Abstract
Mental health is everyone’s business
What do psychiatrists and CEOs have in common? As the CEO of the Royal and Australian New Zealand College of Psychiatrists, my hope is mental health is the obvious answer.
The National Study of Mental Health and Wellbeing conducted in 2021 found that an estimated 1 in 5 (21%) Australians aged 16–85 experienced a mental disorder in the previous 12 months.
At any given time, one in five workers are likely to be experiencing a mental health condition.
According to the Productivity Commission (2020), poor mental health costs the Australian economy $12.2 to 22.5 billion each year. Economic analysis also shows mental illness health costs Australian businesses around $11 billion each year through reduced work performance, absenteeism, staff turnover and compensation claims.
With many of us spending a significant amount of our lives at work, workplaces can play a key role in improving and supporting mental health.
There’s been a growing recognition that mentally healthy workplaces are good for people and good for businesses. Mentally healthy workplaces help people feel more engaged, productive, and valued which all contribute to people’s overall wellbeing.
From an organisational perspective, it improves productivity, drives business outcomes and helps attract and retain staff.
A PwC study commissioned by Beyond Blue found that Australian workplaces can expect a positive return on investment (ROI) of 2.3, or an average of $2.30 in benefits for every dollar invested in workplace mental health.
Safety and wellbeing in psychiatry
The people who provide mental health care to the community, also benefit from - and are entitled to - mentally healthy workplaces.
Beyond simply being the right thing to do, workplace safety and wellbeing leads to better patient outcomes.
At a population level, we’re seeing demand for mental healthcare services surging as we emerge from the COVID19 pandemic. This has a deep impact on the people who are charged with providing the necessary care.
In a report this year from RANZCP’s NSW Branch, frontline mental health workers – many of whom were psychiatrists - described their professional exasperation, distress, burnout, and in some cases, moral injury.
Repeated exposure to sentinel events, acute distress and suffering is a risk to clinician wellbeing. Psychiatrists and those in psychiatry training are at a high risk of experiencing trauma and vicarious trauma.
Workforce shortages, workloads, time pressure, stressful environments, long working hours, poor resources, lack of agency, and incidences of discrimination, bullying and harassment contribute to burnout and adverse psychological outcomes in psychiatry.
These are the dedicated professionals to whom we entrust the most vulnerable in our community and our system is letting them down.
Given the prevalence of mental health conditions across the population, its unsurprising that many clinicians experience mental health concerns at some point in their lives.
At a community level, we recognise and have made significant progress reducing the stigma associated with mental illness but there is much more to do.
The insights of clinicians with lived experience can be a resource to improve the quality of mental health care, informing both clinical practice and service development. However, members of the health workforce receiving treatment for mental illness have reported stigma and discrimination by their employers and colleagues.
Worryingly, wellbeing surveys have found higher rates of psychological distress and attempted suicide in clinicians than the general population.
So what is the solution?
At its core, we must start with the premise that there is no health without mental health.
As a College, our purpose is to support our members, advance psychiatry and advocate for best mental health outcomes for all communities. We can only achieve this outcome by ensuring the safety and wellbeing of psychiatrists, including those in training.
The College’s position statement outlines a number of recommendations. • Supporting development and maintenance of healthy workplace culture for psychiatrists and those in training, including promoting psychological safety and eliminating bullying and harassment. • Advocating for well-resourced mental health systems, including safe staffing levels, safe overtime expectations, and recognition of the value and contribution of psychiatrists and those in training. • Addressing wellbeing issues impacting on psychiatrists and those in training such as burnout, moral injury and distress, and supporting effective organisational responses with evidence-based strategies. • Enacting the responsibility for psychiatrists and those in training to model professional behaviour, act in a way that improves everyone’s wellbeing, and contribute to positive professional peer relationships. In particular, those in leadership positions have a responsibility to lead with compassion and prioritise wellbeing. • Supporting psychiatrists and those in training to have well developed knowledge and skills in relation to their personal wellbeing and maintenance of a positive work-life balance. • Providing and advocating for appropriate support for culturally diverse psychiatrists and those in training for whom there may be additional load in the workplace and beyond it. • Promoting and improving the essential role of supervision, mentorship and peer review in maintaining wellbeing in psychiatry practice across all stages of a career in psychiatry. • Evaluating the wellbeing of psychiatrists and those in training; to support the aspiration of the RANZCP for healthy psychiatrists and those in training.
Having a healthy workforce is central to the success of any organisation, team or profession, psychiatry included. Safe, healthy working environments can - and must - be implemented at individual, systemic and organisational levels.