Dear  ,

From the Editor's Desk

Dear Esteemed Colleagues,

In the spirit of respect and cultural partnership, I wish to acknowledge the Aboriginal and Torres Strait Islander peoples as the Traditional Owners, Custodians, and First Nations of Australia, and Māori as tangata whenua and Treaty of Waitangi partners in Aotearoa New Zealand.

I hope this newsletter finds you in good health and renewed purpose. It is our pleasure to share with you this latest edition, which, while long in preparation, offers a breadth of perspectives and depth of content we trust you will find both timely and thought-provoking.

Our recent Bi-national Faculty of Adult Psychiatry Conference, held from 27–29 June 2025 amidst the serene beauty of the Barossa Valley, South Australia provided a rich space for intellectual exchange, professional reflection, and collegial renewal. It was a pleasure to witness the continued growth and dynamism of our Faculty, with psychiatrists from across both countries contributing to a truly trans-Tasman conversation on the future of our discipline.

This issue also marks a transition in leadership: we extend our deepest thanks to Dr Agnew Alexander, the founding Chair of the Bi-national Faculty of Adult Psychiatry, who now moves into a strategic role on the RANZCP Board of Directors. We warmly welcome Dr Balaji Motamarri as our new Chair. His considerable leadership experience and longstanding service across college committees position him well to guide the Faculty’s evolving mission with strength and vision.

In this edition, we showcase several compelling contributions from our colleagues across Australia and Aotearoa New Zealand. One article explores the mental health vulnerabilities of international students and makes a strong case for systemic reform to address the cultural, economic, and policy gaps they face. Another provides an illuminating first-person account of working as a psychiatrist in the NGO sector in Aotearoa, highlighting the collaborative spirit and bicultural ethos shaping community-based mental health care.

We are also offered a vivid reflection on rural psychiatry in Western Australia’s expansive Goldfields region, where delivering care requires not only clinical expertise but also deep adaptability to distance and context. Lastly, we consider the impending policy shift in New Zealand that will extend ADHD prescribing rights to primary care. The author presents both opportunity and caution, calling on psychiatrists to lead with integrity, equity, and a commitment to diagnostic excellence.

Alongside these feature pieces, readers will find our regular ADHD update by Dr Jagadheesan Karuppiah, a contemplative poem in our Mindfulness Corner, and a book review that may enrich your professional or personal reading lists.

I remain profoundly grateful to all contributors for their thoughtfulness and candour, and to Dianne Gregson for her indispensable work in bringing this edition to publication.

As always, we welcome your future submissions and reflections at: jgdmsanand@gmail.com.

Warmest regards,

Dr Muthur Anand
MBBS, MD, FRANZCP, AFRACMA

Insights from the Chair, RANZCP, Faculty of Adult Psychiatry Committee

As we progress through 2025, I step into the role of Chair of the Faculty of Adult Psychiatry with immense gratitude, a deep sense of responsibility, and a strong commitment to continuing the important work of this dynamic and dedicated Faculty.

It is a true honour to take over the reins from Dr Agnew Alexander, whose visionary leadership has left an enduring legacy. Under Dr Alexander’s stewardship, the Faculty saw the successful consolidation of key projects and initiatives across education, advocacy, and clinical excellence. His collaborative spirit and strategic foresight have now found a broader platform, as he moves into a significant role on the RANZCP Board of Directors. We thank him for his exemplary service and wish him every success in this next chapter.

I bring to this role a long-standing involvement with the College through various committees and working groups. My focus will be on deepening and broadening our Faculty’s partnerships—particularly with our counterparts in the UK, US, and Canada. These international collaborations will allow us to share knowledge, address global mental health challenges, and innovate together.

Our recent annual Faculty conference, held in the stunning Barossa Valley, was a resounding success. With over 200 psychiatrists from across Australia and New Zealand in attendance, the event showcased high-calibre presentations, meaningful discussions, and a vibrant sense of community. It was a privilege to be part of such a well-organised and collegial gathering. Special thanks go to the hard-working Conference Organising Committee, the administrative team, and all our Faculty members whose efforts and engagement made the event possible.

