Imagine waiting almost a full day in a chaotic emergency department while experiencing a mental health crisis. Not because you're waiting for test results, but because there's simply nowhere else for you to go.

That's the reality for one in ten Australians seeking mental health care in our hospitals, according to a report released today by the Australasian College for Emergency Medicine (ACEM). Some patients are waiting more than 23 hours for a bed.

This is the third major report in a month to expose the collapse of Australia's mental health system. Just weeks ago, the Australian Medical Association revealed record-breaking wait times, with mental health patients spending facing the longest delays ever recorded. The Productivity Commission’s final review of the Mental Health and Suicide Prevention Agreement released earlier this month also found our mental health system continues to turn its back on those in greatest need.

Royal Australian and New Zealand College of Psychiatrists (RANZCP) President Dr Astha Tomar said the repeated warnings should be impossible to ignore.

"These aren't just statistics. Behind every number is a person in unbearable distress, someone experiencing suicidal thoughts, psychosis, or severe anxiety, forced to wait in the worst possible environment for care that may never come," Dr Tomar said.

"Psychiatrists working across emergency departments, community clinics, and hospitals see this crisis unfold daily. We're watching people deteriorate while they wait. We're seeing families exhausted from holding the system together. And we're losing colleagues to burnout because they can no longer bear witnessing this failure."

The ACEM report found mental health presentations to emergency departments increased by 11 per cent between 2016 and 2024, with people arriving in greater complexity and urgency. Nearly 75 per cent of patients now need to be seen within 30 minutes, yet the system has fewer resources than ever to respond.

Wait times are particularly dire in South Australia, Tasmania, and Western Australia, where only 40 per cent of mental health presentations are seen on time. The Northern Territory and Tasmania continue to have the lowest bed capacity nationally.

Dr Tomar said the crisis stems from decades of underfunding and fragmented care.

"Emergency departments have become the default, and often only, option for people in mental health crisis because community services are underfunded, private psychiatric hospitals are closing, and Medicare doesn't cover the complex care people need," she said.

"We're forcing people to reach absolute breaking point before they can access help. That's not a health system. That's a system designed to fail."

The RANZCP is calling for urgent investment across the full spectrum of mental health care, from community-based services to adequate mental health bed capacity in public hospitals, and a Medicare system that supports the multidisciplinary care people with complex conditions actually need.

"Mental illness and substance-use disorders carry the second highest burden of disease in Australia, yet investment remains fragmented and inadequate," Dr Tomar said.

"As state and federal governments negotiate public hospital funding agreements, mental health cannot be left out of the equation. We need guaranteed, dedicated funding that reflects the true impact of mental illness on our communities, not another round of short-term fixes that leave the system to collapse further."

"Two damning reports in one month should be a wake-up call. The question is: how many more reports will it take before governments act?,” Dr Tomar said.

ENQUIRIES: For more information, or to arrange an interview call Phil Cullen on +61 437 315 911 or email media@ranzcp.org.  

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org.

In Australia: If you or someone you know needs help, contact Lifeline on 13 11 14 or www.lifeline.org.au or the Suicide Callback Service on 1300 659 467 or www.suicidecallbackservice.org.au.

In New Zealand: If you or someone you know needs help, contact Lifeline NZ on 0800 543 354 or www.lifeline.org.nz or the Suicide Crisis Helpline on 0508 828 865 or www.lifeline.org.nz/suicide-prevention.