‘Breaking point’: Peak psychiatry body warns Aussies will fall through ‘growing cracks’ in mental health system

Concerns those most vulnerable will continue to fall through “growing cracks” in one sector have grown amid a suite of demands.

Vulnerable Australians are at risk of falling through “growing cracks” in the mental health system as the country’s peak psychiatry body calls on the major political parties to step up and commit to addressing gaps in care for those with the most severe mental illnesses.

Royal Australian and New Zealand College of Psychiatrists (RANZCP) president Elizabeth Moore claimed vulnerable Australians were missing out on care, with major political parties remaining quiet on the issue of specialist care for those with the most severe and complex mental illnesses ahead of the looming federal election.

“Hundreds of vulnerable Australians are missing out on the care they need, but no party has stepped up with a real plan to fix it,” Dr Moore said.

One in five Australians aged between 16-85 experienced a mental health disorder in the 12 months to February last year. Picture: Supplied

One in five Australians between the ages of 16 and 85 experienced a mental health disorder in the 12 months to February last year, according to the Australian Bureau of Statistics.

However about 20 per cent of people delayed or didn’t see a health professional for mental health due to the cost during the 2023-24 financial year, data released in November found.

The cost of a first appointment with a psychiatrist at their rooms (not in hospital) – or for patients who haven’t seen the specialist in the past 24 months – is about $480, according to the Department of Health and Aged Care’s medical costs finder.

Patients typically pay about $243 out of pocket, with $237 paid by Medicare.

The cost of appointments between 30 and 45 minutes for patients is about $400; however, patients typically pay about $142 out of pocket.

Dr Moore said psychiatry waitlists were continuing to grow across the country, leaving emergency departments overwhelmed while people present with “more complex conditions that take longer and cost more to treat”.

“Public hospitals are under constant pressure, and private hospitals offering psychiatric services are shutting their doors,” Dr Moore said.

“For many Australians, help remains too far away, too long a wait, too expensive or simply unavailable.

The Royal Australian and New Zealand College of Psychiatrists president Elizabeth Moore claims vulnerable Australians are missing out on the care they need. Picture: Supplied.

“Despite repeated warnings, mental health continues to be treated as a subset of general health policy, with no plan to strengthen specialist mental health services.”

RANZCP has called on the major political parties to address industry shortages and make specialist care more affordable, branding it a “core service, not an optional extra”.

“We need more than vague commitments and piecemeal funding – our mental health system is at breaking point, and without urgent action to bolster all parts of our mental health system, Australians will continue to fall through its growing cracks,” Dr Moore said.

The peak body has also called for funding to be boosted for child and adolescent mental health services and released a scorecard on what Labor, Liberals and Greens have – or haven’t – committed to in regards to specialist care.

While it showed Labor had partially committed to addressing psychiatrist shortages and funding for child and adolescent mental health services, the parties had largely avoided the topic of increased Medicare rebates and the introduction of new Medicare Benefits Schedule item numbers to “reflect the complexity of psychiatry services”.

There are concerns emergency departments have become the ‘default’ for people seeking mental health treatment. Picture: NewsWire / Martin Ollman

RANZCP’s key MBS ask if for the Medicare rebate to be increased to 100 per cent for Aussies who need to see a psychiatrist.

“Our call to Minister Butler and the federal government is clear – help us help you in providing accessible, affordable and the best possible mental health care to every Australian, regardless of their background or postcode,” Dr Moore said.

Other MBS demands include a new psychiatry “complex care” item for patients with severe mental health conditions and a new billing item for private practice psychiatry registrars to allow billing without the need for a referral.

ED ‘default’

RANZCP Emergency Department Steering Group chair Jacqueline Huber says emergency departments have become the “default” for people seeking mental health treatment due to the “chronic” underfunding of community services.

“What we really need is attention to services that treat the most unwell in our community,” Dr Huber told NewsWire.

“Those with psychotic illnesses or in severe psychosocial distress because those are the people most likely to come to the emergency department to seek care.

“We are asking both inpatient and community care to be better funded for those with the most severe mental ill health in our community.”

She said states of “being unwell” varied, and “we’re not addressing the very acute and very unwell end of the spectrum”.

“If people can’t afford a psychiatrist or psychologist, their symptoms are likely to escalate and their distress can become so acute that they could become suicidal and of course come to the emergency department,” Ms Huber said.

Health Minister Mark Butler is hesitant to lift the number of subsidised mental health sessions from 10 to 20. Picture: NewsWire / John Gass

Major party commitments

Labor has announced a suite of measures in the mental health sector over the last few years, including $708m towards extending vocational training for specialist mental health registrars outside traditional metropolitan teaching hospitals.

It’s understood about $117m of that figure is for psychiatrists.

Other measures include an additional $40.5m to be invested to increase the psychiatry workforce over four years, with the government last year announcing it would up the number of postgraduate psychology spots at universities as well as bring about more psychology internships and supervisors.

The government also put forth $69m last month for support for those affected by suicide and distress while rolling out the National Suicide Prevention Strategy 2025-35 and committed to restoring bulk-billed video telehealth psychiatry sessions in 2022.

A free mental health counselling service is also set to be rolled out under Medicare from January next year.

The service would allow Aussies to access support over the phone and online for free.

A spokesperson for Health Minister Mark Butler said the government was “reforming the health system so that everyone can get the mental health care and support they need”.

“We are introducing new mental health services and building the workforce so people can get advice and support when they’re in distress and professional care for more complex mental health needs,” the spokesperson said.

“The Albanese government is addressing the challenges faced by the psychiatry profession by investing over $200m to increase workforce and skillset through expanded training opportunities.”

However, the spokesperson did not disclose or comment on any specific election sweeteners.

Opposition health spokeswoman Anne Ruston said further announcements would be made ‘in due course as we near the election’. Picture: NewsWire / Martin Ollman

The opposition matched Labor’s $8.5bn election pledge to boost bulk-billed GP visits and raised it by another half a billion dollars, including $500m for bulk-billed mental health appointments.

The Coalition would also lift the available Medicare rebated mental health sessions from 10 to 20.

However, Mr Butler earlier claimed reinstating the 10 additional sessions could create a “bottleneck in the system”.

Opposition health spokeswoman Anne Ruston said the Coalition would “restore full access to Medicare-subsidised mental health support on a permanent basis as Australia’s mental health experts have been calling for” if elected.

“We will make further announcements in due course as we near the election,” Ms Ruston said.

The Greens previously announced they would introduce “free” mental healthcare by removing the cap on subsidised psychologist sessions, bring in new local health clinics to allow Aussies to see psychologists for free, and create more pathways for mental healthcare plans.