Newly appointed psychiatrists ‘lack services to do job’

NEWLY appointed psychiatrists have no option but to prescribe drugs for their patients because they lack the basic services they need to do their job properly, a conference heard yesterday.

A survey of 89 newly appointed consultants found that 40% still lacked a junior hospital doctor, community mental health nurse, secretary or office a year after taking up their jobs.

Just 18% were able to refer a patient to a social worker, psychologist or occupational therapist.

Some were still handwriting letters two-and-a-half years after taking up their appointments because they had no clerical support.

Dr Aisling Denihan, an old-age psychiatrist attached to the North-Eastern Service in Navan, Co Meath, who conducted the survey, said it mirrored the situation of other newly appointed consultants.

Because the consultants are on probation for a year, they are too afraid to publicise any shortcomings in case they might be intimidated by management.

“We are not talking about consultants having a Rolls Royce back-up team, we are talking about bare essentials,” Dr Denihan told a meeting of the Irish Psychiatric association in Dublin.

“It is hampering the ability of psychiatrists to deliver even the most basic of services to patients. If you don’t have an office or a clinic to see a patient, you can’t function,” she said.

The study found that over 60% felt that they did not receive adequate support from management in their endeavours to set up a new service or continue running an existing service within the first year of taking up their position.

Around 70% felt their expertise was not used to its full potential in the planning of services and the development of mental health strategies for their area.

What was needed was greater forward planning and properly resourced services, said Dr Denihan.

“The practice of appointing a consultant in isolation without making sure that the funding is there and ring-fenced so that he or she can set up a back-up team is going to have to stop,” she said.

Acceptable facilities and appropriate staffing levels were needed so consultants could do their job properly.

She also said properly well developed multi-disciplinary teams resulted in the delivery of a high quality patient care and a motivated, enthusiastic leadership.

Dr Justin Brophy, a consultant psychiatrist at Newcastle Hospital in Wicklow, described the survey as explosive.

“In the absence of multi-disciplinary teams, the only recourse psychiatrists have is to reach for the prescription pad,” he said.

Finbarr Fitzpatrick, secretary general of the Irish Hospital Consultants Association, told how a surgeon arrived at Dublin to begin a position recently and no one knew he was coming.

Fintan Hourihan, industrial relations director of the Irish Medical Organisation, said the survey highlighted the urgent need for an induction course for newly appointed consultants.