August 16, 2026

mental health nursing

Cash strapped clients delay seeking mental health care

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The latest National Report Card on the state of our country’s mental health has revealed a growing number of Australians are foregoing or delaying mental health support due to cost. 

The 2024 report from the National Mental Health Commission revealed one in five Australians delayed seeking mental health care due as a result of concerns around expenses.  

This is consistent with ongoing concerns about the cost of living, with the report also showing the proportion of people finding it difficult or very difficult to cope on their current income having doubled over the past five years.   

Unsurprisingly, treatment rates continue to be well below the current targets proposed by the National Mental Health Service Planning Framework. This is despite an increase in the number of people with mental health disorders accessing treatment compared to previous years. 

However, the Report Card encouragingly found significant progress in the use of seclusion and restraint in public hospital mental healthcare settings, with their use dropping significantly across the country.  

David McGrath, CEO of the National Mental Health Commission, highlighted the important role the Report Card had in measuring Australia’s successes and shortfalls when it comes to tackling ongoing mental health crises 

“Everyone deserves fair access to the right mental health care, no matter where they live or how complex the system may be,” Mr McGrath said. 

“The Report Card calls out issues for governments to pay attention to, and that’s the value of this report.” 

You can read the full National Report Card 2024 on the Commission’s website. 

 

 

 

Desperate psychiatric patients redirected to ED

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The decline in mental health services across NSW is chronic and escalating.

Cumberland Hospital is the oldest and biggest psychiatric facility in NSW and its assessment centre (previously known as Admissions) has been a first port of call for people seeking mental health support in Western Sydney for decades.

However, the centre closed its doors to the public on January 21 – one of five wards and units “temporarily” shut down due to the mass resignation of psychiatrists in a pay and staffing dispute with the state government.

Three units including the assessment centre (a total of 27 beds) still remained closed in late April.

Enrolled nurse Fran Cavallaro, secretary of the NSWNMA’s Cumberland Hospital Branch, has worked at the hospital for 37 years and the assessment centre since 1996.

“I still have patients coming to my front door seeking help even though we’ve been closed for three months,” Fran said.

“I have to go out and tell them that I’m sorry, we are closed to the public, and if you’re in crisis you need to present to Westmead Hospital emergency department.

“Some of them are in a real crisis; they can’t sleep, or they’re suicidal and hearing voices.

“We have had Corrective Services turn up with court orders diverting people into treatment programs and we’ve had to explain that we’re closed, and they need to go to Westmead.

“I recently had a middle-aged man – a patient well known to us – crying and begging for help because he knows Cumberland, he knows our procedures.

“So, I’m sending him and others to an overwhelmed and hectic ED rather than providing prompt assessment and advice in a calmer, more settled environment.

“They could be stuck in the ED waiting room for many hours before there’s a bed allocated to them.

“Sometimes the people I have to turn away never make it up to the ED and may be lost to care. “It is distressing for us nurses because we are here to help people, not turn them away in their hour of need.

“I have told the district (Western Sydney Local Health District) that I have a moral issue with having to turn people away. “Where is the patient safety for those people that present to my door?”

COMMUNITY MENTAL HEALTH UNDERSTAFFED AND UNDER- RESOURCED

Fran said that even after three months of closure, there had been no update on when the units would reopen – “despite my efforts to get answers at the district and local level on behalf of the NSWNMA branch.”

“The level of transparency from the district to the local level is quite poor and employees are often kept in the dark on issues of vital concern to us and our patients.”

A total of 206 psychiatrists were reported to have submitted their resignations in the dispute with the state government.

The state’s minister for mental health, Rose Jackson, told The Sydney Morning Herald on 14 February that 29 psychiatrists had withdrawn their resignations, 105 had “deferred” their departure and 71 had taken higher-paid visiting medical officer contracts.

Around the same time, 84 admitted mental health patients were stuck in Western Sydney emergency departments waiting for a bed on a ward – with some waiting for as long as 90 hours, the Herald reported.

“Mental health staff say they have been left on hold for more than an hour calling NSW Health’s Mental Health Line to find a service that can take their patients,” the paper added.

Fran agrees that a lot of calls to the Mental Health Line may go unanswered. “Nurses often call the Mental Health Line to get their patients into an outpatient community setting.

“However, community mental health teams have long been understaffed and under-resourced. They continue to struggle with unmanageable workloads – and have been for a long time.”

LOST MENTAL HEALTH BEDS

The decline in mental health services across NSW is chronic and escalating.

The Herald reported that NSW public hospitals lost 150 mental health beds in the five years between 2016 and 2022, according to Australian Institute of Health and Welfare data.

