The AMA’s latest report confirms what frontline psychiatrists have known for years: Australia’s mental health system is in crisis, and the impacts on our emergency departments (EDs) are a sign of a deeper failure.

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) is calling for urgent action to relieve pressure on Australia’s emergency departments, following the release of an Australian Medical Association report showing mental health patients are now waiting more than seven hours for a hospital bed. These are the longest delays on record for the second year in a row.

RANZCP President Dr Astha Tomar said people are being forced to turn to hospital emergency departments in acute distress because there is nowhere else to go.

“Emergency departments are becoming the default entry point for mental health care, not because they’re the right place, but because community services are underfunded, fragmented, and simply not available when people need them,” said Dr Tomar.

The report found the median emergency department stay for mental health patients needing admission was 433 minutes in 2023–24, more than two hours longer than in 2018–19. Even more worrying, 1 in 10 mental health patients admitted to hospital are spending almost a full day in EDs, and some are waiting even longer. Older Australians are also presenting to EDs with mental health issues at rising rates, while post-discharge follow-up care has sharply declined, particularly in remote areas.

South Australia reports the longest emergency department wait times for mental health admissions, while the Northern Territory and Tasmania continue to have the lowest bed capacity nationally. 

“This is what happens when we fail to invest in early intervention and prevention,” said Dr. Tomar.

“People are falling through the cracks until they reach crisis point, and by then, the only option left is a crowded ED.”

The RANZCP warns that the current system is not only failing patients but also pushing healthcare workers to breaking point.

“Our members are seeing the toll this is taking on staff. Burnout is widespread; morale is low, and we’re losing experienced professionals from the workforce,” Dr Tomar said.

“We cannot keep asking frontline staff to hold together a system that’s under-resourced and overstretched.”

Mental illness and substance-use disorders now carry the second highest burden of disease in Australia, yet investment remains fragmented and inadequate. The closures of private psychiatric hospitals and community mental health services across the country are further eroding the system’s capacity to deliver timely, high-quality care.

Current Medicare settings also do not support the multidisciplinary and complex mental health care that many people need. This makes treatment unaffordable, and community or private mental health services increasingly unviable.

The RANZCP is calling for a three-pronged approach to reform: making mental health care affordable, accessible, and available before people reach crisis point.

“This means investing in public, specialised community-based mental health services, ensuring follow-up care after hospital stays, and supporting psychiatrists, GPs and other mental health professionals to deliver the care people need, when and where they need it,” Dr. Tomar said.

“Short and sporadic consultations don’t work for patients with overlapping conditions like schizophrenia, trauma, or addiction. GPs and psychiatrists alike agree that our funding model is broken and does not reflect the clinical reality of providing mental health care on the ground.

“The economic case for mental health reform is strong. The Productivity Commission estimates that priority reforms could improve quality of life by up to $18 billion per year and generate $1.3 billion in workforce gains annually.

“And beyond the economic gains, ensuring the equity of mental health care is about dignity, safety, and recovery. We need a system that meets people where they are, not one that waits for them to break,” Dr Tomar said.

For media inquiries, please contact: Dishi Gahlowt on +61 437 315 911 or email media@ranzcp.org 

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

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.