The President of the College of Psychiatrists has said growing anti-psychiatry rhetoric represents a significant challenge for the profession.

Speaking at the College’s Winter Conference in Limerick last month, Dr Lorcan Martin, Consultant in General Adult Psychiatry, remarked upon “negativity” levelled at the specialty.  

Dr Martin told the Medical Independent (MI) this commentary partly stemmed from the controversial history of the specialty in Ireland and internationally.

He noted, for example, that psychiatry only had effective pharmaceutical treatments from the 1950s. Historically, he said, many people with serious mental illness were consigned to institutions.

“Modern psychiatry is very different. It is an advanced medical specialty,” stated Dr Martin. “Part of it is that we are not seen as scientists or real doctors in some respects, even though we treat very real, very serious illness.”

He also said that psychiatrists only admitted patients involuntarily as a “last resort” and these admissions were not common.

“There is a certain rhetoric that psychiatry wants to ‘lock people up’ and treat them against their will. We don’t want to lock anyone up, but every so often you come across someone that is so seriously ill they don’t know they’re ill, and they’re a risk to themselves or other people…” he stated.

Dr Martin said he had a caseload of several hundred patients, and none of them were inpatients at the time of speaking to MI. He had not had a patient admitted involuntarily in six months.

Now in the second year of a three-year term as College President, Dr Martin described his experience to date as “fantastic”.

He also noted the importance of advocacy on behalf of patients with mental illness.

“Advocacy is really important, particularly for patients. [There was a saying], ‘there’s no votes in psychiatry’ and what that meant was people with mental illness often quietly disappear into the background because they have no-one to speak for them. It was a quote I heard when I started in psychiatry over 30 years ago.”

In this respect, there is a special onus on psychiatrists to advocate on behalf of these patients, he stated.

The College’s Winter Conference heard concerns about under-funding of mental health services and proposed changes to mental health legislation .

For further coverage, see: CPI | The College of Psychiatrists of Ireland | Irish Medical Society

Psychiatrists deeply disquieted by proposed legal changes – Medical Independent

The “perennial inability” to sufficiently fund psychiatric doctors-in-training is having a “detrimental” impact on patients, according to the President of the College of Psychiatrists of Ireland.

Dr Lorcan Martin, a consultant in general adult psychiatry, made the comment as the College’s annual NCHD conference takes place in Dublin today.

According to Dr Martin, the current funding of €1.3 million for doctors to train to be specialists in psychiatry was under 70 per cent of what is needed to meet demand. He said this continuous funding shortfall was a major contributor to psychiatry trainee and specialist consultant burnout, poorer patient outcomes, and significant recruitment and retention problems for mental health services.

“Our psychiatry doctors-in-training are the consultants of the future and they should be given the very best chance to succeed, but instead they are facing a highly stressful and at times unsupportive working environment,” said Dr Martin.

“At present we are underfunded, under-resourced and under-appreciated, and the net result ultimately has been detrimental to Irish patients. There are not enough psychiatrist doctors to meet demand, which makes it harder on those who do stay in this country.”

The College President said psychiatric doctors “have been asked to do more with less for years now, and even though they continually put their own welfare in jeopardy for the sake of their patients, the cracks are visible for all to see”. 

“We urgently need a revised funding and resourcing plan from the Government in order to resolve what has become an untenable situation.”
 
He added that the foundations were in place to provide a best-in-class service for patients.

Dr Martin noted that many of the recommendations in final report from the NCHD taskforce “were already in place in psychiatry”, including publication of statistics, a grievance policy, transparency of eligibility criteria and regionalised training schemes.

The report also recommended regular training of supervisors, which Dr Martin also said the College of Psychiatrists has been doing for many years.