I moved to Australia in 2004 soon after leaving my uniform behind, and started working as a Regional Psychiatrist based in Whyalla, SA. The rural SA experience was truly a heartwarming experience for me, and has increased my attraction towards rural and remote mental health service delivery and Telehealth. I then moved to Toowoomba in 2006, and worked in various capacities with the Acute Mental Health Unit. I completed the Fellowship of RANZCP in 2006. Between 2008-09, I worked as Acting Clinical Director, before taking up the role of Clinical Director of ACT, PA Hospital at Brisbane in 2009. I then shifted to SA as the Dy Director of Country Health in 2010. This was to attempt to complete a dream of developing a service delivery model for country SA based on my initial experience in Whyalla. This was a challenge I thoroughly enjoyed. I had the unique opportunity to work with my ex-supervisor, Dr Ken Fielke (who was the Director of Country Health SA at that time), a man who has shaped alot of my systemic thinking. Subsequently, I returned to Brisbane and commenced full time private practice at my current location in Brisbane in 2011.
I have been involved in managing chronic mental health issues in the public sector, and remain passionate to try to improve the knowledge base around ‘Treatment Resistance’, which I personally believe is a form of ‘Resistance to Treat’, and warrants some thought from my peers and colleagues.
My tryst with administration in psychiatry in Australia as clinical leads of services and teams, including the statewide role with Country Health SA, also had its’ moments of excitement for me. Leadership and understanding organisational behavior to initiate change grabbed my interest for a while, until I found mainstream psychiatric service delivery has been falling prey to economic dominance and budgetary integrity related issues. Politics and psychiatry are strange bedfellows, as I feel it is essentially the grey area of science which requires more financial support, rather than areas well mapped out. That is not necessarily how politicians see this. But I must accept these experiences did help in many ways to develop myself as a Systemic Psychiatrist. I have managed to shape my current private practice around the ‘patient-journey’ model, including focusing on exploring alternative methods to service my patients in a better way. Having complete clinical and budgetary governance in my practice has made things easier for me to manage.
Adult ADHD is not a very well canvassed area, and this has always been an area of special focus for me and my current practice. I have learnt alot from my supervisors and colleagues in managing this disorder. I am especially thankful to my supervisors/peers in SA for their initial support for me to be able to comfortably manage this illness and bring smiles back to some of my patients who have struggled to get their life back on track without previous support and medications. I believe in psycho-education and motivational interviewing, with aspects of life-skill coaching to enhance patient journey for the adults who come to my practice. I feel we need to do more in this area, with more advocacy from RANZCP.