We continue to advocate vigorously for the profession and our patients—whether through engagement with the Emergency Department Steering Group, enhancing dual training pathways, or contributing to vital discussions around medicine access via the PBS. The Faculty has also submitted proposals to enrich the Adult Psychiatry.

Certificate Training with a sharper focus on neurodevelopmental psychiatry, trauma-informed care, women’s mental health, emergency psychiatry, and the evolving landscape of private practice.

As the largest Faculty within the College, our strength lies in our diversity, depth of experience, and the collective commitment of our members. I warmly invite more psychiatrists—early career and seasoned alike—to join us, contribute to our work, and help shape the future of adult psychiatry.

Please mark your calendars for our next annual conference, set against the breathtaking backdrop of Queenstown, New Zealand. I encourage you to join us in large numbers as we continue these important conversations and build on our momentum.

Thank you for your ongoing support. I look forward to working with all of you in strengthening our Faculty’s voice, relevance, and impact across the region and beyond.

Warm regards,
A/Prof Balaji Motamarri
MBBS; MD (Psych); MHM; FRANZCP

Navigating the Future of Mental Health Care in the 21st Century Faculty of Adult Psychiatry Annual Conference 2025 Report - Dr Muthur Anand 

The Faculty of Adult Psychiatry Annual Conference, held from 27–29 June 2025 in the picturesque Barossa Valley, South Australia, brought together nearly 200 psychiatrists from across Australia and New Zealand for a dynamic and thought-provoking gathering. Jointly convened with the Section of Private Psychiatry and the ADHD Network, the conference theme, Navigating the Future of Mental Health Care in the 21st Century, invited reflection on the evolving landscape of psychiatric care, workforce challenges, clinical innovation, and the integration of emerging technologies.

Day one featured a rich array of presentations, with a strong focus on ADHD, private psychiatry, and addiction. The keynote address was delivered by Professor David Coghill, offering a comprehensive overview of ADHD’s complexities across the lifespan. Dr Michelle Atchison offered a compelling critique of the current public-private training divide, advocating for expanded registrar placements in private practice. She highlighted the structural pressures faced by the public system—early discharges, fragmented training, and heavy reliance on locum staff—while underlining the distinct skillsets required for sustainable private practice, including business acumen, medicolegal literacy, and familiarity with the MBS framework.

Dr Jon-Paul Khoo showcased Queensland’s pioneering private sector training initiative—the Improved Access Program—currently RANZCP-accredited outpatient private training scheme in Australia. He provided a detailed overview of the program’s structure, funding model, and clinical curriculum, supported by insights from Mr Jonah Hughson of the College’s Practice and Standards division. The session concluded with a robust panel discussion moderated by Dr Gary Galambos, bringing together senior clinicians and policy leaders.

The afternoon sessions expanded on clinical practice challenges. Dr David Plevin advocated for an integrative bio-psycho-social-spiritual framework in managing addiction. Dr Dianne Grocott traced the evolution of ADHD assessment from paper-based models to AI-enhanced care pathways, offering a four-stage model of comprehensive ADHD management. A panel featuring A/Prof Melanie Turner, Dr Roger Paterson, and Dr David Chapman examined medicolegal complexities and regulatory tensions surrounding ADHD diagnosis and stimulant prescribing. Dr Chapman, speaking on behalf of Dr Petre Heffernan, offered a critical view of AHPRA reform, advocating for a clinician-led regulatory paradigm.

Day two sustained the conference’s intellectual momentum. Dr Susan O’Dwyer (Chair, Medical Board of Australia) addressed the psychological toll of regulatory processes on practitioners and highlighted strategies to support clinician wellbeing. Dr Lyndall White and Dr Victoria Jackson presented on women’s mental health and ADHD in correctional settings respectively, igniting valuable discourse.

