Defining the Role of the Consultant Psychiatrist in a Public Mental Health Service

Abstract

The role of the psychiatrist in public sector psychiatry is a challenging and exciting one. Psychiatrists will start to return to the public sector when they recognise this new role for the consultant psychiatrist. This will be to the advantage of public sector psychiatry in general and to the job satisfaction of psychiatrists. The key features of the clinical role are the demonstration of sophisticated clinical skills, providing clinical leadership via supervision, being accountable for patient care and providing consultant opinion on complex clinical problems.

Interdisciplinary teamwork and leadership: issues for psychiatrists

“…This type of authoritative statement becomes a two‐edged sword and can result in assumed centrality of psychiatrist responsibility and blame when anything goes wrong during intervention. Boyce and Tobin argued the need for psychiatrist supervision of all other health professionals and insisted on direct psychiatrist overview of and accountability for every case 29 . Such insistence would waste scarce and much‐needed medical expertise, delay effective treatment as waiting lists to see ‘the doctor’ get longer, allow people in need of services to drop out, and leave medical staff with no time for home visits or participation in service‐system building or service management 6,30 …”

“…Boyce and Tobin argue strongly that the psychiatrist's roles as service leader, manager and supervisor of every case and every clinician of other disciplines, are pivotal and base this on the assumption that the psychiatrist has had the longest, widest, deepest and most practical apprenticeship‐based training, and therefore is usually in the best position to provide ‘comprehensive biopsychological management plans’, to offer ‘higher‐order’ diagnostic and treatment skills and to give ‘higher‐order’ consultant opinions on management of complex cases 29 . Other professions would equally claim to provide ‘comprehensive’ assessments and interventions, with a detailed focus on their particular areas of expertise.…”

New Roles for Old: The Role of The Psychiatrist in The Interdisciplinary Team

“…While I share with some of my psychiatrist colleagues a renewed sense of optimism and challenge regarding the role of the psychiatrist in the public sector, 3 presently psychiatry training per se is not necessarily the best preparation for service leadership. Psychiatrists, among other senior professionals, should be given or encouraged to seek specific training if they wish to undertake the roles of clinical supervision, clinical leadership or service management.…”

Trainee to trained: helping senior psychiatric trainees make the transition to consultant

“…The dearth of training opportunities available to prepare trainee psychiatrists for their future roles as managers and leaders has been lamented for at least 20 years 1,2 . Recent authors have been unequivocal in their belief that all psychiatrists need to be trained to function as clinical leaders and effective managers, even if not as administrators 3–5 . They are equally unequivocal in their championing of the need for psychiatrists to be trained for these roles in the same way that they are for clinical roles.…”