Psychiatrists say staff shortages, emotional exhaustion and inadequate working conditions are driving them out of the public mental health system – piling up pressure on those left behind.

Figures released under the Official Information Act reveal the number of psychiatrists employed by Health New Zealand dropped from 518 to 497 between September 2022 and September 2024.  

Over this period, the Waitematā region lost 10 psychiatrists, Southern lost eight and Capital & Coast lost seven.

Royal Australian and New Zealand College of Psychiatrists National Committee Chair Dr Hiran Thabrew said psychiatrists are leaving Health New Zealand services because they feel the system inhibits their ability to do their job effectively.

“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 per cent of New Zealand trained psychiatrists.”

He said over-reliance on short term and transient staff undermines a patient's continuity of care.  

“This affects community trust in the in the health system, puts pressure on local teams and makes workforce planning more difficult.”

Thabrew 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.”