How many damning reports does it take to change a politician's mind?
July 2025
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Key Messages
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In the past five years, a number of government-commissioned reports have highlighted the shortages in the mental health workforces and inadequate funding and resourcing of mental health services across NSW and Australia.
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In 2020 the Productivity Commission’s Mental Health Inquiry Report laid out the widespread shortfalls in the mental health system, including critical shortages of specific mental health professionals including psychiatrists.
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The Australian government set out its plan to address these issues in the National Mental Health and Suicide Prevention Agreement (2022–26) and the National Mental Health Workforce Strategy (2023)
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However, numerous reports and inquiries since then have shown that the issues remain unresolved, with chronic workforce shortages and a lack of funding commitment contributing to a persistently fragmented and under-resourced system—one in which clinicians face burnout and patients continue to suffer.
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Most recently, the Productivity Commission’s 2025 review of the Mental Health and Suicide Prevention Agreement offers a scathing critique of the government's failure to address workforce challenges and deliver meaningful outcomes for patients
1. The Productivity Commission’s Mental Health Inquiry Report (Volume 1), delivered to the Australian government on 30 June 2020.
Read it here: https://www.pc.gov.au/inquiries/completed/mental-health/report
The Productivity Commission’s report found that mental ill‑health and suicide impose a staggering annual cost of around A$200–220 billion on Australia’s economy and society. It urgently recommended a comprehensive, person‑focused, prevention‑oriented reform of a fragmented and under-resourced system, highlighting specifically the difficulty of accessing psychiatric care. It provided impetus for various other reports and strategic initiatives mentioned here, such as the National Mental Health and Suicide Prevention Agreement (2022-2026)
Key quotes:
“A lack of clarity across the tiers of government about roles, responsibilities and funding [is] leading to persistent wasteful overlaps, yawning gaps in service provision and limited accountability.”
“Access to psychiatric care is particularly constrained, with high costs and long wait times in some areas. The number of psychiatrists for Australia’s population is at the low end of rates in developed countries. The profound difficulty of children and adolescents, people in aged care and people in rural, regional and remote areas in accessing psychiatrists, should particularly be addressed. Governments should collectively develop a national plan to increase the number of practising psychiatrists, including an increase in the availability of supervision for trainees, with a focus on sub-specialties and localities where there are substantial shortfalls.”
2. The National Mental Health and Suicide Prevention Agreement (2022-26)
Read it here: https://federalfinancialrelations.gov.au/agreements/mental-health-suicide-prevention-agreement
In the wake of the Productivity Commission’s findings, this national agreement introduced bilateral agreements between the Australian Government and each state and territory, identifying national objectives for mental health and suicide prevention and details of initiatives to be implemented. See no.7 of this list for the Productivity Commission’s interim analysis of this agreement for more details.
3. Mental Health: mapping the current reform landscape – Key issues for the 58th Parliament. Parliamentary Research Service, May 2023
Read it here: https://www.parliament.nsw.gov.au/researchpapers/documents/mental-health-mapping-the-current-reform-landscape.pdf
This summary of reports outlines the evolution of mental health reform across Australia over the previous few years. It highlighted issues within the mental health workforce as a consistently reported, enduring issue contributing to limited accessibility and service gaps.
Key quotes:
“Overall, there are insufficient high-acuity and low-acuity services to provide all the care and treatment that people need, which can lead to delays and increasing levels of illness and distress … The lack of services means that people often have to be seen in settings that are not appropriate, unnecessarily expensive and which can increase trauma (for example, hospital emergency departments as gateways to mental health services)…”
“For the mental health system to operate effectively and achieve the best possible outcomes, there needs to be sufficient people who enter and are retained in the workforce, they need to be located in the right places, they need to have appropriate skills and experience, and they need to be supported to deliver appropriate care.
Issues with the mental health workforce were a consistent theme in the recent reports and inquiries, and the National Mental Health Commission has identified issues that affect the ability of the workforce to deliver quality mental health services across the diversity of Australian communities. Challenges include:…Addressing mental health workforce shortages, with a shortage of new recruits, an ageing workforce and high staff turnover …”
4. National Mental Health Workforce Strategy, released by the Australian Government in October 2023
Read it here: https://www.health.gov.au/resources/collections/national-mental-health-workforce-strategy-2022-2032
This strategy sets a 10-year roadmap for building a sustainable mental health workforce capable of meeting current and future demands, in response to the critical issue of workforce shortages raised by the Productivity Commission in 2020. It outlines five strategic goals: attract, train, maximize, support, and retain the mental health workforce. The strategy’s failure to commit funding to its goals was criticised in the Productivity Commission’s interim review of the Mental Health and Suicide Prevention Agreement (see no. 7)
Key quotes:
“There is a need to support the mental health workforce and systematically address key issues that impact workforce retention. The provision of supportive, safe and rewarding experiences responds to attraction and retention challenges… Key factors contributing to negative perceptions include the underfunded mental health services; employee stress, fatigue and burnout; quality of workplace conditions, such as insecure employment and remuneration; and workplace safety.”
“The Productivity Commission identified critical shortages in several professions, including psychiatry, psychology, mental health nursing, and other relevant allied health professions. Through the National Agreement, governments have identified that these professions require immediate action to address critical shortages and promote multidisciplinary care.”
5. NSW Community Mental Health Services Priority Issues Paper- NSW Ministry of Health Dec 2023
Read it here: https://www.health.nsw.gov.au/mentalhealth/Documents/gap-analysis-report.pdf
This consultation-based gap analysis four key issues in NSW community mental health services: underfunding of services despite rising demands; workforce challenges including staff shortages, burnout and lack of training; emergency response gaps; and limited access to psychosocial supports. It highlights the fact that NSW has the 2nd lowest per capita expenditure on community mental health services in Australia, providing quantitative data on the under-resourcing of community teams and the projected worsening of this shortfall. The report addresses issues specific to the psychiatrist workforce, in particular how consultant psychiatrist vacancies force reliance on costly locums and threaten continuity of care.
