Widespread issues with access, long wait times, and a lack of community-based supports are leaving many Australians with mental health needs with no option but to seek help in EDs. There just aren’t enough staff, beds or resources needed to provide therapeutic, trauma-informed, recovery-oriented care and support to people experiencing a mental health crisis.
The Productivity Commission’s Mental Health and Suicide Prevention Agreement Interim Report delivered a bleak assessment of Australia’s mental health system, describing it as “fragmented, under-resourced and not fit for purpose.” The National Mental Health Commission’s National Report Card 2024 also shows a continued rise in psychological distress and mental illness in the community, with six in ten Australians living with a long-term mental health condition.
New data obtained by ACEM indicates that the situation in EDs is worsening. In September 2025, the College will release a national report presenting a snapshot of mental health-related ED presentations. The forthcoming report, a follow-up to ACEM’s 2018 The Long Wait: An Analysis of Mental Health Presentations to Australian Emergency Departments, reflects deepening strain across the health system. Early analysis demonstrates that the number of presentations, acuity of illness and time spent in EDs by people with mental health conditions have increased significantly.
In 2020, ACEM commissioned Nowhere Else To Go: Why Australia’s Health System Results In People With Mental Illness Getting ‘Stuck’ In Emergency Departments, an analysis from an ED perspective. The report examined why Australia’s mental health system was failing people presenting to the ED in mental health crisis and presented a comprehensive set of recommendations for urgent reform.
A once-in-a-generation window of opportunity to construct a balanced mental health system, that combines inpatient and community-based services to support early prevention, early intervention and acute care, was offered by the Fifth National Mental Health and Suicide Prevention Plan and the final report of the Royal Commission into Victoria’s Mental Health System. Recommendations were informed by lived experience perspectives and consultations from stakeholders including ACEM. However, without adequate and sustained resourcing, consistent implementation and accountability, these commitments remain largely unrealised.
ACEM supports the recommendations made by the Productivity Commission and other key peak bodies and sector leaders in calling for immediate action, without losing sight of the need for a renewed national agreement backed by long-term strategy, stronger governance, and accountability measures. ACEM is calling for a unified approach from federal and state/territory governments to work with the sector and act on desperately needed reforms to the system.
Background:
ACEM is the peak body for emergency medicine in Australia and Aotearoa New Zealand, responsible for training emergency physicians and advancement of professional standards.