A note before we start. This episode contains mention of complex mental illness from the Australian. Here's what's on the front. I'm Christinamia. It's Thursday, January sixteenth. Prime Minister Anthony Albanesi says strong action should be taken against people who perpetrate anti Semitic attacks on Australian synagogues, but he won't back mandatory sentences for the offense or convene a national cabinet to tackle the nation's antisemitism crisis. That story is live
right now at the Australian dot com dot au. After days of negotiations, Israel and Hamas struck a ceasefire deal overnight. You can read all the details about the long awaited agreement to end the Middle Eastern conflict right now at the Australian dot Com dot aus. Experiencing complex mental illnesses could be blocked from specialist psychiatric care in New South Wales as hundreds of psychiatrists abandoned the state's flailing mental
health care system. That's today's episode. Arianne Beaston remembers those sleepless nights with her son Henry well he was waking up as newborns tend to do every forty five minutes, making her return to work after a stint of parental leave all the more challenging. But even in those hazy, waking moments, Arianne felt like she was living a nightmare. She saw dragons everywhere, their apparent hunger for her tiny
baby burning in their eyes. She doubted if the hands attached to the ends of her arms truly belonged to her, and she wondered more than once if her blue eyed baby was the product of a mix up at the hospital.
I experienced postpartum psychosis, which is a rare mental illness bit effects one to two in every one thousand months.
Arianne was admitted to a private mothers and baby psychiatric unit to help her manage the delusions and hallucinations she experienced following the birth of her son.
It was the only unit of its kind. It was critical for me to be a bitt. I was experiencing quite severe side effects on the medications I'd been prescribed.
At the time, no such service was available in the public healthcare system. Instead, mothers and babies who couldn't afford to take the private route were typically separated during treatment. In the years since Arian's son Henry is now a thriving teenager. Dedicated perinatal psychiatric health care beds have been made available in hospitals across New South Wales.
The Australian Political Guidelines recommend that where possible, moms and babies should be admitted together. And what this allows is the opportunity for women, where it's safe and where they're able to do so, to really bond with their baby, to receive help not just around their mental health but also new settling and feeding their babies on all of those things that can be really, really difficult when you're also experiencing a complex mental illness.
But now New South Wales mothers could be without this vital care as some of Sydney's biggest hospitals close the few beds they have available.
First thing to say is that mental health disorders in the postpartum period are very common and will be experienced by between ten and twenty percent of new mothers.
Natasha Robinson is the Australian's Health Editor.
In the most severe cases that can include dug postnatal psychosis and relapses of severe conditions like a schizphrenia and bipolar and what this requires given breastfeeding is involved, is very specialist skills and knowledge as to medication management for new mothers, and that's why it's really important to have care provided by specialists trained perinatal psychiatrists, of which there are very few in New South Wales and everywhere really, but in New South Wales there's only sort of less
than twenty of these specialists that actually exist.
There are just two mental health units comprising sixteen beds in New South Wales where new mothers can be admitted with their babies, and those beds are now being capped or closed for service altogether as the state's mental health care sector spirals into chaos. A mental health system already under immense strain and days seventy seven percent of the state's public psychiatrists will leave.
Their jobs, so there's only in fact four beds open at the moment, and the information from psychiatrists within those units and across the state from community mental health teams is that admissions have been denied out of area. So this really leaves people in regional areas in particular, in a very bad situation because these units are supposed to provide care statewide.
Arianne is grateful that she was able to access this kind of vital health care via the private system, and she knows better than anyone why it needs to be available to other new mums, no matter where they live.
Not having access to these units means that women with complex perinatal mental illness need to be admitted to general psychiatric woards without their babies, which is hugely in an already really difficult time and a really vulnerable period for these women. So these beds, these units are critical a.
Save live of course for the most vulnerable people and people who can't afford that care, they're left with no option and for a long time in all states, including New South Wales, these new mums, breastfeeding mums have been separated from their babies, so they're admitted to acute wards in public hospitals and they're not able to be with their baby, which is very very devastating, but it also has profound impacts on the entire family and on the
development of the child. And of course the worst case scenario if you can't even access an acute impatient bed, and of course all beds will be under pressure. Across the New South Wales of these resignations take effect, is that mothers can't access inpatient care at all in these dire situations, and that posts is a fairly high risk to mother and baby. In fact, severe mental health conditions in the postpartum period are in fact a leading cause
of death for these mothers and babies. So the states are very.
