NSW’s mental health system is on its knees. Here is why psychiatrists like me have resigned

I’ve been working in New South Wales’s public mental health system for 15 years.

I’ve cared for some of the most unwell people in our community, at a really vulnerable point in their lives. I trained for 13 years to do this work and I can’t imagine doing anything else.

But I’ve resigned. From next week, I won’t have a job I love.

As a psychiatrist I think a lot about safety. I think about the safety of my patients, of my friends and colleagues who work alongside me, and the community.

The frontline workforce has been sounding the alarm for years. The level of staff shortages is putting both patients and the workforce at risk.

I also think about recovery. The mental health system has become something we describe as dysfunctional, broken, disjointed and complicated.

It’s devastating – both personally and professionally – to see people repeatedly failed by a system that should be a place of hope, healing and recovery.

NSW has a critical and chronic shortage of mental health workers and the system can’t keep up with community needs.

This has been said time and time again – in countless reports, inquiries and inquests. By patients, their families, by other professionals. And by us.

People are suffering and psychiatrists are rushing from one emergency to the next.

Patients are seen by short-term locums unfamiliar with their history, forcing them to relive painful experiences and leaving them feeling unseen, unheard and retraumatised.

People are getting help too late, or not at all. They arrive sicker, with more chronic and complex issues, into a health system that’s already struggling – and failing – to keep up.

For us on the frontlines, it is demoralising and heart-breaking. Resigning wasn’t a decision we took lightly but the system leaves us no choice.

We want to do nothing more than to be able to stay and keep providing the vital, often life-saving mental health care our patients need. But the system is not able to cope and neither are we.

Many registrars I supervise are anxious. They have joined a system already on its knees and are watching it fall apart as they try to care for patients without enough support, tools, or resources.

This isn’t just about the next generation of mental health workers – it’s about the future of our mental health system and the people who depend on it.

The same conditions that are causing burnout in the profession are also compromising patient care.

For too long, the workforce has carried the system, bearing immense pressure. But the cost of inaction falls on those least able to fix it – frontline workers, their patients, and the community.

It’s not the community’s job to understand the system and make it work. All they need to know is that the system works and is there for those who need it.

It’s ours, together with our governments. It is simple really, we get the tools and resources and funding from the governments to do our job, and then we do it well.

We’ve been doing our bit tirelessly – while desperately waiting for the government to do theirs.

While the New South Wales premier, Chris Minns, did not create this crisis, it’s his government’s responsibility to break the cycle of dysfunction.

The challenges facing the NSW government aren’t unique. The psychiatrist shortage is a national issue.

But without a national plan, states are forced into competition to attract and recruit from across state borders.

And if it’s a race, NSW is being left behind. Right now, the pot is boiling over. We’re counting on the NSW government because we can’t do this alone. Not any more.

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