The post-lunch symposium focused on artificial intelligence and its transformative implications for psychiatric practice. Presenters explored AI’s application in clinical documentation, its psychological impact, and its future potential in diagnostics and drug discovery. The day closed with standout presentations by A/Prof Sathya Rao on contemporary challenges in BPD care, Dr Stephane Verhaeghe on cultivating positive affect via AI, and Dr Sebastian Rositano on AI’s role in psychiatric research.

The final day opened with an impactful session by Dr Steve Robson, who addressed psychiatry’s workforce crisis, especially in light of systemic funding constraints and service delivery pressures. The conference concluded with a visionary presentation by Dr Galambos and Dr Grocott, unveiling a person-centred, shared care platform for ADHD—pointing toward a future of digitally integrated, collaborative mental healthcare. 

The conference succeeded not only in highlighting pressing clinical and systemic challenges but also in fostering a spirit of innovation and professional solidarity-vital elements for navigating the future of mental health care.

Strategic Leadership in a Sprawling Landscape: Mental Health Care Across the Goldfields of Western Australia

The Goldfields Health Region of the WA Country Health Service (WACHS) covers the Goldfields-Esperance Region of Western Australia.

The region is located in the south eastern corner of Western Australia and covers 770,488 sq km (including offshore islands). It is the largest of the state's 9 regions and over 3 times the size of the State of Victoria. Geographically, the region is bounded by the Pilbara region to the north, the Wheatbelt region to the west, the Great Southern region to the south-west, the Southern Ocean and the state border to the east.

The region supports a wide range of industry, including mining, agriculture, aquaculture and tourism. Mining is the predominant sector in the central and northern parts of the region, with a well-established agricultural sector in the south.

Goldfields Mental Health provides specialist mental health services to the Goldfields region for all age groups. The service aims to deliver a comprehensive range of high quality, community focused mental health services to residents of and visitors to the Goldfields region.

Locally based, multi-disciplinary teams are located in regional centres across the Goldfields region. Regular visits are made to outlying areas within the region to meet current community needs. Outreach is supported by telephone consultation and videoconferencing. Clinical liaison is provided to hospitals within the region.

Kalgoorlie Hospital has a six bedded authorised, open mental health unit, with restricted access. There is a community mental health service in Kalgoorlie and one in Esperance providing services for adults and older adult patient. CAMHS services are available in Kalgoorlie and Esperance.

After working in various roles in North Metropolitan Health Service for over twenty years I moved to WACHS three years ago, in my current role as Clinical Director Mental Health Goldfields. While working in the metropolitan area I had no understanding and no appreciation of the distances and the areas that the Goldfields region covers. I work remotely and travel to Kalgoorlie and Esperance regularly for one week at a time. I provide cover for the inpatient unit and CMHS in Kalgoorlie when the consultants are on leave and I remember when in my first visit to Kalgoorlie I was reviewing a patient on the ward and asked them whether their family visited them in hospital. The patient looked at me and said “doctor you are really dumb, my family lives at 12000 km from here, how would they do that?” Yes, I was rather dumb:

I do live in Perth but over the last three years traveling to Kalgoorlie and Esperance, both towns have grown on me. Kalgoorlie is a desert town with red sand and the perfect sunsets ever and Esperance although bit too cold for my liking is very pretty and the most beautiful beaches I have seen. So yes, although I was raised and I lived in cities all my life, I really enjoy my time in the Goldfields and the clinical teams in Kalgoorlie and Esperance are just great!

Expanding ADHD Prescribing in Primary Care: A Psychiatrist’s Perspective

Starting 1 February 2026, New Zealand will expand prescribing rights for ADHD stimulant medications, allowing general practitioners and nurse practitioners to initiate treatment in adults. Mental health nurse practitioners will also be able to prescribe for children and adolescents. This shift, enabled by changes to Medsafe approvals and Pharmac’s Special Authority criteria aims to improve access while maintaining diagnostic quality through targeted training programmes. The update applies to medications like methylphenidate, dexamfetamine, and lisdexamfetamine, with rollout timed to align with stabilised global supply chains.

