08-05-2025
Concerns over impacts of shrinking psychiatry workforce
'Many psychiatrists are experiencing burnout and moral distress, being regularly forced to make unsafe decisions or discharge people too early due to a lack of beds, staff, or appropriate services.'
He said demand for psychiatry services has increased by almost three-quarters over the past decade – with rates of psychological distress nearly tripling.
But he said resignations are outpacing recruitment, with forecasts pointing to further strain if nothing changes.
Thabrew said the workforce shortages are also adding pressure to other parts of the health system, like emergency departments and general practice.
'People experiencing mental health crises cannot be given enough help or the right help in a system that's always operating at crisis point itself.'
Health New Zealand said it's committed to growing the psychiatry workforce to make it sustainable both now and into the future.
The Royal Australian and New Zealand College of Psychiatrists spoke to members last year who had moved away from the public mental health system and into private or locum roles.
Thabrew said they raised numerous issues contributing to widespread job dissatisfaction, including workforce shortages, unsustainable workloads, burnout, inflexible conditions, poor management, and insufficient pay.
'All of these are driving them into alternative models of work that offer greater autonomy and better work-life balance - or to go overseas where working conditions are more lucrative.'
Meanwhile, Thabrew said a fifth of New Zealand's psychiatrists are aged over 65 – with many looking to retire over the next decade.
The College estimated we need about 60 new psychiatry trainees a year to cope with workforce changes and service demand.
Thabrew said we also have ongoing problems with retention because we depend so heavily on overseas-trained psychiatrists.
'About two-thirds of them will stay long term compared to 93% of New Zealand-trained psychiatrists.'
Thabrew said over-reliance on short-term and transient staff undermines a patient's continuity of care.
'This affects community trust in the health system, puts pressure on local teams and makes workforce planning more difficult.'
He said we need to properly invest in training a local workforce that knows the health system, is culturally competent, and is likely to stay.
Health New Zealand national chief mental health and addiction Leeanne Fisher said the service relies on a combination of permanently employed staff and locum (temporary) doctors.
Fisher said there is significant work underway to increase the number of psychiatry registrar placements and develop a framework for accrediting experienced nurses and allied health professionals into non-senior medical officer responsible clinician roles.
'These senior staff would then provide some of the care and responsible roles required by the Mental Health Act.'
Claudia O'Neill is an Auckland-based multimedia journalist with interests in science, health and geopolitics. She holds a Bachelor of Science degree from the University of Auckland and a Postgraduate Diploma in Journalism (Distinction) from Massey University. She joined NZME in 2023.
