What Killed Four Australian Psychiatric Trainees?

Last week the Royal Australian and New Zealand College of Psychiatrists announced the sudden deaths of three Victorian psychiatric trainees as well as one intern. The news has lead the mental health community to express concerns over the pressure and stress placed on young people working in the area. While the causes of death are yet to be determined, the events have spotlighted the under-resourcing of Australia's public mental health sector as well as the emotional well-being of those working within it.

With the deaths currently under investigation by the coroner, Patrick McGorry a professor at Youth Mental Health at the University of Melbourne, suggests the incidents show a lack of support for students and trainees. "I've never heard of this number of deaths happening in a short space of time," he tells VICE. "I don't think they were influencing each other, but I think it's a very tragic symptomatic indicator of the state of the mental health system."

Over the past several years the public health sector has suffered massive cuts, with mental health being especially affected. This has in turn led to many young and inexperienced trainees being forced to make difficult decisions on who is deserving of treatment on a daily basis. "They're forced to exclude people who are very ill," Professor McGorry continues. "This is something that wouldn't happen in other parts of the health sector. The public mental health sector needs a tremendous overhaul. It's in free-fall."

Nick Arvanitis, head of research and resource development at mental health advocacy group beyondblue, blames pressure leading to patient neglect for the personal toll the work is taking. "When you think about doctors and their personality traits, they're quite selfless and very committed to providing the best possible care," he explained over the phone. "The combination of high demands within the workplace and very limited resources is a definite risk factor."

In terms of psychiatry specifically, many experts have identified the high-stress exams with very low pass-rates and a general lack of funding as reasons why trainees may have been suffering recently. The theory was reflected recently on talkback radio with callers sharing similar stories.

Ironically, this enormous stress is compounded by an underlying stigma that prevents many from seeking the help they need. This was documented in a 2013 study by beyondblue that reported one in five surveyed medical students had considered suicide in the previous 12 months, and suffered from depression at higher rates than the general public. "Young doctors appeared to be particularly vulnerable to poor mental health and high levels of stress," the report said. "They face long working hours, a need to balance competing work and personal demands, and a stressful work environment."

According to James Lawler, the president of the Australian Medical Students' Association, this stigma is the biggest issue that needs to be addressed to prevent any further tragedies. "There needs to be a cultural shift that allows medical students the ability and freedom to talk about their mental health," he tells VICE. "There needs to be more research, and there needs to be more commitments from the government."

Encouragingly, action seems to be finally taken in Victoria with new premier Daniel Andrews making several key pre-election promises on mental health: including to develop a 10-year Mental Health Plan for Victoria within the year, and the creation of a Mental Health Workforce Plan. The report acknowledges the dire state of mental health at work, and outlines the government's plan to tackle this important issue. "Mental health workers are saying that things have never been as bad as they are right now," the report reads. "We want to support mental health workers and peer support workers to provide high quality care."

If you're a medical professional, trainee, student, or a person in general, who may be experiencing mental health concerns, seek help through confidential resources such as Lifeline (13 11 14) and beyondblue (1300 22 4636).

Any doctor in need of support can contact the Australian Medical Association Victoria's Peer Support Service (1300 853 338), or the Victorian Doctors' Health Program (03 9494 6011).

Follow Denham on Twitter: @denhamsadler