When psychiatrist Dr. Ravi Bhat arrived in Australia from India in 1999, it was to Shepparton in Victoria that he was headed. He has never left.
Today he has received an AM in the King’s Birthday honours for significant contributions to rural psychiatry.
A major part of his contributions has been advocating for more mental health service in rural Victoria. The Goulburn Valley Area Mental Health Service (GVAMHS, where he is now Divisional Clinical Director, has seen significant capacity build in the last two decades.
“The challenges are different,” Dr Ravi Bhat told Indian Link. “There are many factors that impact mental health in rural Australia. Poverty rates are higher. As are rates for intimate partner violence. There’s some evidence also that rates of adverse childhood experiences are higher. Add to that, natural disasters such as bushfires, drought, floods.”
And then there are workforce issues.
“Not many health practitioners choose to work in country Australia,” Dr. Bhat lamented. “We may be 30 % of the population, but only 10% of psychiatrists live here. Clearly, the problems are greater, and the availability of help is less. It’s important to change that disparity.”
He can look back at his career and feel satisfied that he has done his bit in this direction.
He elaborated, “In 2004, there were three full-time consultant psychiatrist positions and a Child and Adolescent Psychiatrist visiting weekly. GVAMHS offered opportunities for trainees from Melbourne to spend time in rural practice. The service has now grown to include two locally-based Child and Adolescent Psychiatrists and one Consultation-Liaison Psychiatrist.”
Another solution was to develop rural clinical schools to train doctors, he offered. “The University of Melbourne has been doing that for some time now. I have myself been Associate Professor of Psychiatry in the Department of Rural Health, University of Melbourne, since 2006. The GVAMHS is now accredited by The Royal Australian and New Zealand College of Psychiatrists for specialist training in psychiatry since 2012.”
In 2018, Dr. Bhat helped develop a collaborative working model that enables trainee psychiatrists to have supervised experience in the area of addiction medicine.
His capacity building work extended to Indigenous communities, another sector that was calling out for attention. “We have the state’s largest population of Aboriginal and Torres Strait Islander people outside of Melbourne. Working with the Rumbalara Aboriginal Cooperative, we were able to establish the Spiritual and Wellbeing Clinic for the Aboriginal and Torres Straits Islander peoples with mental health problems. Our telehealth clinics now support general practitioners across the GVAMHS catchment area in providing consultant psychiatrist diagnostic assessments and management planning.”
You don’t necessarily have to be a doctor in a major city to do significant work, Dr. Bhat emphasized.
Alongside these administrative and strategic initiatives, the clinical and research work continues unabated for this CMC Vellore-trained professional. A Doctorate in Medicine (MD) from the Central Institute of Psychiatry in Ranchi (India) has not stopped Dr. Ravi Bhat to take on another PhD, this time in his special interest – Old Age Psychiatry. Whiles suicides in older adults has been a research interest, his PhD is on delirium in hospitals.
“Delirium is common in senior patients,” Dr. Bhat explained. “Hospitals are not made for old people. They come with multiple problems, are confined to beds, with decisions made for them. It’s not surprising they become delirious. Delirium in hospitals is underdiagnosed, and must be properly managed. National guidelines are now available for clinical care conditions – I was a member of the working group for this in 2014 and 2015. The evidence is strong that with timely diagnosis, delirium can be prevented.”
Yet the best way to prevent it, the good doctor says, is to concentrate on general health early on.
“Exercise. Ensure you do regular physical activity. Are you doing your recommended 300 minutes of moderate physical activity per week?”