“Mental health services have been in crisis for years and the doctor resignations put the spotlight on the problem and widened the cracks,” Fran said.

“In parts of Western Sydney such as the Hills district, population numbers have exploded over the last 10 years, but our bed numbers have declined.”

At a rally outside Cumberland Hospital in February, NSWNMA members called on the government to meet psychiatrists’ pay demands, urgently improve mental health staffing and reopen closed units.

The rally also raised the alarm about a Health Ministry proposal to treat psychiatric patients in general wards in order to overcome the shortage of mental health beds.

“The Ministry/LHD is considering placing patients whose primary diagnosis may be related to drug and alcohol issues or neurological conditions into general wards, even when they have a secondary diagnosis involving mental health,” Fran said.

“The ministry calls it remodelling but I call it rebranding. “This isn’t about patient safety – it’s about maintaining appearances. The recent resignations forced a review of current practices, but the consequences of these decisions could be serious and sometimes fatal.”

“The general ward is not a mental health unit, it’s not designed, staffed or resourced to provide the specialised care, supervision and support that mental health patients need.”

A mental health system in crisis

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Recently, I spoke before a parliamentary inquiry into the ‘Equity, accessibility and appropriate delivery of outpatient and community mental health care 
in New South Wales’, on behalf of the NSWNMA.

As a mental health nurse, it was a privilege to be given a voice in what is a very important inquiry. I arrived at the inquiry hoping to shed light on the inequity of access experienced by mental health consumers in the community and outpatient settings. This is something I witness in my everyday working life.

I used this opportunity to speak about burnout for frontline mental health workers, and the support required for nursing staff in this field. I stressed the reality that this is often traumatising work. There was also discussion about the Mental Health Telephone Access Line, which has been privatised in some LHDs. We also examined the opportunities, including financial support, for mental health nurses to further their studies and gain higher grade positions by accessing postgraduate study.

While I was initially nervous about the prospect of speaking before a parliamentary inquiry, I found the overall experience to be not quite 
as intimidating or as unfriendly 
as I expected.

I sincerely hope the panel members listened to my evidence and take action to address the dire state of our mental health system.

Victoria Norris, RN

Bandaids on bleeding stumps

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The pandemic has brought with it a steep rise in people experiencing mental health issues. As a result, public mental health services are being flooded. Even before COVID-19, mental health nurses were struggling to keep up – but now, we are drowning.

We are being forced to push people out of the units faster and faster, to make space for the next person who needs a bed. Even if this means discharging people to unsafe environments that contributed to their mental health issues, or if they are still mentally unwell and a risk to themselves or others.

Nurses are leaving mental health en masse, and as a result mental health units are chronically understaffed. Those of us who stayed are working with increasingly unsustainable workloads, and are expected to do the same amount of work each shift with fewer nurses.

We can no longer guarantee safety for our patients or ourselves, with incidences of aggression becoming not just daily but on every shift.

We feel like we are failing every single patient who comes onto our wards. They came to get help, to find a way to get better. But with things the way they are, mental health nurses have become, at best, bandaids on bleeding stumps, and at worst we are just working in a system that causes harm. It’s become commonplace that when I come home from work – late yet again because I put patient care before my personal time – I break down in tears from stress and the knowledge that I came into mental health nursing to help, and it never feels like I’m doing that anymore.

Aislynn Kearney, RN

3 out of 4 kids with mental health disorders aren’t accessing care

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Three-quarters of Australian children with mental health disorders aren’t getting professional help, according to our new research. Girls, younger children and families from non-English-speaking backgrounds are the least likely to access mental health services.

We looked at the mental health of just under 5,000 Australian children aged eight to 13 via parental surveys of their child’s emotional and mental health. We then linked the results with Medicare data to see which families had accessed help.

Fewer than one in four children we identified as having a mental health problem saw a health professional in the 18 months after we surveyed them.

Left unaddressed, mental health problems can become more entrenched and harder to treat. And mental health problems in childhood can have lifelong ramifications including increased risk of mental health problems in adulthood, poor educational attainment, unemployment, and contact with the criminal justice system.

So ensuring children and adolescents who experience mental health problems receive access to timely and effective care is essential.

What types of mental health problems do kids have?

Around 14% of children and adolescents aged four to 17 meet diagnostic criteria for at least one mental health disorder.

The most common mental health disorders in Australian children in this age group are anxiety disorders, which affect 6.9% of children, and attention deficit hyperactivity disorder (ADHD), which affects 7.4% of children.

Around 50% of all adult mental disorders begin before the age of 14. Yet in 2017-18, children under the age of 15 had the lowest use of Medicare-rebated mental health services (5.1%) of any Australian age group.

