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Loni Schramm
2025 AMSA Rural Psychiatry Placement Bursary Reflection
Loni Schramm
Medical student 3rd year at Flinders University
Doing my psychiatry placement in Alice Springs Hospital has been incredibly powerful, particularly so when previous clients from my past career in mental health who have been patients in ASH MHU had set my expectations of what it felt like as a patient. To be in such a position of power and with such limited resources, practicing psychiatry in such a small and complex town like Alice Springs is a huge endeavour and one I hope to effect positive change in, not just for people in inpatients and community, but for the psychiatry department teams across NT as well. I feel that this placement has strengthened my drive to deliver quality mental health care to those most vulnerable in terms of remoteness, complexity and disadvantage, and I am privileged to be in a position to choose to do so.
The challenges I may face and have faced so far mostly involve the limitations of the hospital resources and my lack of language and clinical insight impacting on the load on the team of both permanent psychiatrists and the Aboriginal Liaison Officers responsible for facilitating culturally-safe care, including effective communication and translation, cultural safety, and context-dependent insight for Indigenous patients from remote communities. Additionally, visiting locum psychiatry consultants and registrars often find the local cultural, remote and resource-poor context difficult to apply to patients’ care and treatment plans as required when they have never worked with remote First-Nations people before, and this can cause barriers to delivering accessible and appropriate care. I have found the biggest challenge so far to be centred in provision of advocacy for doctors and patients and ensuring culturally safe care for patients in an environment lacking in resources, staff, and access to appropriate and adequately-funded and -staffed community supports.
Doing my psychiatry placement in Alice Springs Hospital has been incredibly powerful, particularly so when previous clients from my past career in mental health who have been patients in ASH MHU had set my expectations of what it felt like as a patient. I have learned that to be in such a position of power and with such limited resources, practicing psychiatry in such a small and complex town like Alice Springs is a huge endeavour and one I hope to effect positive change in, not just for people in inpatients and community, but for the psychiatry department teams across NT as well. I feel that this placement has strengthened my drive to deliver quality mental health care to those most vulnerable in terms of remoteness, complexity and disadvantage, and I am privileged to be in a position to choose to do so.
My current career goals involve working in the Northern Territory as a psychiatrist, for which I’m currently completing a research project on psychosis prevalence in Top End remote communities under supervision of the NT Chief Psychiatrist. This and my placement have so far impressed upon me the significance of ALO engagement, supporting First-Nations doctors in mental health professionally and to become psychiatrists themselves, and to deliver appropriate care with the training, experience and knowledge in language and culture I have received in my many years in the Territory (and multiple years in Alice Springs).
This rural placement provided deeper understanding of the role I hope to fill in future as a psychiatrist in the Northern Territory and who wants to work collaboratively and ethically with all patients and their families, regardless of their level of English, distance from specialist care, or complexity of their condition. I have been able to foster my love for mental health with the connections I make during my placement with the psychiatrists and mental health workers who have welcomed me into their small and passionate team, and their supervision and mentorship I have gratefully received. I understand now on a deeper level what it takes to be a good clinician in this context, educating myself appropriately and realise that supportive teamwork, inclusive of ALOs and mentorship, is essential.
Doing my psychiatry placement in Alice Springs Hospital has been incredibly powerful, particularly so when previous clients from my past career in mental health who have been patients in ASH MHU had set my expectations of what it felt like as a patient. To be in such a position of power and with such limited resources, practicing psychiatry in such a small and complex town like Alice Springs is a huge endeavour and one I hope to effect positive change in, not just for people in inpatients and community, but for the psychiatry department teams across NT as well. I feel that this placement has strengthened my drive to deliver quality mental health care to those most vulnerable in terms of remoteness, complexity and disadvantage, and I am privileged to be in a position to choose to do so.
The challenges I may face and have faced so far mostly involve the limitations of the hospital resources and my lack of language and clinical insight impacting on the load on the team of both permanent psychiatrists and the Aboriginal Liaison Officers responsible for facilitating culturally-safe care, including effective communication and translation, cultural safety, and context-dependent insight for Indigenous patients from remote communities. Additionally, visiting locum psychiatry consultants and registrars often find the local cultural, remote and resource-poor context difficult to apply to patients’ care and treatment plans as required when they have never worked with remote First-Nations people before, and this can cause barriers to delivering accessible and appropriate care. I have found the biggest challenge so far to be centred in provision of advocacy for doctors and patients and ensuring culturally safe care for patients in an environment lacking in resources, staff, and access to appropriate and adequately-funded and -staffed community supports.
Doing my psychiatry placement in Alice Springs Hospital has been incredibly powerful, particularly so when previous clients from my past career in mental health who have been patients in ASH MHU had set my expectations of what it felt like as a patient. I have learned that to be in such a position of power and with such limited resources, practicing psychiatry in such a small and complex town like Alice Springs is a huge endeavour and one I hope to effect positive change in, not just for people in inpatients and community, but for the psychiatry department teams across NT as well. I feel that this placement has strengthened my drive to deliver quality mental health care to those most vulnerable in terms of remoteness, complexity and disadvantage, and I am privileged to be in a position to choose to do so.
My current career goals involve working in the Northern Territory as a psychiatrist, for which I’m currently completing a research project on psychosis prevalence in Top End remote communities under supervision of the NT Chief Psychiatrist. This and my placement have so far impressed upon me the significance of ALO engagement, supporting First-Nations doctors in mental health professionally and to become psychiatrists themselves, and to deliver appropriate care with the training, experience and knowledge in language and culture I have received in my many years in the Territory (and multiple years in Alice Springs).
This rural placement provided deeper understanding of the role I hope to fill in future as a psychiatrist in the Northern Territory and who wants to work collaboratively and ethically with all patients and their families, regardless of their level of English, distance from specialist care, or complexity of their condition. I have been able to foster my love for mental health with the connections I make during my placement with the psychiatrists and mental health workers who have welcomed me into their small and passionate team, and their supervision and mentorship I have gratefully received. I understand now on a deeper level what it takes to be a good clinician in this context, educating myself appropriately and realise that supportive teamwork, inclusive of ALOs and mentorship, is essential.
