NSW Psychiatrists call for transparency and action after newly obtained papers reveal full scale of mental health need

Newly obtained NSW Health documents suggest the full scale of mental health need in New South Wales has been known for some time, but the community has not been given the complete picture needed to drive meaningful reform. Psychiatrists say this has raised serious questions about transparency and accountability.

The NSW Branch of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) has expressed serious concern following the release of NSW Health documents indicating that the substantial scale of unmet mental health need across the state was not made fully available to the public.

The documents, released under a Standing Order 52 call for papers, reveal NSW Health estimated a recurrent annual shortfall of between $550 million and $600 million in clinical and support staff across the state's public mental health system and $187 million a year for psychosocial support.

A comprehensive review of the papers uncovered internal discussions about the significant investment needed to address unmet need, and concerns that making the full scale of that need public would require the largest expansion of mental health services in NSW history.

RANZCP NSW Branch Chair Dr Ian Korbel said the revelations were deeply concerning, urging the NSW Government to acknowledge the scale of the challenge, consider the evidence in front of them in its entirety, and scale the practical solutions that strengthen hospital services, community mental health care and psychosocial supports.

"Transparency in health service planning is fundamental to public accountability, informed policy decisions and the confidence of patients, families and clinicians in our mental health system," Dr Korbel said.

"These documents suggest there were concerns that an honest assessment of need would reveal the requirement for a level of investment well beyond what governments have traditionally allocated to mental health.

"The reality is that mental illness is already costing our state. People still need care, families still need support, and communities still need services regardless of the size of the investment required.

“When governments fail to invest in the appropriate models of care, emergency departments, people living with mental illness, their families and carers, and the broader community bear the costs. 

"The required investment in Mental Health Services, in the order of $787 million a year, should be seen as an investment in the health of the NSW people. It would lead to more people with mental health conditions being able to return to work, more of their carers to also return to the workforce, less homelessness and less people being incarcerated.

“The investment is likely to be returned in gains to the economy of around $4 for every dollar spent. Choosing not to make this investment is economically irresponsible "

The release comes after years of advocacy from the RANZCP NSW Branch and others in the mental health sector for a comprehensive gap analysis to identify unmet need across NSW.

When the Mental Health Gap Analysis was finally released earlier this year, the College welcomed the report as an important step towards better planning but raised concerns about the absence of sufficiently granular Local Health District data needed to support transparency and accountability.

"The RANZCP NSW Branch spent years calling for a gap analysis because good planning starts with an honest understanding of community need, and clinicians had been seeing the consequences of unmet need in the community long before this data was collected," Dr Korbel said.

"While we welcomed the eventual release of the report, we were disappointed that important details remained unavailable, including place-based data that would allow communities to understand where need is greatest and where services are falling furthest behind.

“Communities have a right to know where services are falling short. Clinicians need this information to advocate for their patients and to hold governments to account.”

Dr Korbel said the focus should now shift from the process of releasing the analysis to responding to what it found as a matter of priority.

"The evidence is clear that there is unmet need, and people do not stop needing mental health care simply because services are unavailable or underfunded” Dr Korbel said.

"We can’t continue to rely on crisis-driven responses. The question is whether we are prepared to acknowledge the scale of the challenge and let investment be guided by clinical need, evidence-based models of care and accompanied by meaningful accountability.”

The RANZCP is advocating for addressing the shortfall through a commitment to adequate investment across hospital-based services, community mental health care and psychosocial supports, while ensuring people can access evidence-based treatment before reaching crisis point.

"People should not have to wait until they are acutely unwell before they can access support," Dr Korbel said.

"Alongside investment in hospital services, we need stronger community mental health services and better access to evidence-based treatments, including therapies such as cognitive behavioural therapy and dialectical behaviour therapy.

“Just yesterday, the Minister for Mental Health heard from mental health sector representatives at the Mindgardens Psychosis Forum about the importance of integrating mental and physical health care, through programs such as the successful ‘Keeping the Body in Mind(gardens)

"Psychiatrists stand ready to work with the NSW Government, NSW Health, consumers, carers and the broader mental health sector to plan and implement the necessary reforms.

"The people of NSW deserve to know what their mental health system needs, what decisions have been made, and when they can expect meaningful improvements in their access to mental health treatment and care.”

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

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