Pharmac’s proposed change represents a significant evolution in ADHD care. As a psychiatrist, I see both valuable opportunities and potential risks and believe our profession has a pivotal leadership role to play in shaping the success of this change and ensuring safe, equitable, and effective implementation.

Undeniably, this policy could increase access. ADHD remains underdiagnosed and undertreated in New Zealand similar to the rest of the world. Many patients especially in rural or underserved areas face long delays for specialist assessments. Empowering primary care to diagnose and initiate treatment could help address these gaps and enable earlier intervention. However, expanded access must not come at the expense of diagnostic accuracy or prescribing safety. A compelling nationwide study published in JAMA Psychiatry (Li et al., 2025) examined ADHD prescribing in Sweden from 2006 to 2020. It confirmed that stimulant medications were associated with lower risks of self-harm, injury, traffic crashes, and crime. But the benefits weakened over time as prescribing rates rose possibly suggesting potential shifts in diagnostic thresholds or treatment practices.

These findings are a cautionary tale. Without robust frameworks, we risk misdiagnosis, overprescription, and inappropriate use. The RACGP has reported a 4450% increase in lisdexamfetamine prescriptions in Australia over two years a trend that may reflect overdue recognition, but also raises concerns about hurried assessments, social media influence, and stimulants being used as a simplistic solution for complex issues like trauma or anxiety.

Some in our profession may understandably worry about professional jurisdiction with “turf protection” and the dilution of psychiatric expertise. But rather than retreat, we have an opportunity to lead. Psychiatrists are uniquely positioned to ensure diagnostic clarity, particularly in presentations where ADHD coexists with mood disorders, trauma, or neurodivergence. We can promote the use of structured diagnostic tools and nuanced clinical judgment.

We also have a critical role in teaching and mentorship from developing training modules to supervising complex cases and co-building communities of practice. This is an opportunity to strengthen inter-professional relationships and collaboration that could elevate care system-wide. There is also the exciting prospect of service innovation. Psychiatrists can help design shared-care pathways, support co-located ADHD clinics, or establish "hub-and-spoke" models where general practice manages straightforward cases under specialist guidance.

We must also be vigilant about equity. Māori, Pasifika, women, and adults with late-diagnosed ADHD are already underrepresented in services. Without deliberate safeguards, this reform could inadvertently widen disparities. We should advocate for culturally responsive diagnostic pathways, targeted outreach, and monitoring of access and outcomes.

Finally, there is an opportunity for psychiatry to lead research and evaluation, to study outcomes of primary care-led prescribing, assess unintended consequences such as stimulant misuse, and inform future policy.

Ultimately, this reform is neither an automatic success nor an inherent threat. Its impact will depend on how we, as psychiatrists, choose to engage. We can defend traditional roles or we can lead, teach, partner, and innovate to ensure this reform delivers better, safer, more equitable ADHD care for all New Zealanders.

Key points: What This Means for Psychiatrists

1. Upskill Primary Care: Mentor and train GPs/Nurse Practitioners.

2. Protect Diagnostic Quality: Promote structured assessments and triage complex cases.

3. Design Services: Help shape hub-and-spoke or shared-care models.

4. Promote Equity: Ensure underserved groups are reached.

5. Lead Research: Study outcomes and monitor safety.

References

1. Li, L., Coghill, D., Sjölander, A., et al. (2025). Increased Prescribing of Attention-Deficit/Hyperactivity Disorder Medication and Real-World Outcomes Over Time. JAMA Psychiatry, June 2025. 

2. Coghill, D. et al. (2019). Improving access to ADHD care through shared-care models. Australian & New Zealand Journal of Psychiatry, 53(9), 873–875. 

