Psychiatrists have welcomed the NSW Government's $270 million investment in health-led mental health emergency care as a major step towards ensuring people in crisis receive clinical, rather than law enforcement, responses wherever possible. The RANZCP NSW Branch says the reforms must be part of a broader shift towards 24/7 community crisis care, clear pathways to specialist psychiatric support and stronger investment in community based treatment outside emergencies.

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) NSW Branch has welcomed the NSW Government's new health-led response model for mental health emergencies, which will establish a statewide Virtual Mental Health Hub within NSW Ambulance and eight Mental Health Acute Assessment Teams operating 12 hours a day, seven days a week in areas of high need. 

RANZCP NSW Branch Chair Dr Ian Korbel said the announcement reflects many of the principles psychiatrists have long advocated for, including greater use of clinician-led responses to mental health crises. 

"Mental health crises are fundamentally health issues. Wherever possible, people should be met with clinical expertise, skilled de-escalation and appropriate care from trained mental health workers, rather than a response that can unintentionally escalate distress or trauma,” Dr Korbel said. 

"This reform addresses the pointiest end of the mental health system, and it's both needed and welcome. 

"But if our goal is better mental health outcomes, we also need to invest in specialist and multidisciplinary community mental health teams, including peer workers, that can provide ongoing care, help prevent people from reaching crisis point in the first place, and support access to treatment, rehabilitation and other services within the community once the immediate emergency has passed. Isn't that ultimately what we're trying to achieve?" 

The RANZCP supports retaining police discretion where there is an immediate safety risk, or police are the most appropriate agency, provided decisions are guided by clear public criteria, and support clinically appropriate, least-restrictive care. 

Dr Korbel said the model aligns with approaches the RANZCP has previously advocated for, including health-led crisis responses informed by international models such as the UK's Right Care Right Person approach.  

"The RANZCP proposed a model with many of these features, and we're pleased to see those ideas being taken seriously. We're also encouraged to see this model shaped through consultation with consumers and carers, Aboriginal Community Controlled Organisations, clinicians and advocacy groups,” Dr Korbel said. 

"For too long, police have often been called upon to respond to situations that are fundamentally health crises. While police will always have an important role where there are immediate safety risks, people experiencing mental distress should, wherever possible, be met first with clinical expertise and appropriate care." 

While welcoming the announcement, Dr Korbel said the success of the model would depend on strong triage processes and clear pathways to specialist mental health care when required. 

"A well-designed health-led first response is an important first step. But the people responding on the ground will need clear pathways to specialist mental health services, including psychiatric assessment and treatment when required,” Dr Korbel said. 

"Not everyone experiencing a mental health crisis will need a psychiatrist, but those with severe mental illness, significant risk, diagnostic complexity or co-occurring conditions must be able to access specialist care quickly." 

Dr Korbel said crisis responses must also be supported by ongoing community treatment and follow-up care. 

"The effectiveness of this model will depend on how well people are assessed, triaged and connected to ongoing treatment. Crisis responses work best when they are backed by a broader system of multidisciplinary community mental health care,” Dr Korbel said. 

“Mental health services across NSW already face significant workforce shortages. Expanding communitybased responses will require sustained investment in recruiting, training and retaining psychiatrists, mental health nurses, peer workers and other specialist clinicians to ensure these teams can operate safely and effectively. 

The RANZCP said the long-term goal should be a fully integrated, statewide system capable of delivering rapid, community-based mental health crisis responses at any time of day or night. 

"This is an incremental but significant improvement. Over time, we'd like to see access to comprehensive, community-based mental health crisis support available 24 hours a day, seven days a week across New South Wales,” Dr Korbel said. 

Dr Korbel said psychiatrists look forward to continuing to work with the NSW Government, NSW Health, ambulance services, consumers, carers and lived experience advocates as the model is implemented. 

"While today's announcement is a significant step forward, its success will ultimately depend on statewide access, clear escalation pathways to specialist care, meaningful involvement of people with lived experience and Aboriginal communities, and continued investment in the community mental health workforce. 

"Every person experiencing a mental health crisis deserves a response grounded in safety, dignity and clinical care. This reform moves NSW in the right direction, and we look forward to helping ensure it delivers the best possible outcomes for patients, families and communities." 

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.