The clinician, who did not wish to be named, said nurse practitioners were taking on work beyond their scope, and working unsupervised.
"These are nurses who are experienced, who've done an extra year or two.
"They're not psychiatrists, and the crazy thing is they're working without supervision, so it's potentially an incredibly dangerous situation they've got there".
Southland’s mental health, addiction and disability (MHAID) service is budgeted to have 7.8 fulltime equivalent psychiatrists, but has only two.
One of these sustained serious injuries in an assault at the hospital last week, as reported by the Otago Daily Times.
Multiple psychiatrists had left in the last year and a-half, the clinician said.
Senior managers had sat on the problem, reluctant to say they were in difficult circumstances, he said.
The situation was getting worse and bids to address it until now had been "wildly inappropriate".
Another suggested fix was to send patients to Dunedin, yet Dunedin had very limited beds available.
If a death, suicide or other catastrophe occurred, Te Whatu Ora Health New Zealand (HNZ) Southern would be in an indefensible situation, the clinician said.
A psychiatrist would have to be "psychotic" to take a permanent job in Southland, when they could easily get a job elsewhere due to the general shortage.
"I would really strongly suggest get out there and hire people, and the chances are you're going to have to pay people a bit more than the basic salary."
Perhaps they might be trying to save money, but the service was falling over, he said.
Mental health care in Southland has been under pressure for some time — a damning July report said MHAID staff dreaded going to work amid claims of bullying and feeling burnt out.
Staff vacancies exacerbated the difficulties for staff and patients, the report said.
Occupancy of more than 100% in the inpatient unit had also been a “longstanding problem”.
Earlier this week HNZ said it was actively recruiting for more staff and there was a national and international shortage of specialist mental health workers.
Dunedin was providing support, as were locum specialist psychiatrists and nurse practitioners from throughout the country.
The organisation said it was leading a broad programme of work to grow and upskill existing mental health and addiction workforces, and develop new workforces to better support people’s mental health and addiction needs.
HNZ Southern group director of operations Hamish Brown said a nurse practitioner would occasionally work on the on-call roster instead of a senior medical officer.
Asked if the practice was dangerous, he said they would access support if required.
"Nurse practitioners are highly skilled and experienced clinicians with advanced mental health nursing education and clinical training with the demonstrated competence and legal authority to practise beyond the level of a registered nurse.
"They can work autonomously or in collaborative teams and provide high-quality, patient-centred care," he said.
Across Southern there were eight nurse practitioners working in MHAID services, he said.
"Patient care is delivered by a multidisciplinary team which includes senior medical officers, junior doctors, registered nurses, nurse practitioners, social workers, and other Allied Health staff."
