Mental Health Crisis: Are Emergency Departments the Breaking Point?

Emergency department (ED) wait times for mental health patients are ballooning, a new report reveals. Troubling, yes, but hardly surprising. The Australasian College for Emergency Medicine (ACEM) sounds the alarm: patients now face waits exceeding 23 hours for a bed. A decade ago, that wait was seven hours shorter. That’s a significant drop, and it paints a concerning picture of a system struggling to keep pace.

The report highlights a sector stretched thin. It notes that EDs increasingly serve as the initial port of call for mental health crises, without the funding needed to manage increased demand. The human cost? Patients endure extended waits, families grapple with the strain, and healthcare professionals operate under immense pressure. Frankly, this is a recipe for burnout.
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Digging into the data, ED presentations for mental health issues jumped 11% between 2016 and 2024, climbing from approximately 277,000 to over 310,000. Increased numbers of First Nations people and the elderly are seeking help. What’s prompting this sharp rise? A simple answer eludes us.

It’s also not just volume, either. People are arriving with more urgent and complicated needs. Almost 75% of patients needed to be seen within 30 minutes in 2023-24, compared to 63% in 2016-17. This suggests a growing severity of mental health crises presenting at EDs.

Outgoing ACEM president Stephen Gourley warns that the standard of care is at risk. “We’re really trying to signal that we are reaching the point where we may not be able to care as well as we could,” he said. His words are a stark wake-up call, especially considering these are often the most vulnerable people, those on the brink of self-harm.
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Certain states are hurting more. South Australia, Western Australia, and Tasmania are seeing particularly lengthy delays; only about 40% of mental health presentations were seen on time. Dr. Gourley, working on the front lines as the director of emergency medicine at Alice Springs Hospital, lays the blame on years of insufficient investment.

He shares a chilling anecdote: patients stuck in the ED for over a week, enduring noise, constant light – conditions he describes as “almost inhumane.” This highlights the critical need for suitable mental health facilities that provide a therapeutic environment.

ACEM proposes solutions: more inpatient beds and greater investment in community services. The goal: early intervention to divert people from crisis situations needing ED care. Dr. Gourley championed some inspiring projects happening in certain states. One example is partnerships between mental health professionals, paramedics, and police, to give treatment on the spot and prevent hospital stays. Plus, “Safe Haven Cafes” offer after-hours, trauma-informed support. These are all good starts.

The ACEM report isn’t an isolated warning. A Productivity Commission inquiry found a key mental health agreement between federal, state, and territory governments wasn’t working as intended. That inquiry noted “shocking” consequences, including 3,000 suicide deaths annually and significant economic costs. And the ABS recently released data showing nearly one-fifth of Australians needed mental health support in 2024-25, with over a third delaying seeking it.

Mental health professionals express concern. Workforce gaps exacerbate problems. Bed numbers are down, with roughly 27 specialized public beds for every 100,000 people, below the recommended 60.

Dr. Pramudie Gunaratne, CEO of the Australian Society of Psychiatrists, outlines three primary reasons behind the underfunding: public misunderstanding of severe conditions such as schizophrenia; doubts about treatment effectiveness; and persistent stigma. She wonders aloud, “What is it we need to do?”

The states and the Commonwealth are currently squabbling over hospital funding. This adds another layer of complexity. The Feds say it’s up to the states to manage public hospitals. On the other hand, states are promising more mental health beds and community services.

Dr. Gourley fears even worse results next year unless real action is taken. “I can guarantee you that if there’s not extra investment we will see things deteriorate even further,” he says.

The core issue here is a systemic failure to adequately resource mental healthcare. We need to shift focus to proactive, community-based care to reduce reliance on crisis-driven ED visits. Increased funding for preventative services and workforce development is required. The mental health of Australians hangs in the balance.

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Keywords: Mental health crisis, emergency departments, ED wait times, mental health patients, community mental health, mental health funding, suicide prevention, mental health services