Open Menu
Close Menu

Royal Commission into Victoria’s Mental Health System

Personal story:

Dr Catharine McNab

Dr Catharine McNab

Catharine is a clinical psychologist who has worked in the mental health system for almost 20 years. She has had a number of roles across public and private practice, and is currently a lecturer at Mindful, the Centre for Research and Training in Developmental Health at the University of Melbourne.

Previously, Catharine worked in a public tertiary mental health service, in a senior role that included supporting acute parts of the service. She emphasised the need for formal structures to create space for professionals to stop, step back and reflect on the best way forward when working with consumers, particularly in stressful and complex situations.

When we’re very stressed, or our work evokes other strong feelings in us as clinicians, our capacity to think clearly is often understandably affected. Having somebody to support those background functions, in whatever way this can happen, creates better outcomes for people accessing care, because there’s more support, more scaffolding, to stop and think.

Catharine also noted the importance of workplaces having a framework in place to support and facilitate effective collaborative reflective practice, and believes that public mental health services have an opportunity to foster this more as a way to retain staff. One thing she misses about working in the public sector is the team‑based environment in a clinical setting. She spoke about the benefits of interprofessional teams who get together to review clients and work through complexity in collaborative, reflective ways.

A team is at its absolute best when it can think together about the work we are all doing.

According to Catharine, the incidental peer support that can be fostered in team environments is also critical to staff wellbeing and the creation of reflective, supportive workplace cultures.

It is coming out of a session and being able to use another colleague, just in the moment, and say, ‘This is how I feel right now. Do you have five minutes when we can just stop and think about that together?’

Catharine noted this is something that is more difficult in private practice. She also noted that the public sector may have difficulties in retaining professionals such as clinical psychologists, who may be attracted to the private system later in their careers. She believes the public sector may be able to retain staff by offering flexible working conditions and roles that combine consultation, training, supervision and clinical support, while also explicitly capitalising on the support that is offered to practitioners in public health that is less often offered in the private practice context.

Catharine also spoke about the opportunities to better support clinicians to combine clinical practice with translational research in the future system. As someone who completed her PhD in a clinical service, she reflected on the importance of service leadership encouraging her to use her clinical practice to inform her research and undertake practice translation activities. She reflected on how valuable this was, but also on the challenges that services might sometimes face in helping their staff work across these domains.

It is reasonably unusual, particularly for non‑psychiatrists, to have positions which span clinical and research practice, especially early in your career. You might be a clinician who dabbles in a bit of research, but you have to fit that into your clinical time. So that happens because you stay later or you work weekends. Or you’re a researcher who, who does a bit of clinical work often as part of your research. It is often hard to combine all of that in the current system.

Source: RCVMHS, Interview with Catharine McNab, October 2020.