W(h)ither psychiatry? Contemporary challenges in Australian mental health workforce design.

OBJECTIVE: To consider the changing profile of Australia's mental health workforce and the implications, particularly for specialist psychiatry services. METHOD: We analyse data from a national collection that describes changes in the workforce over a decade, to 2017-2018. RESULTS: While single practitioner-based psychological services flourish, other areas of more complex and team-based care are struggling to remain relevant. Psychiatry and mental health nursing, two areas that previously led Australia's response to complex mental illness, are under enormous pressure. CONCLUSION: The shifting balance of specialised mental health workforces is affecting the mental healthcare available in each region of Australia. Questions arise regarding the desired or optimal mix of professionals we wish to deploy. What roles should each professional group play and how should they work together? What does this mean for how various groups should be trained and paid? These data challenge the role specialist psychiatry wishes to play in leading reform. Current mental health reforms risk foundering should psychiatrists fail to take up the challenge of leadership.