A new analysis by the Royal Australian and New Zealand College of Psychiatrists (RANZCP) of its Child and Adolescent Psychiatry Workforce Report shows that while Australia's shortage of child and adolescent psychiatrists (CAPs) is a national problem, its causes look different in every state and territory.

The analysis draws on existing data from the Australian Institute of Health and Welfare (AIHW), the Australian Bureau of Statistics (ABS), the Psychiatry Supply and Demand Study based on the National Mental Health Service Planning Framework (NMHSPF), RANZCP membership data and surveys and focus groups with child and adolescent psychiatrists from every Australian state and territory and Aotearoa New Zealand.

Nationally, Australia currently has around 657 child and adolescent psychiatrists, a rate of just 11.2 per 100,000 children. The RANZCP projects a shortfall of at least 229.9 full-time equivalent (FTE) specialists by 2028, rising to 307.9 by 2048 unless investment in the workforce increases now.

The report also found that:

• NSW has the largest shortfall of CAPs of any state in the country in every year modelled: 64.3 FTE now, growing to 86.7 by 2028, 102.9 by2033and 119.0 by 2048. That is despite NSW having the largest current training pipeline of any state (45 trainees and Fellows) and one of the largest five-year intakes (59 doctors since 2020).
• Western Australia and the Northern Territory tell the opposite story. WA has trained just 11 new CAPs in the past five years, the lowest intake of any mainland state, leaving only 7 people in its entire current training pipeline.
• Only one doctor commenced CAP training in the Northern Territory over the past five years, and as of October 2025 there were no CAP trainees in the Territory.
• WA’s unmet gap is projected to increase to 37.8 FTE in 2028, growing to 57.1 in 2048.
• NT’s unmet gap is projected to be 7.1 FTE in 2028, increasing to 12.1 in 2048.
• Victoria has trained the greatest number of new CAPs of any state (64 intakes since 2020) but still carries the second-largest projected shortfall in the country by 2028 (39.1 FTE).
• Queensland has the highest number of graduates (45) and the largest current training pipeline (49), yet its 2028 gap still sits at 35.6 FTE.
• South Australia's shortfall is smaller in absolute term sat 5.7 but is on track to more than double by 2028 at 11.9 and 13.7 in 2048.
• Tasmania and the ACT currently have the smallest gaps in the country due to lower population numbers, and both have produced among the fewest CAP graduates of any jurisdiction the past five years.

The report's consultations with psychiatrists uncovered consistent concerns regardless of jurisdiction. 

Practitioners described routinely having to decline five to ten new referrals each week, and said public services have been forced to stop seeing children under 12 so they can prioritise the most acutely unwell adolescents.

They also discussed vacancy rates, with some services relying on locums for 30 - 50% of their workforce, and psychiatrists said access to private specialists remains concentrated in major cities, leaving children in rural and regional areas with almost nowhere to turn.

In a separate survey of child and adolescent psychiatrists in NSW conducted by the RANZCP, more than 7 in 10 said the NSW specialist workforce is not at all prepared to absorb the additional demand expected from NDIS reforms requiring state and territory health departments to take on greater responsibility.

Chair of the RANZCP’s Faculty of Child and Adolescent Psychiatry, Scientia Professor Valsamma Eapen AO said there was no single fix to Australia’s psychiatry shortfall. 

“Some states are training psychiatrists and still losing the fight to keep them. Others can't get enough doctors into training in the first place. Every state and territory needs a different response, but every state needs to act for its children who need specialist support for their mental health needs,” Prof Eapen said.

“Child and adolescent psychiatrists do much more than prescribe medication. 

“Each additional specialist can help improve holistic care for those with complex mental health presentations with co-occurring autism, ADHD, Tourette Syndrome, eating disorders and trauma, and the only profession able to provide the full range of assessment and medical tests, and the continuum of care from early intervention, medication management, authorising admission to hospital and involuntary treatment as well as clinical leadership across hospital, community and private settings. They are critical to the mental health workforce.

“But right now, many children are waiting months and even years for help and families are trying to manage increasingly complex mental health needs without the specialist support they need from a psychiatrist.

“We know that half of all mental health conditions emerge before age 14, yet workforce shortages are forcing services to prioritise only the most acute cases and turning many children away before they reach crisis point with consequent adverse life trajectory outcomes, including educational failure, forensic involvement, life-long physical and mental health conditions and reduction in life expectancy. 

“The report found an estimated social return of $13.64 for every dollar invested in the CAP workforce, improving outcomes across health, education, employment, and social services.

“We need more funded child and adolescent psychiatrist positions in all settings alongside a training pipeline proportional to the population numbers and characteristics, with additional targeted support for rural and underserved communities, and continued investment in early intervention initiatives, thereby reducing downstream demand on emergency and crisis specialist CAMHS services.

“These reforms will help ensure children get the right care at the right time, before problems become more severe and other co-occurring conditions emerge making treatments more expensive and less effective,” Prof Eapen said.

ENQUIRIES: For more information, or to arrange an interview, call Dishi Gahlowt 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.