3. Royal Australian College of General Practitioners (RACGP) prescribing trends data, 2023.

Reflections from an adult psychiatrist working within an NGO

Tēnā koutou katoa
He Pou Matanga Haumanu au
Kei Tāmaki Makaurau au e noho ana
Ko Cheryl Buhay au
Tēnā koutou katoa

Hello everyone.  I’m Cheryl Buhay, Clinical Director for Pathways NGO, based in Auckland.  Having worked in specialist mental health services during my registrar training and as a fellow across different teams, I recall asking myself the question almost two years ago where else can a psychiatrist work aside from more well-known pathways such as private and locum work, academia and report writing for organisations like the Health and Disability Commission and ACC.  I never thought that joining a non-government organisation (NGO) as their Clinical Director would be in my bingo card for 2023.  It’s been a career highlight being in this role.  And as a family/whānau representative told me before I left secondary mental health and having worked both in specialist services and as a Primary Care Liaison psychiatrist, I would be moving on to the last piece of the pie by embarking on my journey with Pathways New Zealand.

Pathways is one of the largest NGOs in Aotearoa New Zealand that provides mental health and addiction support to many communities.  It has 96 services spread across the country delivering different types of support, from acute services, alcohol and drug support services, group wellbeing programmes, mobile services, primary mental health and residential services.  Kaimahi (staff) within Pathways are a mixture of clinicians (with backgrounds in nursing, occupational therapy, social work, psychology, dietetics and addiction counselling), support workers and peer support workers.  The Clinical Director role is a national role appointed to a specialist psychiatrist.  I am the sole psychiatrist for the organisation.

My initial observations after having joined Pathways is the sheer size of the organisation where I interface with different teams belonging to different service types, different stakeholders (including primary care and Te Whatu Ora/Health New Zealand specialist mental health teams), and from different locations which make each interaction and connection unique.  Pathways and its kaimahi are dedicated to achieving equitable health outcomes for the tāngata whai ora (people seeking wellness) we support, guided by their shared purpose, mission, values and Te ao Māori.  Instead of declining referrals and saying ‘no’ to requests at the outset, there is a shift to having the willingness to help and working collaboratively to come up with solutions: “Yes we would like to help, but what do we need to make it happen/work?”. 

Within my role the tasks vary and include clinical governance (such as quality improvement, reporting on adverse events), delivering training tailored to kaimahi to help with confidence on more ‘clinical’ topics such as mental health risk assessment and mental state examination, clinical consultations with teams on complex tangata whai ora referred to our services, and at times seeing tāngata whai ora face-to-face to help troubleshoot and advocate what would be helpful in their recovery journey. The variety of service types and presentations meant that I have had to draw on my breadth of knowledge, past learnings and experiences as a trainee in sub-specialties in forensics, mental health for older adults and addictions.  The mix of tasks and responsibilities makes this role highly rewarding, impactful and motivating, and offers many opportunities to further develop personally and professionally.    I look forward to what’s next.

Mental Health in International Students: Systemic Challenges, Care Gaps, and the Need for Policy Reform 

Australia remains one of the world’s most sought-after destinations for tertiary education, with over 1.09 million international student enrolments reported in 2024 and an economic contribution of $51 billion (Department of Education, 2024). However, this population—while crucial to the economic and academic fabric of the nation—is uniquely vulnerable to psychological distress. The intersection of acculturative stress, financial strain, social isolation, and complex visa conditions creates a multifaceted risk environment for mental ill-health. Despite this, service access remains limited, and policy frameworks are not adequately aligned to meet their needs. 

Acculturative Stress and Psychological Vulnerability 

Acculturation involves psychological, behavioural, and social adaptation following continuous contact with a new culture (Berry, 2006). Berry’s acculturative stress model outlines four phases: honeymoon, culture shock, adjustment, and adaptation. While many international students successfully navigate these phases, others encounter persistent distress, particularly when transitioning from collectivist cultural norms to Australia’s more individualistic society. This disruption often manifests in loneliness, identity confusion, and increased susceptibility to mood and anxiety disorders. 

