Ruth Vine | Insights from Industry Leaders
Deputy Chief Medical Officer at the Australian Government Department of Health
Ruth Vine is the Deputy Chief Medical Officer at the Australian Government Department of Health
Ruth recently sat down with Ccentric CEO, Wayne Bruce to discuss her career. Some of the questions they discussed include:
- What influenced your decision to study medicine, and then psychiatry?
- Has there been one or more roles across your career that has been your favourite? Which one did you learn the most from?
- As the inaugural Deputy Chief Medical Officer Mental Health for the Commonwealth, how do you hope to shape mental health policy to improve mental health service delivery nationally?
- There can be a stigma around speaking about one’s mental health. What do you think we can do to encourage more open and honest conversations in the workplace and community in general?
- Who or what has inspired you the most in your career?
- What are your top tips for aspiring leaders in medicine?
What influenced your decision to study medicine, and then psychiatry?
It was a long time ago, I started studying medicine in 1975. I think back in the day, if you did reasonably well in your final year exams and you’d done a mixture of science and art subjects, then your choices were in medicine or law. I got in and was accepted into law at ANU, in medicine in Melbourne and chose medicine. I would love to be able to say I had a burning passion to be a doctor, but my father was a doctor, so I probably grew up being exposed to medical practice. But really, I think it was it was just one of the things that you do. Having studied medicine, I quite enjoyed my studies and enjoyed being a university student. I was a university student at a very lucky time when, of course, we were given tertiary education assistance funding, and that was great. I was successful in my studies.
When I finished medicine, I planned to be a physician and go into general medicine. I started that, but I really didn’t like some of the procedural aspects, so I experimented with a few things. I taught anatomy for a little while, I did a little-term in anesthetics and eventually settled on psychiatry. I completed my psychiatry training in 1990. I think the thing about psychiatry, which was very different then and it is now, was that it invited curiosity. It invited you to want to talk to other people about it, often very personal aspects of their life and invited that sort of more reflective practice of psychiatry. It was particularly public psychiatry is a team-based endeavour. Private psychiatry, of course, is very different. You are often one person on your own with another person. But public psychiatry is a very dynamic environment. It’s quite often quite pressured and you certainly see a range of presentations and again, often see people at their most vulnerable times.
Has there been one or more roles across your career that has been your favourite? Which one did you learn the most from?
I have been incredibly fortunate, so, again, more by accident than design, I started being a psychiatrist in the forensic setting, working in prisons and secure environments within courts. I think that was very much a learning experience, exposed me to a lot. I then moved into the department and again, I moved into a role as deputy chief psychiatrist. But just by good fortune, a person had left and I acted in the director role and I was in the director of mental health role as well as some acting times, probably for about six or seven years. Then subsequently the chief psychiatrist. It’s probably in that Director role I got to work as a bureaucrat and within the government. Again, I was very fortunate. Minister Parker was responsible for health and mental health. But I also worked with John Thwaites and Daniel Andrews was actually the parliamentary secretary for mental health back then. That really exposed me to national policy as well as state policy and system-wide work. Then I worked for a little while as Chief Psychiatrist.
More recently, I was able to able to head up a very large mental health program under Melbourne Health. That brought me into really into close contact with youth, adult and aged psychiatry. The whole operational issue of mental health at a time when it was not receiving the funding that I believe it should and at a time of growing pressure. So I can’t say which was my favourite when I think I’ve been incredibly fortunate and have learnt a lot and been exposed to some great, great people and great experiences during that time.
As the inaugural Deputy Chief Medical Officer Mental Health for the Commonwealth, how do you hope to shape mental health policy to improve mental health service delivery nationally?
It was a great honour to be appointed to this role, and I think it was tremendous that this role was created. It has to be said it was created in the COVID context. Whether it will be an ongoing position is unknown. It has changed many things in our lives, some more so than others. Clearly travel, but also home education and lots of things that people are going through in their lives. But it’s also changed the health system. The conversion to telehealth and video-health, the increased use of digital platforms, I think has been pretty significant and I think will endure beyond COVID. So I think there’s some of that shaping. But I also think it’s important to reflect that COVID came along at a particular time and the Productivity Commission had been working on a very large program or project about mental health reform in Victoria.
We had a royal commission that is due to release their report now in February. It’s at a time when there is a hopefully, I think, an appetite for reform. If I can shape that reform, that would be tremendous. I guess the big thing that has happened to mental health over the past 10 or 20 years has been both Commonwealth and states and territories funding bits into the community. That has resulted in a system that is often fragmented, complex and confusing, often almost duplicates.
If that reform could better result in a more navigable system, that to the user of the system, it didn’t really matter who was funding it, they were working well together then. Then in my view, that would be important. The other big thing, I think is to think the fact that mental health funding has not kept pace with general health funding and has not kept pace with the population growth. We’ve seen a real narrowing of services, enormous pressure on inpatient beds, and evidenced by things like long stays in the emergency department and people struggling to access particularly the urgent care.
There can be a stigma around speaking about one’s mental health. What do you think we can do to encourage more open and honest conversations in the workplace and community in general?
Well, I think you’re right that it has improved a lot. I mean, just last week we had RUOK Day and Suicide Prevention Day, so I think people are talking a lot more about it. I think the stigma, persists because, in my view, we’re not having a very honest conversation about some of the more severe manifestations of mental illness. We’re talking much more about mild, moderate mental illness, people feeling anxious or feeling depressed, reaching out for help through things like BeyondBlue and others. But we’re not really yet talking about the sort of disruption that can happen to people’s lives when they experience severe mental illness. The more severe manifestations of mental illness are still, poorly understood, poorly explained and often negatively portrayed in the media. We just have to keep working at that.
Who or what has inspired you the most in your career?
It’s perhaps trite to say, but I actually think it’s people who experience mental illness and their families. Particularly the commitment and the dedication that many people who work in the mental health sector demonstrate, often against considerable odds in their workplace. So I think it’s been the people who I’ve worked with that have inspired me the most.
What are your top tips for aspiring leaders in medicine?
I’ve been very lucky, but I’ve also been very keen to say yes. When opportunities arise, say yes. When you’re asked to come and give a talk to someone, say yes. I think that then exposes you to a whole raft of experiences and that’s really what we want to do, isn’t it? We want to keep our minds open to different ideas, but also to how you can make a contribution.