The long wait for care: addressing the urgent gaps in our mental health system.

If you’ve stepped into an emergency department recently, you’ll know how stretched they are. For people in urgent psychological distress, the wait for help can be hours – or sometimes an entire day. Even then, many face significant delays in getting the help they need beyond the ED doors.  

The Australasian College for Emergency Medicine’s (ACEM) latest report, Still Waiting: Trends in Mental Health Presentations to Australian Emergency Departments, highlights the depth of this crisis.  

The report articulates what communities are experiencing. The number of people presenting to EDs for mental health care rose by nearly 12 percent between 2016-17 and 2023-24, with the sharpest increases among Aboriginal and Torres Strait Islander peoples and those over 65.  

Presentations are also more complex and urgent, with more people arriving by ambulance and requiring admission. Yet 10 percent of people waited more than 23 hours for an inpatient bed last year, seven hours longer than they were less than a decade ago. These are unacceptable outcomes for people experiencing severe distress.

For many people in Australia, public hospital EDs remain the only option for acute mental health support, despite years of calls to build the capacity of urgent care. ACEM’s report makes it clear: we need stronger investment across hospital and community settings so people can access the right care, in the right place, at the right time.

A new approach is needed, and the good news is that successful alternatives already exist. Peer-led Safe Spaces provide welcoming environments specifically designed to support people experiencing psychological distress. Evaluations show they help reduce distress, connect people to ongoing supports and divert people away from EDs.

Psychosocial supports are equally critical. At Mental Health Australia, we’ve heard the deep concerns from the community and sector about the continued delays in increasing access to psychosocial supports and the pressure this puts on both people and our already stretched health system. You can read our renewed statement on this here.

As governments negotiate the next National Health Reform Agreement and National Mental Health and Suicide Prevention Agreement, we as a sector have an opportunity to raise our collective voice to help reshape the system. Expanding community mental health services, increasing public health capacity, embedding cultural safety and scaling up effective models will be critical to creating a more responsive and equitable mental health system.

Behind every statistic is a person seeking care – and often a family, carer or kin supporting them through some of the hardest moments of their lives. This is why reform matters. It is not just about improving data points; it is about ensuring that people can access timely, compassionate, and appropriate support when they need it most.

Carolyn Nikoloski, CEO

Mental Health Australia