New report highlights urgent need to reform emergency mental health care

24 September 2020

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has congratulated the Australasian College for Emergency Medicine (ACEM) on the launch of their important report Nowhere else to go: Why Australia’s health system results in people with mental illness getting ‘stuck’ in emergency departments.

Following on from the 2018 ACEM Australian Summit on Mental Health Care in the Emergency Department, the report has highlighted the need for improved access to mental health services in the community to relieve the strain on emergency departments and improve the care and experiences for people in mental health crisis.

RANZCP President-Elect, Associate Professor Vinay Lakra noted the timeliness of the report’s release given the pressing nature of people presenting for emergency mental health care across the country who routinely experience unacceptably long wait times often in inappropriate and, at times, unsafe environments.

‘The increase in mental health presentations to emergency departments (EDs) in the last 20 years is due to a number of systemic issues, including the lack of direct access to mental health units,’ said Associate Professor Lakra.

‘As a result of an undersupply of beds and a lack of investment in community mental health resources, consumers are presented with limited options when seeking help – the ED has become the default option for mental health service entry and few, if any, have been designed for the appropriate assessment and management of those with mental health presentations.’

The RANZCP calls on all governments to commit to a comprehensive overhaul of the mental health system to allow for earlier intervention.

‘Emergency departments are a barometer of the quality and equity of our mental health system as a whole,’ explained Associate Professor Lakra.

‘A mental health system which fails to deliver appropriate prevention and early intervention services will see more people present to EDs, more acutely unwell and requiring more intensive treatment and support.’

Professor Sharon Lawn, a community member of the RANZCP Community Collaboration Committee, explained that the situation occurring in EDs is unacceptable and needs to be addressed with longer-term solutions, not mere band-aid measures.

‘People with mental distress and their families need to know that if they need to seek help at this level, attending an ED is not going to make their situation worse, that they are not going to be more traumatised by the experience,’ said Professor Lawn.

‘There is a lot of rhetoric about help-seeking at the moment but this is a real problem if people can’t access support when they need it, either because it doesn’t exist, there are long waiting lists to get help, or the support is spread so thin or uncoordinated that it makes little impact on their mental health and wellbeing in the longer-term.

‘We need better and more timely support in the community so that people don’t need to present to emergency departments in crisis.

‘Fixing ED flow is one part of the solution but the whole system needs to work together so that there is proper support for people to get help early and get quality and timely follow-up support to help keep them well.’

The RANZCP strongly supports the need for more to be done, by the state, territory and federal governments to address the issues of mental health presentations in EDs and provide more community services to provide earlier support, sooner.

For all other expert mental health information, visit Your Health in Mind, the RANZCP’s consumer health information website.

ENQUIRIES: For more information, or to arrange an interview call Sarah Carr on +61 437 315 911, or email