High coming up. Why hundreds of psychiatric specialists have handed in their resignations, Natasha, You've been covering healthcare for a long time as the paper's health editor. Have you ever seen anything like this?
No, I never have, and their state has never seen or resignations on mass in these numbers, I mean, they're extraordinary numbers. Two hundred and one star specialist psychiatrists making up a very large tunk of the workforce, and it really is just an indication of how carless the state of mental health care is in New South Wales at this time.
By next Tuesday, the state's mental health care system could look completely different. More than two hundred psychiatrists, half of the state's current cohort, are set to walk away from their jobs citing concerns about pay and conditions they say are unworkable. Now, with just five days to go and no resolution in sight, the state and federal governments appeals to doctors to abandon their resignation plans have become more desperate. Please don't do this.
Remain at the table.
This was the plea made by Minister for Health Ryan Park in a press conference this week. We can't afford wage increases are kin to around ninety thousand dollars.
What they're saying is, look, if we give a twenty five percent immediate uplifting pay to psychiatrists, then every medical specialty is going to be coming to us wanting the same. So that is an understandable position. But no other specialty has thirty percent of its staff specialist positions vacant at the moment. No other specialty has an extraordinary staff exodus like this. No other specialty really has experienced the kind of spiral of decline that mental health care has. Amd
record demand. Given all of that, there would seem to be a case that this is a special case. It's not just another industrial demand.
Natasha says. The new South Wales government needs to decide if it's actually possible to run the state's mental health care system with next to no specialist psychiatrists on their books.
It seems to be an extraordinary proposition that you could do that. It will have knock on effects the government is admitting freely and patients will be impacted. So is it feasible for a government to wear that and to have that on its record. That's for them to decide.
There's a bit of a misconception that hundreds of special psychiatrists in New South Wales are resigning because they're not paid enough. In reality, they say years of underfunding and under resourcing has created a tinderbox. Doctors are exhausted and they're concerned vulnerable patients will pay the price.
This has been cast by the government as an industrial dispute. It's not really an industrial dispute. The reason that they're asking for this twenty five percent immediate pay rise is to stem the tide of staff from the system, which they say is making the system unsafe. They feel as if they're now complicit in an unsafe system. They feel so desperate and concerned in terms of working within a
system like that. So this is really the result of not just a disparity between the staff salaries that can be commanded in the public system versus a private and also interstate it's also about decades of underfunding a mental healthcare, which we've of course covered very extensively recently in the Australian I think it's fair to say it is at rock bottom at the moment. The system is on its knees and it's really the morale that is just so so bad in this system. They're feeling just battered and
bruised within the system. It's exhausting. The culture in public health systems across the country is in a very bad way.
The need for specialized mental health care doesn't disappear just because the assistance is no longer there. So where does this saga end?
The reality is that most of these specialists that are handed in their resignations do not want to resign. These are people who are committed to the public system. They're committed to the most vulnerable patients. They wouldn't be in psychiatry if they weren't altruistic, if they weren't committed to care of some of the most disadvantaged people in our country. A lot of them don't actually know where they're going to go.
There are options for psychiatrists outside the New South Wales public system. There's academic or local work, private opportunities as well as work in other states and territories, but redeploying them as visiting medical offices or locums could end up costing the state just as much, if not more than the pay rise they've requested.
But the reality is that by not having these people attached to the public system as permanent employees who are working not only on behalf of patients who they know, with colleagues that they know, but also contributing to the positive culture and the promotion of safety unsafe systems within those public hospitals. If we lose all of that, it's a tragedy. It's very concerning for the safety of patients is going to have knock on effects right throughout the system.
But of course, in something like perinatal psychiatry, child and adolescent psychiatry, the whole system is under threat because there's not very many of these specialists psychiatrists, So what on earth are they going to do.
Natasha Robinson is The Australian's Health Editor. You can read all her reporting and analysis on the state of Australia's mental healthcare system anytime at the Australian dot com dot au