Younger children

Younger children were less likely to access services than older children. Some 20-27% of children aged 12-13 years accessed services, compared to 9-15% of children aged eight to nine years.

Young children respond to and process emotional experiences and traumatic events in ways that are very different from adults and older children. Consequently, it can be more difficult to recognise problems in early childhood.

A child acting up in the classroom, for example, may be perceived as being “naughty” rather than having mental health problems. Or a child may experience stomach aches and headaches which are caused by anxiety but thought to be a physical problem.

When problems are recognised, families may delay getting help for young children in the hope that they will “grow out of” the mental disorder.

While this may apply in some cases, treatment is still important. Take ADHD, for example. Although about 80% of children with ADHD will grow out of it by adulthood, children with ADHD often find it hard to make friends. If they miss out on developing their social skills early in life, it can become increasingly difficult to make friends during adolescence and adulthood when peer relationships become more complex.

In our study, the factors most consistently associated with getting support were symptom severity and parent perception that the child needed help.

The gradual onset and increase in severity over time of many mental health problems means children and their parents are more likely to seek services when the symptoms become severe or impact significantly on the child’s ability to function. This typically occurs as they grow older.

Boys versus girls

We found girls were less likely to receive care than boys. Girls made up 50% of children with mental health problems in the study, yet accounted for just 30% of children who received support for emotional problems at ages eight to 11.

This may have something to do with the fact that mental health conditions can be more difficult to recognise in girls.

Boys are more likely to externalise problems such as anxiety by reacting angrily when asked to do something that upsets them. Girls are more likely to internalise these issues by withdrawing or appearing very quiet, making problems harder to detect. In an environment like the classroom, boys’ problems are more likely to get noticed because of their disruptive nature.

Culturally and linguistically diverse backgrounds

Around 14% of children with emotional problems came from a non-English speaking background, but they only accounted for 2% who received help.

The reluctance of parents from non-English speaking backgrounds to get help may be related to different cultural understandings of mental health and illness. They may also struggle to find services for their child in their own language.

Mental health conditions may also be more difficult to recognise among children from non-English speaking backgrounds, where quietness in the classroom may be mistaken for a language issue rather than a mental health issue.

We need change

Over the past 20 years there has been little change in the prevalence of child and adolescent mental disorders in Australia despite increased investment in resources. This is likely in part because the quality and the intensity of services provided have not improved.

Children may not be receiving sufficient treatment sessions or treatment sustained over a long enough period to meaningfully impact on their symptoms. It’s recommended that children receive at least eight sessions of cognitive behavioural therapy for the treatment of anxiety, for example, but many children will require more.

Australia’s health system rewards discharging patients from care within a set number of appointments rather than once they have improved. The Medicare Better Access scheme allows for a maximum of ten subsidised appointments with a psychologist in a calendar year. But again, many children require more.We need a system-level shift to funding based on measured symptom improvement rather than a capped number of appointments both in hospital settings and in the community.

Our research suggests we need to better understand parent and child drivers of why children miss out on care, particularly girls, younger children, and those from diverse backgrounds. Doing so and ensuring access to high-quality care will benefit not only the child and their family now but also the adult they will become.The Conversation

Melissa Mulraney, Postdoctoral research fellow, Murdoch Children’s Research Institute and Harriet Hiscock, Principal Fellow, Department of Paediatrics, The University of Melbourne, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Female nurses twice as likely to commit suicide: study 

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A University of Michigan study has indicated that suicide rates among female nurses were roughly double that of the female population as a whole. 

The study, conducted using data from over 150 000 individuals including over 2 000 nurses gathered between 2007-2018, found a suicide incidence rate of 17.1 per 100 000 for female nurses, compared to just 8.6 per 100 000 for women as a whole. 

The study thus indicated a significantly increased suicide risk for women within the nursing profession.  

The study’s lead author, Associate Professor Matthew Davis, expressed shock at the results of the study. 

“It’s much higher than I expected,” he said. 

He noted that the unique demands placed on female nurses may have contributed heavily upon the study’s results. These demands include workplace stressors, childcare demands and issues around housework and education. 

Co-author Christopher Freise also indicated concern over the results of the study, apportioning the group’s findings to the increasingly stressful nature of the profession. 

“[H]ealth care systems are placing increased demands on nurses”, Freise said. “Even before COVID, nurses reported substantial workplace stressors, including reduced staffing, increased complexity of care and additional bureaucratic tasks”. 

“You put the workplace and home stressors together and it’s no surprise that nurses are struggling”, he continued. 

The authors recommended that further interventions be made to address the suicide risk associated with female nurses.  

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