Our mental health system is in a 'permacrisis', writes Professor John Mendoza
One of the country’s leading mental health experts has called for Queensland’s health minister to urgently commission an independent review of the state’s mental health act on the 11th anniversary of his nephew’s death by suicide on the Gold Coast.
Today, Saturday November 15, 2025, marks 11 years to the day that our family lost Jeffery John Mendoza to suicide.
Jeff was my nephew and godson.
He was 36 at the time of his death and was “released” to nothing and no one with no follow up just two days prior from the Gold Coast University Hospital’s Emergency Department. Writing this piece, this week, is torturous.
Over the past month the Gold Coast Bulletin has reported on the suicide deaths of three young people who had been receiving care from the Gold Coast mental health services, and tragically the reports reflect similar failures to those that preceded Jeff’s death.
I know the pain that forever changes families, communities, and lives.
I know there are three more families grieving and bewildered as to how this could happen to their child.
They deserve answers as to how a specialist service could fail so fundamentally when their child needed care and compassion.
They deserve to know why their child was reportedly subject to harmful coercive practices including involuntary treatment, seclusion and physical and chemical restraints.
Involuntary treatment in mental health is an anathema to therapeutic care.
It discourages help seeking and engagement in treatment.
Moreover, coercive practices cause harm to those subjected to them, to those applying them and people witnessing them.
I have dealt first-hand with the moral injury and traumatic stress caused to staff from the use of coercive practices.
The Queensland Minister for Health, The Hon. Tim Nicholls MP, last week ordered a review into the Gold Coast’s Child and Youth Mental Health Service (CYMHS).
It will be led by Victorian child psychiatrist, Paul Denborough, and will report in early 2026. This investigation is in addition to those under way by the coroner, the Health Ombudsman and Gold Coast Health.
Queensland Police are also reportedly conducting investigations following allegations against a nurse employed by Gold Coast Health.
I welcome Minister Nicholls’ intervention, but he must go further, much further.
He will be aware that these deaths and the allegations of the misuse of compulsory treatment orders and excessive use of coercive practices are not confined to the Gold Coast CYMHS.
In October, the coroner announced a “cluster inquest” into the suicide deaths of three inpatients at the Prince Charles Hospital in Brisbane in 2023.
This is indicative of system-wide problems confronting the minister.
Indeed since 2016 when a new Mental Health Act (MHA) was introduced by the Palaszczuk Government, the use of coercive practices has significantly increased.
The intent of the 2016 MHA was precisely the opposite – “to safeguard individual rights, using the least restrictive treatment possible, and promoting a person’s recovery and ability to live in the community”.
That intention aligned with global endeavours to improve mental health care and uphold the rights of persons receiving treatment.
Yet on almost every measure, the MHA has failed.
Queensland has the highest rates of involuntary treatment among the Australian states – be that in hospitals, rehabilitation units or in the community – and this has steadily increased since 2016.
The lack of transparency and accountability are all too obvious.
Internationally, Australia has the second highest rate of involuntary treatment (among 22 developed nations) and our rate is 15 times that of Italy. Non ha alcun senso!
Minister Nicholls must go further than investigating the Gold Coast’s CYMHS.
He must commission an urgent independent review of Queensland’s Mental Health Act.
This review must include Queenslanders with lived experience of our services.
It must have human rights, legal and clinical expertise from outside our state to ensure integrity and provide confidence to Queenslanders.
The Minister must go further still.
Tim Nicholls will know from discussions with his state and territory counterparts, this is not just a Queensland problem.
As the AMA reported earlier this month, Australia’s mental health services are in dire straits with a “logjam of mental health patients in our emergency departments” with the worst ever wait times.
More than half of the mental health presentations at our EDs are arriving by ambulance. People seeking care cannot access a GP and GPs are now spending more time on mental health-related issues than any other condition.
Psychological injury is now the fastest growing category of workplace injury.
Mental ill-health is holding Australia back and annually costing $220bn.
These are all clear signs of a system in a ‘permacrisis’ unable to provide timely care and increasingly overwhelmed by both the severity and numbers of people needing help.
These are all signs that a vigorous and sustained national response with new leadership, investment in what works and accountability is urgently needed.
In 2005, NSW Premier Morris Iemma and Prime Minister John Howard, pushed through the Council of Australian Governments (COAG) national reforms, resulting in the largest ever boost to mental health funding – a real increase of 20 per cent over five years.
Howard said at the time, this “was a down payment” and promised to continue the reforms. Sadly, that has not happened.
Minister Nicholls and Premier David Crisafulli must work with their counterparts at national cabinet, particularly the Albanese Government, and engage with the community in a genuine and sustained reform of our mental health services.
In the years since Jeff Mendoza’s death, some 35,000 families have experienced the grief and enduring sadness of losing a loved one to suicide.
If we don’t transform the nation’s mental health services and do more to reduce the drivers of despair that contribute to suicidal behaviours, then there will be tens of thousands more families grieving and asking how this continues in one of the world’s richest and safest nations.
Professor John Mendoza is a co-director of suicide prevention and mental health consultancy ConNetica and the former Mental Health Council of Australia CEO
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