“I actually wasn’t surprised.”
That was NSW mental health minister Rose Jackson’s response to our Four Corners story exposing the state of the system she oversees.
We uncovered that people are waiting up to four days for critical mental health treatment in one of the country’s busiest emergency departments. Doctors revealed they feel pressured by higher ups to discharge patients too soon. And most devastatingly, we heard from the families of people who’ve lost loved ones after being turned away from care.
“I’m familiar with a lot of those issues, they are things that are across my desk regularly,” the minister told 2GB radio on Tuesday morning, after declining Four Corners’ repeated requests for an interview.
As journalists, we were stunned by these revelations.
But if the minister has heard all of this before — including that young people are dying after being sent home without treatment — it raises a disturbing question: why is the NSW government still refusing to offer meaningful solutions to fixing the mental health care system?
Instead, it’s been relying on misleading figures to defend the status quo.
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Jackson claims $700m figure
Everyone agrees there’s a major shortage of psychiatrists in NSW. Our story found it’s led to the closure of several mental health wards and beds, including child and adolescent units.
That means people are unable to access timely and urgent care.
To help solve the workforce shortage, psychiatrists have been pushing for a 25 per cent pay rise to retain staff in the state who are leaving for better offers elsewhere.
Even with that increase, first year psychiatrists in NSW would still be among the lowest paid in the country.
Minister Jackson on Tuesday told the media the pay rise would cost $700 million.
“When you increase the pay of an already relatively well-paid doctor by 25 per cent in one year, and there are obviously hundreds and hundreds of those doctors, the cost is significant,” she told ABC Radio Sydney on Tuesday.
Yet, NSW Health’s own figures, tendered to the Industrial Relations Commission, show the increase would cost an extra $30 million per year, a stark difference to the $700 million figure the minister is repeatedly quoting.
When asked in parliament on Tuesday why there’s such a big disparity in the numbers, the minister gave an incomprehensible response: “I’m aware of the suggestion that there is a misalignment, but my response to that is that it is not comparing the same cost, it is not an apples to apples comparison and that explains the difference.”
In response to us, the minister’s office said the $700 million “represents the total projected costs into the future, including the full suite of conditions and entitlements sought by the psychiatrist staff specialists”.
But the government would not provide a breakdown of what those costs cover or how many years the costs are spread, so it’s still hard to know how its reached this conclusion.
The NSW government has a track record of massaging the numbers to win a publicity war against psychiatrists, scores of whom resigned in January protesting dire conditions in the mental health system.
The NSW Premier Chris Minns has consistently said a 25 per cent increase would equate to an extra $90,000 for one doctor for one year.
In reality, only the most senior, full-time psychiatrists would receive that amount.
Around half the workforce is at the senior level, and the average psychiatrist is not employed full-time.
The NSW government has referred the pay question to the workplace disputes referee, the Industrial Relations Commission, promising to honour its decision while reiterating it has overall budget concerns in the state.
The pay dispute is only one small part of a much larger crisis in the mental health care system.
It’s the government’s job to question if a pay rise is the best way forward, but aside from a lower counteroffer and statements with tricky mathematics, it has failed to provide any new alternative to fix the sector.
NSW still has the lowest funding per capita in mental health care across the country, but Rose Jackson on Tuesday stopped short of committing to more resources. (ABC News: Marcus Stimson)
Major shortfall in services
On Tuesday, Minister Jackson acknowledged it was unacceptable that people are waiting days for urgent care in emergency departments, and promoted Safe Havens, as an alternative to hospital.
Part of the government’s Towards Zero Suicides initiative, the Safe Havens are walk-in centres for people experiencing suicidal thoughts or in need of therapeutic support, and there are 21 across NSW.
The centres were praised by one person we spoke to, 20-year-old Carly Richardson, but she said they’re not set up for her complex needs. And she has to travel for more than an hour on public transport to get there.
‘The Safe Haven’s great. It’s definitely not a place that fixes me, but it kind of [tides] me over a bit when I’m really not okay. I think we need more services that offer that step-up, step-down approach.”
Medical professionals say strategies like this do not adequately address the major shortfall in services for people with life-threatening mental health conditions.
Many we spoke to in the system said what needs to be urgently fixed is community mental health care — teams of health professionals who aim to keep people out of hospital.
We found some of the teams are severely understaffed with unmanageable workloads — in a crisis team in the Sydney Local Health District, for example, there’s one part time psychiatrist for around 130 patients.
The minister has admitted that more funding is needed in community care but said it will take years to deliver despite saying she’s known about these problems for a long time.
The government’s own data from the end of 2023 shows almost 60,000 people with severe mental illness likely aren’t get the community care they need.
“It’s about how we spend that money and doing that in a thoughtful way that doesn’t just keep delivering more ambulances at the bottom of a cliff but actually investing in community base care to desert people from and those kind of game changing investments and realigning the system, they take some time,” the minister told ABC Radio Sydney on Tuesday.
The government’s own data from the end of 2023 shows almost 60,000 people with severe mental illness likely aren’t get the community care they need. (Four Corners: Nick Wiggins)
‘Not something you can turn around in one budget’
Hearing the response from the NSW government, it’s clear there’s a massive disconnect between what the health department says it provides, and what people experience on the ground.
For example, Minister Jackson said on Tuesday that if someone walked into a Sydney hospital, she could guarantee they would get the help they need.
But we heard from doctors who said they had no choice but to turn people away from hospital because of a lack of resources, and from patients on the receiving end.
The government continues to defend itself, reiterating that it’s spending $2.9 billion on mental health services.
But the state still has the lowest funding per capita in mental health care across the country, and Minister Jackson on Tuesday stopped short of committing to more resources.
“We are now trying to deliver more money into the system. We have a budget coming up in a few weeks but it’s not something that you can turn around in in one budget or in one year,” she told ABC Radio Sydney.
The problems in the system have been laid out and there’s a growing chorus of voices demanding urgent action before more lives are lost.
The government insists it knows its system is struggling — now it needs to decide how many more people must suffer before it acts.
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