Kapiti Psychiatrist doing job of three resigns after being denied panic button

Professor Marie Bismark
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A Kāpiti psychiatrist, who has resigned after months of doing the work of three specialists, says the final straw was being denied a panic button in her office.

In an interview with RNZ’s Nine to Noon, Professor Marie Bismark said she was caring for more than 300 patients at the Kāpiti Mental Health Clinic, some of whom were “seriously unwell ” with a history of violence, including rape.

Over a 20-month period, she made several requests to Health New Zealand management for a personal alarm to be installed in her office.

However, just before Christmas, she was advised the “business case” had been turned down.

“And I’m sure you can imagine how that feels,” she said. “I don’t know what a duress alarm costs to install but I’m sure it’s less than the cost of a locum psychiatrist for one day.

“And to essentially be told by an organisation that your safety and the value of the work you’re providing to the community you care for is worth less than the cost of a duress alarm, that was pretty devastating.”

It was just one example of the way in which the health system was not taking adequate care when it came to staff health and safety, she said.

“We see those kind of false economies all the time where people are trying to cut costs and it ends up costing the health system more,” said Professor Bismark.

The World Health Organisation recommends one psychiatrist for every 14,000 people, whereas Ms Bismark had sole responsibility for a region of 60,000.

Prof. Marie Bismark says mental health services underfunded

After a site visit to the Kāpiti Mental Health Clinic, WorkSafe inspectors issued three improvement notices to Te Whatu Ora Capital and Coast.

“At one point I said to a senior manager that I was barely holding on by a very thin thread. And he said, ‘I can meet with you in four weeks’.”

Professor Bismark, who was just been appointed to the Medical Council, said the entire psychiatry profession was under pressure, with 20 percent of positions currently vacant.

“The median age is now 55, so many of them are going to be retiring within the next ten years and we don’t have the new pipeline coming through.”

While the government had previously committed to funding an additional 13 training places for psychiatrists, there was nothing for that in the recent Budget, she noted.

Meanwhile, clinicians of all kinds were becoming inured to overwork, and health managers were taking advantage of their commitment to their patients and ignoring basic safety measures.

In her new role with the Medical Council, Professor Bismark said she was particularly keen to support doctors who had their own mental health struggles to return to “sustainable” practice.