Emergency department wait times for mental health patients stretching over 23 hours, report finds

Some patients with serious mental health conditions are waiting more than 23 hours for a bed in emergency departments, new data shows, as the peak body for ED doctors warns of "profound consequences" without urgent action from all levels of government.

A new report by the Australasian College for Emergency Medicine (ACEM) has detailed an overstretched and under-resourced sector, leaving patients waiting for clinically unsafe periods and without appropriate care.

The report said once they arrived at hospital, 10 per cent of patients waited more than 23 hours for a bed — seven hours longer than they were less than a decade ago.

"EDs have been left as the default entry point for crisis care, but without the resources to meet growing demand," the report states.

"The consequences of this are profound — for people who wait too long or do not receive appropriate care, for families and communities who carry the weight of crisis, and for staff working under relentless pressure."

The ACEM analysed data between 2016 and 2024 and found mental health presentations to emergency departments increased by 11 per cent, from about 277,000 in 2016-17 to more than 310,000 in 2023-24.

The increases were particularly prominent among First Nations people and those over 65.

People were arriving at EDs with greater complexity and urgency, the report found, with almost 75 per cent of people triaged as needing to be seen within 30 minutes in 2023-24 compared to more than 63 per cent in 2016-17.

Outgoing ACEM president Stephen Gourley said if governments did not act now, quality of care would be compromised.

"And these are people at the more severe end … people who are so low they're threatening to self harm or actually have harmed themselves."

Waiting times for admission have become worse in almost every state and territory, especially South Australia, Western Australia and Tasmania. 

In those three states, only about 40 per cent of mental health related presentations were seen on time.

Dr Gourley, who is the director of emergency medicine at Alice Springs Hospital, said higher wait times in particular states and territories were the result of a lack of investment over years.

"It's really sad … these are real human beings, someone's family member," he said.

The ACEM has called for more inpatient beds for mental health, as well as more funding for community services, so people could get help earlier without ending up in an ED.

Dr Gourley said promising initiatives already happening in some states could be expanded, including mental health workers pairing up with paramedics and police so they could deliver care at the scene and prevent hospital admissions, as well as Safe Haven Cafes, which have been providing after-hours, trauma-informed care in New South Wales, Western Australia and Victoria.

'This will deteriorate even further'

The ACEM report comes after a scathing Productivity Commission inquiry found a landmark mental health agreement signed by federal, state and territory governments three years ago was failing.

The commission found mental health services were falling short, leading to "well-known but still shocking" consequences, with 3,000 deaths by suicide each year, one in five Australians experiencing mental illness, and an economic cost of more than $200 billion a year.

Australian Bureau of Statistics data released last week revealed almost one-fifth of Australians reported needing to see a health professional for their mental health in 2024-25, but of those more than one-third delayed care on at least one occasion.

Mental health professionals have long complained the beleaguered sector is at breaking point, with workforce shortages and gaps in care.

Over decades there has been a decline in the number of mental health beds available per person in Australia, with recent figures estimating around 27 specialised public beds per 100,000 people, which is below the recommended 60 beds.

Neuropsychiatrist Pramudie Gunaratne, CEO of the newly-launched Australian Society of Psychiatrists, said there were three main reasons mental health was not receiving enough funding.

She said they were a lack of understanding about serious mental health conditions like schizophrenia, the misplaced belief those conditions cannot be treated effectively even if quality care is provided, and the stigma associated with mental illness.

The ACEM report has also landed in the middle of a dispute between the states and Commonwealth over public hospital funding, with states angrily reacting to the prime minister telling them to rein in spending growth.

The ABC approached the states with the longest ED wait times, who said they were investing in more mental health beds or community-based services.

A federal health department spokesperson said the Albanese government was making a record investment in mental health, and management of public hospitals was a responsibility of the states.

However Dr Gourley said he was dreading next year's statistics if governments did not do more to try to shift the dial.