A revolving door of psychiatrists at Shellharbour Hospital's highest care mental health unit is compromising patients' care.
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The Eloura High Care unit is staffed by locum psychiatrists on short-term contracts, which is "a clear breach of the concept of continuity of care" according to a source who contacted the Mercury.
The source cited a recent case where a long-term patient was under the care of six different psychiatrists in a 10-week period.
"This person's mental state was often affected in a negative manner as each successive psychiatrist introduced a differing treatment regime," they stated.
They need someone with good assessment skills who can determine which type of care will be best; and they need continual follow-up.
Glenn Hayes, president of the Illawarra mental health nurses branch of the NSW Nurses and Midwives Association, confirmed that many patients were treated by multiple doctors throughout their stay at the unit.
Mr Hayes said he hoped that the boost to frontline health staff promised in this week's state budget - which included more than 1000 doctors, psychiatrists and specialists statewide - would see a permanent psychiatrist attached to the unit.
"We haven't had a permanent psychiatrist at the unit since 2008," he said.
"After that we had several doctors rotate from other areas of the service for 12 months or so. But in the past few years we've only had locums.
"It means that one patient could see three or more doctors during their stay - each of whom could change that person's treatment.
"That could mean anything from a change in medication, to changing the form of treatment entirely - such as from a medication-based treatment to electroconvulsive therapy, which is far more intrusive."
Mr Hayes said Illawarra Shoalhaven Local Health District management had provided no timeframe for a full-time replacement.
"The two other acute mental health units at Shellharbour, and the acute unit at Wollongong, are all staffed by permanent psychiatrists," he said.
"But we have been calling for a full-time specialist for the Eloura high care unit for years.
"This is a unit which treats those with higher need requirements - those who need observation due to self harm or aggression; those with mental health diagnoses like bi-polar or schitzophrenia.
"They need someone with good assessment skills who can determine which type of care will be best; and they need continual follow-up.
"We've had some excellent locums, but it's about that continuity of care for patients."
Mr Hayes said the constant rotation of specialists also had an affect on staff, and the overall environment of the unit.
"We work as a team and so it can be disruptive for staff too to continually have new locums in, who need to be oriented and familiarise themselves with the unit - and the policies and procedures," he said.
"And it's not cost effective having locums who would be paid more than a staff psychiatrist."
ISLHD acting director mental health Adam Bryant said the district employed more than 21 full-time equivalent psychiatrists, who provided care to consumers in inpatient and community mental health services across the region.
"There is a national shortage of psychiatrists and the district does employ specialist locums to cover vacancies," he said. "The district is continually seeking to recruit psychiatrists locally, interstate and internationally."
Mr Bryant welcomed the boost to frontline staff in the state budget: "The LHD understands these positions will be aligned to increasing demand and complexity of care across the state".