Mental Health Burden in International Student Populations 

A systematic review of international student mental health in Australia demonstrates elevated rates of anxiety, depression, and psychological distress compared to domestic students (Maharaj, 2024). Contributing factors include: 

· Social isolation and loneliness, driven by language barriers, difficulty forming cross-cultural friendships, and separation from familial support systems. 

· Financial stress, despite limited working rights, with some students subjected to exploitative labour conditions or financial risk-taking, including problem gambling. 

· Discrimination and exclusion, particularly for female students, contribute to heightened psychological vulnerability. 

· Academic stress, linked to full-time enrolment requirements and high performance expectations, often in a non-native language. 

Barriers to Help-Seeking 

Despite heightened mental health needs, international students underutilise mental health services (Veresova, 2024). Cultural stigma, low mental health literacy, language barriers, and a perceived lack of cultural competence among providers all contribute to a reluctance to engage. Many delay help-seeking until crisis point. Peer networks often serve as informal support systems, but these are ill-equipped to manage moderate to severe psychiatric presentations. 

Systemic Gaps in Care Access and Continuity 

Though international students are required to maintain Overseas Student Health Cover (OSHC), access to mental health care is inconsistent. While inpatient psychiatric treatment is generally covered, outpatient services are often only partially reimbursed—typically up to 85% of the Medicare Benefits Schedule (MBS) fee—and many public outpatient clinics charge full fees for Medicare-ineligible patients. This creates substantial out-of-pocket costs and hinders continuity of care, especially post-discharge from inpatient services. 

Moreover, the distinction between MBS-covered and non-covered services is often poorly understood by students and clinicians alike. University counselling services are typically short-term and under-resourced, while low-barrier community services like Headspace only cater to the under-25 demographic. 

Visa and Policy Constraints 

Student visa conditions require continuous full-time enrolment, limiting flexibility in academic load or study leave. While provisions exist for leave under “compassionate or compelling circumstances,” approval processes are often complex, time-consuming, and poorly understood by both students and providers. Academic institutions are only permitted to extend enrolment periods—and by extension, visa validity—under strictly defined circumstances. Consequently, students experiencing psychiatric illness may face delays in course deferral, financial hardship due to reapplication fees, or risk of visa cancellation due to academic non-progression. 

Repatriation following serious psychiatric illness is another policy gap. Despite psychiatric illness being a leading cause of medical evacuation globally, there are no standardised Australian guidelines on return-to-study post-illness for international students, nor on cross-border continuity of psychiatric care. 

Implications for Clinical Practice and Policy 

Improving mental health outcomes for international students requires a coordinated approach across sectors. Key recommendations include: 

1. Culturally responsive care models, with enhanced interpreter access and clinician training in cross-cultural psychiatry. 

2. Policy reform in OSHC coverage, ensuring parity in outpatient psychiatric care and improved clarity for both patients and providers. 

3. Streamlined visa and academic processes, including fast-tracked medical leave approvals and structured reintegration plans for returning students. 

4. Cross-border care planning, particularly for students returning home post-treatment, to ensure continuity of psychotropic medication and psychiatric monitoring. 

International students are a vital yet underserved population in Australian mental health care. A proactive, systems-based response is essential to reduce risk, promote wellbeing, and foster equitable access to mental health services. 

References 

· Berry, J. W. (2006). Stress perspectives on acculturation. In D. L. Sam & J. W. Berry (Eds.), The Cambridge Handbook of Acculturation Psychology (pp. 43–57). Cambridge University Press.  

· Department of Education. (2024). International Student Data 2024. Australian Government.             

· Maharaj, A. (2024). Mental health and wellbeing of international students in Australia: A systematic review. Journal of International Student Health, 12(1), 15–32. 

· Veresova, Z. (2024). Suicide risk among international students: A review of recent evidence. Australasian Psychiatry, 32(2), 89–94. 

