The Minns government's plans to plug gaps in the mental health system with existing health workers have been called "ludicrous" and a "declaration of war" by nurses and psychiatrists, as 100 mental health doctors walk off the job in a bid for higher pay and better conditions.
Mental Health Minister Rose Jackson revealed this morning that under proposed reforms to the public mental health system, 5600 nurses would manage care for mental health patients, including diagnosis and recovery.
Another 2000 health professionals, including psychologists, occupational therapists and social workers, would then oversee case management and therapy, to lighten the load on psychiatrists.
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"We have had discussions … they have involved how we might do some of that system redesign, not just involving nurses but general practitioners, peer workers," Jackson said.
It comes as 100 psychiatrists threaten to resign over the next two weeks over concerns about the public mental health system's integrity.
There are 43 psychiatrists who have already walked off the job, 25 have rescinded their resignation and another 99 have pushed back their resignation date to keep the system staffed.
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"Negotiations have been going on for a long time, staff psychiatrists have maintained their position that they would like to see a 25 per cent increase in one year. The government have a lot of different opportunities on the table … but we couldn't come to an agreement," Jackson said.
"We do anticipate potentially negative impacts to the system, as part of our contingency planning is managing the highest-risk individuals as a priority."
The matter will now be heard for arbitration at the Industrial Relations Commission.
Reforms met with intense criticism
The proposed reforms have been met with intense scrutiny by psychiatrists as well as nurses, who say mental health professionals are already overloaded.
"We've got serious concerns about how the current public mental health system will cope," NSW chair of the Royal Australian and New Zealand College of Psychiatrists Dr Pramudie Gunaratne said.
"It's unacceptable for other professionals to be put in a position to make decisions on things that are out of their scope of practice.
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"It is incredibly disappointing that the government is choosing to see this as being purely an industrial dispute rather than really taking ownership of what is a severely underfunded and collapsing mental health system."
Gunaratne described the public mental health system as "grossly underfunded and inadequate".
Forensic psychiatrist Dr Ian Korbel said the reforms were a "declaration of war" on the mental health system.
"What [Jackson] is calling for is for a substandard service to be provided, she's asking for psychologists and peer support workers to run the system. We don't have enough psychologists in the system as it is," Korbel said.
"I hope what we're going to see is a government that comes to its senses … otherwise what we're going to see is further deterioration of the mental health system to the point it'll have to be rebuilt."
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The NSW Nurses Union called the proposal "unacceptable".
"It is completely unacceptable and ludicrous that the government expects nurses to step in and fill the gaps in the wake of the psychiatrists' resignations," a union spokesperson said.
"The government can't expect nurses to mop up this mess by taking on even larger workloads than they already are.
"We're seeing beds and wards close across numerous local health districts without adequate consultation. This whole situation is being managed appallingly."
Jackson said eight beds had been lost at Prince of Wales Hospital in the wake of the resignations, with wards across the state being reconfigured to cope.
The government has also hired 23 locums to fill the gaps with another eight being processed.
