Growing chasms: Australian psychiatrist workforce distribution across local government areas by socioeconomic status.

Abstract

Objective: Local socioeconomic status may influence psychiatrist distribution, yet this remains systematically unexamined in Australia. We aimed to assess how psychiatrist availability varies across regions with differing socioeconomic advantage.

Methods: Psychiatrist workforce data from the Health Workforce Data Tool (2013-2023) were linked to local government areas-level quintiles of the Index of Relative Socioeconomic Advantage and Disadvantage. We calculated and compared the proportion of local government areas with psychiatrists, psychiatrist counts per local government area, and psychiatrists per 10,000 population by Socio-Economic Indexes for Areas quintile. Panel regression analyses examined per capita variations, adjusting for state/territory and year effects in the same analyses.

Results: Outer regional/remote/very remote areas had relatively low access to psychiatrists compared to metropolitan/inner regional areas. Disparities widened over time between the highest socioeconomic status quintile and all others. The average psychiatrist count per 10,000 population for top-quintile local government areas was 2.8 (standard deviation: ±4.8; from 0.6 (standard deviation: ±1.0, Northern Territory) to 5.5 (standard deviation: ±7.0, South Australia)), compared with 0.2-0.5 per 10,000 population for all lower socioeconomic status quintiles. In panel regression with interaction between Socio-Economic Indexes for Areas and remoteness, psychiatrist counts (adjusted for state/territory and year) in non-top-quintile local government areas were 2.6 (95% confidence interval: -4.1 to -1.1) to 3.0 (95% confidence interval: -4.4- to -1.7) per 10,000 population lower than top-quintile metropolitan and inner regional local government areas.

Conclusions: Psychiatrists are densely concentrated in high socioeconomic status and metropolitan/inner regional areas. Lower socioeconomic status local government areas shared similar, limited psychiatrist distributions. Targeted strategies are required to improve the equitable distribution of mental health resources across socioeconomic gradients.