Silencing psychiatry

Dear Editor,

Academic psychiatrists have historically provided strong independent voices to introduce new research, improve knowledge and standards of training and clinical practice, and comment on issues that could compromise, or improve, the health of the nation.

I have had considerable concerns about the absence of any review of gender transition for children and young adolescents where the prevailing services in Australia adopt an affirmative approach, notwithstanding concerns raised in the UK ([e-mail]). Separately I have been very concerned about the inadequacy of funding of psychiatric services in the public sector, compromising both patient care and training standards.

In speaking to many senior Professors of Psychiatry, I sought the support of my colleagues in co-signing a letter to your journal emphasising these concerns.

Regrettably no colleague was prepared to add their name to these two concerns, with the most common reason being their public sector contracts precluding employees making critical comments of these services, and perceived conflict by some who are also on government committees.

Silence on these concerns does not help the profession, or the community, and increases the vulnerability to major future disruptions as seen with the recent resignations of multiple psychiatrists from the public sector in New South Wales.