Mental health services – alongside aged care, primary care, and First Nations health – are under-resourced and ill-equipped to meet growing demand. The Special Commission of Inquiry into Healthcare Funding in NSW report underscores the daily pressures, inequities, and unsustainable gaps in care that frontline mental health workers and services have navigated for years.
Led by Justice Richard Beasley, the recent release of the Special Commission of Inquiry into Healthcare Funding in NSW report confirms rising levels of psychological distress in the community and highlights severe workforce fatigue across the health system.
The Inquiry report also calls out the limitations of current government commitments to health reform, stating that intentions to create a ‘nationally unified and locally controlled health system’ have remained ‘just words on paper’ for too long.
Mental Health Coordinating Council contributed to the Inquiry through our formal submission in November 2024 and meeting with the Commission shortly after to raise concerns about the challenges of procurement processes for community-managed organisations. It’s encouraging to see some of these issues acknowledged in the final report, particularly the call for improved procurement, funding transparency, and greater inclusion of community-based providers in health system planning.
Mental health in the general population
The report reveals that more than 40% of the NSW population have a lifetime mental health challenge, including anxiety disorders and substance use disorders. Alarmingly, the proportion of adults experiencing high or very high psychological distress has almost doubled in the past decade, increasing from 9.8% in 2013 to 18.1% in 2023. These rising rates significantly impact demand for healthcare services, particularly among older adults, who account for a substantial portion of healthcare activity.
Mental health workforce challenges
The Inquiry highlights workforce shortages in key specialties such as psychiatry and emergency medicine, which could impact the future availability of specialist care. There is also an identified need for expanded training opportunities in psychiatry and other under-resourced areas, with the Health Education and Training Institute encouraged to play a greater role in coordinating placements and vocational training networks.
Justice Health and Forensic Mental Health Network
The report underscores the underfunding of mental health services within the prison system, where rates of chronic disease and mental health conditions are particularly high. It also calls attention to the nutritional challenges faced by inmates, noting that current dietary provisions—such as large quantities of white bread—are inconsistent with supporting health and wellbeing.
Recommendations include improved nutritional standards and increased bed availability for transitioning patients from high- to lower-security settings.
Systemic issues and recommendations
Mental health services require long-term systemic reform, including better workforce planning and increased funding to meet growing needs. The Inquiry highlights the importance of standalone investigations into mental health service delivery, such as the NSW Inquiry into equity, accessibility, and outpatient care. Additionally, high levels of stress and burnout across the NSW Health workforce underscore the need for routine staff wellbeing assessments and targeted support initiatives.
A shift toward person-centred care
A key theme emerging from the Inquiry is the need for person-centred, community-based care—an approach that prioritises dignity, choice, and recovery. The report reinforces calls for more integrated, accessible services to support individuals in environments best suited to their needs.
The full Special Commission of Inquiry into Healthcare Funding in NSW report is available below.
Read the report
