The challenges facing the public mental health sector: implications of the Victorian Psychiatry workforce project

Investigating Attraction and Retention of Staff Within Public Mental Health Services in Victoria, Australia: Protocol for a Mixed Methods Study

BACKGROUND

A large proportion of Australians are affected by mental illness each year, and treatment gaps are well known. To meet current and future demands and enable access to treatment that is safe, effective, and acceptable, a robust and sustainable mental health workforce is required. Factors reported to attract people to work within the mental health sector include aspiring to help others, having an interest in mental health and human behavior, the desire to make a difference and do something worthwhile, personal lived experience, recognition, and value of discipline-specific roles. However, despite the various reasons people enter the public mental health workforce, recruitment and retention continue to be ongoing challenges. To date, there has been limited investigation into understanding which factors are most relevant to the current Victorian workforce. Furthermore, a comparison to health care workers outside of mental health is also needed to better understand the specific needs of staff within the mental health sector.

OBJECTIVE

This study aims to explore factors related to attraction, recruitment, and retention of the public mental health workforce in Victoria, Australia.

METHODS

The study is a multisite, mixed methods cross-sectional study to be conducted at 4 public hospital services within Victoria, Australia: 2 in metropolitan and 2 in regional or rural locations. Current, previous, and nonmental health workers will be asked to complete a 20-25-minute web-based survey, which is developed based on previous research and offered participation in an optional 30-60-minute semistructured interview to examine personal experiences and perceptions. Both aspects of the project will examine factors related to attraction, recruitment, and retention in the public mental health workforce. Differences between groups (ie, current, past, and nonmental health workers), as well as location, discipline, and health setting will be examined. Regression analyses will be performed to determine the factors most strongly associated with retention (ie, job satisfaction) and turnover intention. Qualitative data will be transcribed verbatim and thematically analyzed to identify common themes.

RESULTS

As of May 2023, we enrolled 539 participants in the web-based survey and 27 participants in the qualitative interview.

CONCLUSIONS

This project seeks to build on current knowledge from within Australia and internationally to understand role and service/system-related issues of attraction, recruitment, and retention specifically within Victoria, Australia. Seeking up-to-date information from across the health workforce may provide factors specific to mental health by illuminating any differences between mental health workers and health care workers outside of mental health. Furthermore, exploring motivators across health care disciplines and locations to enter, stay in, or leave a role in public mental health settings will provide valuable information to support how the sector plans and develops strategies that are fit for purpose.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/48855.

Clinical update on public and private psychiatric practice shared-care partnerships - Can the twain work together?

OBJECTIVE

We explore the previous research and current context regarding opportunities for shared-care partnerships between public and private psychiatric practice.

CONCLUSIONS

Since the early 2000s, when there was impetus for the development of public-private psychiatric shared-care models as part of a previous National Mental Health Strategy, there has been surprisingly little research and policy development. Given an apparent exodus of psychiatrists to private practice due to current challenges facing the public health sector, it is timely to reconsider models of private and public sector shared-care that may improve the quality of public mental healthcare.

Psychiatrist workforce planning: contexts, considerations and recommendations

OBJECTIVE

To provide a clinical update for psychiatrists and trainees on psychiatric workforce-planning in the Australasian context.

CONCLUSIONS

There is a lack of detailed evidence regarding effective psychiatric workforce planning. Planning may be based on a foundation of psychiatrist-to-population ratios. This would be modified by needs assessment, understanding of service models and existing service demand. Given that it has recently expressed significant concerns about workforce shortages, the RANZCP should lead development of an independent Australasian psychiatric workforce planning model to inform policy advice to governments.

Through the looking-glass: private and public practice psychiatry in the RANZCP

OBJECTIVE

To provide reflections on the representation of and engagement with private practice psychiatrists by the Royal Australian and New Zealand College of Psychiatrists (RANZCP).

CONCLUSION

We consider some of the reasons for private psychiatrist disengagement with the RANZCP. We suggest approaches to better engage private psychiatrists in the RANZCP, including: involvement in mental health policy, improved committee representation, specific private practice and business training for Fellowship, broader private practice peer support networks (welfare, clinical research, leadership), tailored professional development, branch-based networks of public and private psychiatrists, and collaboration with specialist medical colleges and the Australian Medical Association.