Psychiatrists say ongoing neglect of community mental health services and underinvestment in health-led crisis responses continues to place pressure on hospitals, increase risks in the community, and leave many people without timely support in NSW.

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) NSW Branch said today’s Budget includes some welcome investments, including:

• Continuation of funding for suicide prevention services with the Australian Government
• Investments in short stay units and hospital infrastructure
• Improved regional access through the Isolated Patients Travel and Accommodation Assistance Scheme
• Nursing and paramedic workforce measures

The RANZCP also welcomed recent commitments from NSW Health to strengthen the psychiatry training pipeline in New South Wales, including additional roles within Training Networks to support supervision and education. 

“These roles are critical to building the specialist workforce needed to meet future demand,” Dr Korbel said.

However, the Budget does not address the need for health-led frontline responses and the scale of unmet mental health need in the community. 

RANZCP NSW Branch Chair Dr Ian Korbel said the state continues to rely on a crisis-driven and hospital-centric mental health system that steps in far too late, often only once people have already reached a breaking point.

“Not too long ago, the Bondi Junction inquest laid bare the devastating consequences of fragmented service delivery, gaps in continuity of care, and the absence of coordinated follow-up and outreach for people who disengage from treatment,” Dr Korbel said.

“Those findings should have been a turning point. This Budget had the opportunity to respond, yet it falls short of delivering the investment needed in health-led crisis responses, community mental health care and community outreach to address these failures.

Dr Korbel said decades of underinvestment in community mental health services have left too many people without access to timely care, early intervention and prevention.

“As a result, people are presenting to emergency departments, ambulance services and police in acute distress, when earlier support could have prevented escalation,” he said.

“When people fall through the cracks in our mental health system, the consequences are devastating for them, their families and the wider community. We know it all too well.”

The RANZCP said the Budget’s approach to community safety appears to place greater emphasis on policing and justice system responses, including increased investment in frontline policing and public prosecutions, while the sector continues to wait for dedicated investment in health-led mental health crisis responses, particularly in light of the recent Four Corners investigation.

“Without properly funded health-led crisis teams and stronger community mental health services, we will continue to see people with serious mental illness pushed into emergency departments, police interactions and the justice system,” Dr Korbel said.

“We can expect emergency departments to remain overcrowded and continue to act as the inappropriate front door to mental health care for many people whose conditions could have been stabilised or improved with the right support available earlier in the community.”

Recent evidence, including the NSW Legislative Council inquiry into community mental health and NSW Health’s Community Mental Health Priority Issues Paper, has highlighted the consequences of underinvestment in community care.

Dr Korbel said NSW continues to lag behind other jurisdictions in community mental health workforce capacity.

“We are a state of more than eight million people with a substantial workforce gap compared to the rest of Australia and reduced access to care for people who need treatment in the community, closer to home and their support networks, in environments that feel more familiar and less intimidating.

“When people cannot access timely treatment in the community, their condition can deteriorate and become more complex to treat, making recovery feel out of reach and increasing the likelihood of hospitalisation.

“That is more disruptive for individuals and families, and more costly for the health system.”

The RANZCP said investment in community mental health is both a clinical and economic priority and is calling for a staged expansion of the workforce, including an initial increase in frontline clinicians.

“Strengthening community-based services means people can access care earlier and avoid escalating to crisis and unnecessary hospital presentations,” Dr Korbel said.

“What we need is additional community mental health clinicians to begin rebuilding capacity while longer-term workforce growth is planned. Investment in the Community sector will save the government money by decreasing hospitalisations and improving people’s health.”

“This Budget has missed the mark on mental health, but we continue to hope the NSW Government will act on the evidence before it,” Dr Korbel said.

“Without serious investment in community care and health-led crisis response, people experiencing mental ill health will continue to be supported too late, and at far greater human cost than necessary.”

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.