Efficient deployment of scarce specialist staff

However rich a country may be, specialist mental health staff will nonetheless be in relatively short supply and therefore policy is needed to ensure their efficient deployment. In low-income countries specialist services are usually in extremely short supply, and therefore it is even more important to use them to best effect. Often the distribution of specialists is not equitable relative to the population, with most concentrated in the main cities for a variety of reasons including the availability of private practice, academic links and posts, and schools and other facilities for families. Attention therefore needs to be given to the construction of attractive posts which offer exciting and interesting work, are suitable for people with families, but which nonetheless meet the overall service needs of the country. (46)

Where countries cannot afford a wide variety of different specialists, it is not uncommon for one professional to fulfil a variety of roles. For example the psychiatric nurse may take on the additional role of occupational therapist or social worker. If this is the case then policy needs to consider how far the basic training of psychiatric nurses should take account of and support this situation by incorporating modules on occupational therapy and social work.

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