Key quotes:
“The data, as well as feedback from stakeholders, suggests that the CMHC system is experiencing significant challenges in meeting increasing service demand. Over the past 10 years, to 2020-21, NSW has been providing CMHC to an increasing number of people (approximately 146,000 in 2020-21) with more client contacts (around 3.4 million in 2020-21). However, in the same time period, the number of fulltime CMHC workforce positions in NSW per 100,000 people has declined (and is the second lowest nationally at 48.9). In addition, over the past 5 years, average number of treatment days per patient decreased (although this is the highest nationally at 16.9 days). The average number of service contacts also decreased (although is also the third highest nationally). Although NSW spends a considerable amount on CMHC, with a 13% increase in funding over the past 10 years, comparative analysis shows that NSW’s per capita spend is the second lowest nationally.”
The extent of mental health workforce shortages was quantified in the “National Mental Health Workforce Strategy 2022-2032” using the NMHSPF. An estimated mental health workforce shortfall of 32% was found using 2019 NMHSPF targets. This shortfall is expected to grow to 42% by 2030 if current shortages are not addressed
“There are critical shortages in nearly all mental health workforce areas which need to be addressed. However, three workforce groups were raised consistently in the consultations and emphasised in literature. These are the: Peer workforce, Aboriginal workforce and Psychiatrists… Consultant psychiatrists make up about 10% of the NSW Mental Health workforce… The result is that, even in inner metropolitan Sydney, services are dependent on the most expensive model (locum coverage) to allow for services to remain open. This comes at the expense not only premium labour, but continuity of care”
6. Equity, accessibility, and appropriate delivery of outpatient and community mental health care in NSW- Parliament of NSW Legislative Council, June 2024
Read it here: https://www.parliament.nsw.gov.au/committees/inquiries/Pages/inquiry-details.aspx?pk=2973#tab-reportsandgovernmentresponses
This 2024 inquiry examining outpatient and community mental health services yet again highlighted severe under-resourcing and workforce shortages causing barriers to access and burnout in staff. Among its recommendations were that the NSW Government immediately commit to increase funding of the mental health system, including increasing NSW public mental health clinician pay to match other states and territories. The report also criticised the NSW government’s failure to act on the Productivity Commission’s 2020 directive to improve the collection of data about the mental health workforce to aid policy and planning. (Case in point: watch NSW Minister for Mental Health Ms. Rose Jackson failing to produce any meaningful workforce data in Budget Estimates earlier this year)
Key quotes:
“Recommendation 19- That the NSW Government immediately commit to increase and maintain funding across the entire mental health system to support both the workforce and consumers, with a priority investment in community-based mental health services.”
“Recommendation 10- That NSW Government immediately increase pay for NSW public mental health clinicians including staff specialists, junior doctors, nurses, and allied health professionals to at a minimum on par with other states and territories, with consideration given to the number of staff lost to the private sector…”
“Throughout the inquiry, the committee heard that challenges faced by the mental health workforce, such as staff shortages, increased workloads and burnout are contributing to a 'crisis-driven' mental health system… Additionally, a number of stakeholders asserted that the sector is suffering from widespread lack of funding and inadequate data sharing, creating more pressures for the mental health workforce.”
“…In particular we were struck by the evidence received regarding the 2020 Productivity Commission Inquiry Report into Mental Health and its recommendation that the Australian Institute of Health and Welfare (AIHW) publish all relevant data on mental health services at a national, State and Territory level, to help coordinate and develop the national mental health workforce. It is unacceptable that this recommendation remains unimplemented almost four years later and we call on the NSW Government to explore, with the Australian Institute of Health and Welfare, the provision of any information necessary for the timely publication of this data.”
7. Mental Health and Suicide Prevention Agreement Review- Australian Government Productivity Commission 2025
Read it here: https://www.pc.gov.au/inquiries/current/mental-health-review#interim
The Productivity Commission’s scathing interim assessment of the National Agreement (2022-2026) concluded that Australia’s mental health system remains “fundamentally flawed, alienating, inadequate and ill-informed.” Care remains fragmented, expensive, and lacks crisis support. Not only have suicide rates not improved over 10 years, Indigenous suicide rates are rising. It recommended an overhaul of the Agreement to introduce clear national targets, transparent governance, and real accountability- including specific funding commitments to the mental health workforce, which were absence in the National Mental Health Workforce Strategy.
Key quotes:
“Most outputs have not necessarily led to better outcomes nor had a significant effect on policy or planning…”
“While there has been progress in achieving elements of the Agreement, these actions have not led to meaningful improvements across the system for people with lived and living experience of mental ill health and suicide… “Since the Agreement was signed, there has been no change in the suicide rate and anecdotal evidence points to an increase in rates of distress.””
“The National Mental Health Workforce Strategy does not contain any funding commitments or clear accountability structures. … The mental health workforce is a key example.”
“Addressing workforce needs is an important part of the Agreement and the National
Mental Health Workforce Strategy was welcomed but there was concern that it was yet to be implemented… Australian, state and territory government funded services in local areas were often competing for workers. State and territory health services were also competing against each other for the same workforce…. Actions have failed to impact chronic workforce issues… Since 2013, there has been minimal growth in the number of mental health professionals per 100,000 Australians, except for psychologists (figure 2.6). However, it is not at a rate required to meet need given the extensive wait times”
“Estimates show the number of mental health professionals would need to grow by at least 42% by 2030 to fully respond to community demand (DoHAC 2023).”