What is a psychiatrist?

What is a Psychiatrist and What do they Do?

February 2025

Key Message

"A Psychiatrists’ primary responsibility is to patients. Particular care is needed when this conflicts with responsibility to an employer or government. If clinical services fall below acceptable standards, psychiatrists have a duty to advocate for services and take appropriate action. Exceptionally, they may have to dissociate themselves from such services.”
RANZCP Code of Ethics, Principle 11.5

The state of public mental healthcare in too many parts on NSW is such that many psychiatrists have decided this has meant they need to resign and do not know if they will be able to ethically return. Removal of systemic obstacles to psychiatrists working at the top of their scope of practice are necessary for ethical practice.

A medical doctor who has decided to devote their career to improving the lives of people with psychological distress or mental illness.

A psychiatrist is the only health professional:

trained to work with an individual to understand their psychological state, diagnose mental illness, diagnose psychiatric symptoms that are caused by physical illness or medications, using an integrated knowledge of human biology, physical and mental illness; together with the impacts of social, psychological and social factors on mental health.

with a mandated role across Australia (and internationally) in use of the Mental Health Act to determine whether a person may be treated involuntary, and has associated training on related clinical, legal and ethical considerations in this care.

who has specialist skills in individualised prescription and review of psychotropic medications, brain stimulation treatments; and integration of these treatments with talking therapies and social interventions.

who takes ultimate clinical responsibility for people receiving care in psychiatric hospitals.

Who is able to provide the formal and apprenticeship elements of training future psychiatrists, and future doctors.

A psychiatrist is also a person who:

Has undertaken at least 12 years training; followed by a career long commitment to learning.
Is trained to work as part of multidisciplinary teams and provide leadership within systems.
Is driven to excel, from competitive entry to medicine, then psychiatry, followed by a rigorous training and assessment process to qualify as a psychiatrist.-

is deeply aware of their ethical responsibilities to patients and staff.
valuing people with mental illness, within their own profession, and is a member of the first health professional organisation to internationally recognise the contribution of people with lived experience in the provision of mental health care.

Work in a wide range of settings integral to provision of effective, high-quality public healthcare. These include mental health inpatient units, community mental health, medical and surgical wards, medical clinics such as Chronic Pain clinics and Cancer Care clinics, Emergency Departments, subspecialised units such as Parent-Baby Units and units managing patients with severe behavioural disturbance from dementia, Nursing Homes, homeless settings, units treating patients with drug and alcohol problems, youth justice centres, prisons, community justice settings, and research units.

Psychiatrists must be able to work at the top of their scope of practice by:

knowing the person, their situation and goals before discussing treatment options with them.

being able to work closely with a team and patient to avoid seclusion or restraint.

applying understanding of the ethical tensions in involuntary treatment and knowing patients well enough to avoid it through mutual trust and actions to avoid relapse.

being able to lead their teams and contribute to efforts to improve services.

being allowed to be clinical leaders to role model how to work with people with mental illness and their families to train the next generation of psychiatrists.