Australia’s emergency departments (EDs) are buckling under the weight of a mental health crisis, with the rising violence reported by a new Australian College of Emergency Medicines report signalling a system that is failing both patients and frontline workers. 

“Emergency departments were never designed to be the default entry point for mental health care, yet they’ve become so because community services are chronically underfunded, overburdened, and often inaccessible,” said Dr Jacqueline Huber, Chair of the RANZCP Emergency Department Steering Group. 

“People in crisis need safe, therapeutic care—not long waits in crowded, unsuitable settings that only add to their distress. When patients wait for hours or days in environments unfit for mental health assessments, tensions escalate, putting both patients and healthcare workers at risk.” 

The Australian Medical Association’s Public Hospital Report Card: Mental Health Edition had previously revealed that patients with mental health conditions are spending an average of seven hours in emergency departments—the longest on record—with 10 per cent of patients waiting more than 23 hours before receiving a hospital bed. Emergency presentations for mental health triaged as emergencies have more than doubled since 2010–11, while urgent cases have also risen sharply. More patients were arriving by ambulance or police, reflecting the lack of alternative care options.  

Now, emergency psychiatrists are calling on parties to prioritise mental health investment in the upcoming election beyond just primary care, particularly for those with severe and complex mental illnesses that need specialist support. 

“For patients who aren’t unwell enough for hospital admission but are at risk of their conditions worsening, the system offers few treatment options beyond instructions to see a GP for referrals to a psychiatrist or an overloaded community crisis team. Yet psychiatry services are often unaffordable, too far away, involve long waitlists, or are completely unavailable,” said Dr Huber. 

“The longer it takes for someone to get help, their conditions become more complex and harder to treat, causing them to eventually turn up at EDs in a state of distress. 

“While recent measures to boost bulk billing are welcome, far more needs to be done to address the mental health crisis peaking in our EDs. 

“Growing and retaining the mental health and psychiatry workforce is essential—more psychiatrists mean faster assessments, early interventions, and better long-term care that reduces reliance on EDs. 

“Investment in accessible, community-based mental health teams that offer specialist services will also reduce pressure on emergency departments, prevent mental health conditions from escalating, and improve outcomes for patients.  

“This election, governments must prioritise specialist mental health care outside of EDs —because emergency departments should not be the only pathway for people to access treatment,” Dr Huber said. 

ENQUIRIES: For more information, or to arrange an interview call Dishi Gahlowt on +61 437 315 911 or email media@ranzcp.org.   

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.