ADHD News

The ADHD Network witnessed another successful joint conference with the Adult Faculty and the Section of Private Psychiatry. The Network has joined hands with the Faculty of Child and Adolescent Psychiatry for the upcoming conference in Hobart and the Network will facilitate the pre-conference workshop in ADHD on 17th September 2025. For this workshop, three excellent speakers (Prof David Coghill, Prof Valsamma Eapen and A/Prof Soumya Basu) will cover assessment and treatment related topics.

There is shortage of different preparations of Methylphenidate. Approvals for overseas brands of Methylphenidate LA and Concerta have been confirmed by the Medicine Shortage Advisory Committee. Fellows practising in ADHD care are encouraged to check the TGA medicine shortage database regularly to see the current status of the shortage.

An important and emerging change in the space of ADHD practice is the Governments' plan to improve access to ADHD assessment and treatment through primary care sector (GPs) in Queensland, Western Australia, and New South Wales.  The Network Committee has been liaising through appropriate channels to emphasise the importance of adequate training of GPs in mental health broadly and the risk of over-diagnosis and treatment without thorough assessment and training.

The monthly Grand Rounds remain an excellent source of group learning. Members are encouraged to convey their interest if they wished to present a clinical scenario or a topic in ADHD.

Mindfulness Corner

How to be calm and content in a chaotic world 

With 50 practical and easy-to-follow life hacks, this book will make you a calmer, happier and more chilled-out version of yourself.

The Buddha worked out how best to deal with the challenges we face today over 2000 years ago. His teachings show us that human stress, anxiety and suffering are nothing new.

Life Hacks from the Buddha will help you to quieten your mind, create more peaceful environments to live in, and find the calm and contentment you need to help you function at your very best, which will leave a lasting impression on everyone around you. 

'This is an awesome collection of life hacks to help you feel calm amidst all the calamity. It worked for me.' - Nigel Latta

'Full of great tips for your mental wellbeing' – Sir John Kirwan

'Brilliant, relevant, practical. Ancient Eastern wisdom meets modern science' –Art Green

The Companion - Dr Samir Heble
A/Executive Director Medical Services
A/Executive Director
Mental Health and Aboriginal Health Strategy
WA Country Health Service

Today, we had a very sensuous companion accompany us at every moment of our trek. At 6 am, whilst it was still dark and the rain droplets were kissing our cheeks , she was there ready and waiting for us - the ever gracious waterfall. As we took our first steps in the early lights of dawn, she began accompanying us all through the lush forest. She mesmerized us with her freshness, her energy , her force. It was so motivating to see her pass through every obstacle on her track, be it large boulders or even larger branches of fallen trees, and still continue on her path with zeal and zest. She wanted me to stop and pause and be with her. And so did I. We engaged with each other in this authentic, heart to heart inner conversation. I breathed her and she breathed me. It was rejuvenating. And refreshing. Exchanging our breaths. Breathing in calm. Breathing out peace. She had this unique musicality to her voice. Her force reverberated through my whole being, recalibrating me to the sounds and rhythms of our universe. Divine. Healing. And as we finished our trek in Perth, she kissed us goodbye, knowing that we will return to see her again and again.

- poetic reflections on and in acknowledgement of our sensuous companion - the waterfall.

Bi-national Faculty of Adult Psychiatry Committee

A/Prof Balaji Motamarri – Chair
Dr Muthur Anand – NZ Representative
Dr Suneel Chamoli – ACT Representative
Dr David Chapman – NT Representative
Dr Dharshanie Gunaratne - SATAP Chair
Dr Petre Heffernan – TAS Representative
Dr Karuppiah Jagadheesan – VIC Representative
Dr Peter Melvill-Smith - WA Representative
Prof Nagesh Pai – NSW Representative
Dr Suman Sinha - NZ Representative
Dr Surabhi Sinha - Trainee Representative
Dr Georgina Weir – SA Representative
Dr Ashlea White - QLD Representative

A/Prof Balaji Motamarri
Chair, Bi-national Faculty of Adult Psychiatry Committee