive payments for telehealth we have also been advocating for an increased Medicare rebate for telepsychiatry appointments. Analysis of our telehealth project indicated a strong satisfaction level with telehealth and promising usage by patients who find it difficult otherwise to access mental health care in a timely manner. Whilst neither advocacy approach has fallen on fertile ground yet, we will continue to water the shoots of interest and hope in time for revision and improvement.
Another important area of advocacy is in respect of the information we hold. This information is shared with us by our patients for the purposes of their care and treatment, but increasingly is being sought by other parties involved in legal proceedings in which our patients may be taking part in some way. We will be further developing work in this area.
Another challenge for the College has been advocating for the mental health needs of children in detention. The College has been prominent in this discussion for many years, largely led by the Faculty of Child and Adolescent Psychiatry, and it was flagged as a key concern of many members in our advocacy survey earlier this year. The recent Australian Human Rights Commission inquiry into children in detention involved several of our Fellows in a variety of roles, including Dr Peter Young who spoke publicly and courageously about the impact of detention on the mental health of asylum seekers, and has reignited much debate about the policy of offshore detention. Pleasingly the College has received substantial feedback from the community commending Dr Young, and his integrity as a psychiatrist. The College will continue to advocate in this area, along with our fellow medical bodies – the Royal Australasian College of Physicians (RACP) and the Royal Australian College of General Practitioners (RACGP) - who both share our concern for these vulnerable people.
Another joint project is our working group with RACGP which aims to support and improve the relationship between GPs and psychiatrists for the benefit of our patients. Recent community engagement highlighted for us the importance of GPs as the first ‘port of call’ for people concerned about their own or a family member’s mental health. This reminds us of the importance of an appropriate referral made in a timely fashion, and of complementing psychiatric diagnosis and treatment with ongoing GP care as appropriate. The Working Group seeks to continue the excellent work begun by the Private Practitioners’ Network with their Professional Practice Guidelines: Best practice referral, communication, and shared care arrangements between psychiatrists, general practitioners and psychologists which is now available on the RANZCP website.
Alongside these strategic projects continues the progress of plans for our upcoming annual meetings. Congress 2015 in Brisbane is shaping up well. Keynote speakers have been confirmed, and we look forward to another great programme in a city that is a favourite destination for so many people. We are buoyed by the recent success of Hong Kong conferences for both the Section of Psychotherapy and the Faculty of Forensic Psychiatry, and I congratulate them on their recent events.
Lastly, as I sign off I would like to offer a formal note of appreciation and congratulations to Dame Marie Bashir AD CVO and College Fellow as she retires from her role as Governor of New South Wales after 13 years. She has been an admirable ambassador in public life for psychiatry and mental health care and I offer her our most heartfelt well wishes for her retirement.