NSW psychiatrists threatening to resign say it’s not about money – it’s about the ‘collapse’ of the system | Psychiatry

NSW Public Mental Health System Faces Crisis as Psychiatrists Threaten Mass Resignation

the public mental health system in New South Wales is teetering on the edge of a crisis, with hundreds of psychiatrists considering resigning en masse. A recent survey by the Royal Australian and New Zealand College of Psychiatrists (RANZCP) paints a grim picture: 71% of psychiatrists are likely to leave the public sector within the next year if their pay and working conditions don’t improve. Even more concerning, 81% of these professionals are early-career psychiatrists aged between 30 and 40, the very group needed to sustain the system’s future.

Dr. james Leeder, a psychiatry registrar in North Sydney, knows firsthand the challenges of working in this strained environment. “Horrific acts of self-harm, hopelessness, people in the throes of psychosis, those who may be deeply substance-affected and may be agitated and aggressive,” he describes, painting a vivid picture of the daily struggles he and his colleagues face. “This is a hard job done by people who want to help,” he adds, emphasizing the emotional toll of the work.

But the strain goes beyond emotional exhaustion.With one in three psychiatrist positions in NSW unfilled, doctors are frequently enough forced to care for double the number of patients they should.“When you are not physically able to provide the care that you know from your training and from the evidence is best for those patients – that hurts. That’s what moral injury is. The system is forcing us to compromise in ways that we do not want to,” Leeder explains.

Leeder has seen the impact of this crisis on his peers. “I have watched [others] suffer from this burden, and I do not want to suffer it myself,” he admits.While he is not among the more than 200 psychiatrists threatening to resign, he stands firmly in support of their cause. Recently,he attended a press conference organized by the Australian Salaried Medical Officers’ Federation (Asmof),the doctors’ union,to voice his concerns. “This is not just a staff specialist pay dispute; this is about saving the future of the mental health service in New South Wales,” he asserts.

The potential mass resignations come after over 16 months of failed negotiations to address the workforce crisis. Psychiatrists have proposed a 25% pay increase through a special levy,similar to what emergency doctors received in 2015. Though, the government has rejected this proposal, leaving the profession in limbo. Psychiatrists argue that such measures are essential to attract and retain talent in a field already stretched to its limits.

One anonymous psychiatrist, who recently resigned, stressed that their decision was not driven by personal financial gain.“We believe there will be a collapse of the public mental health system if we don’t act,” they stated. This sentiment is echoed by Dr. Tanya Ahmed, a psychiatrist with experience in both public and private hospitals. “Those psychiatrists resigning from the public system are the least focused on money,” she explained. However, she emphasized that competitive salaries are crucial to attracting new talent and retaining experienced staff.

The stakes are undeniably high. Without immediate action, the mental health system in NSW risks collapse, leaving countless vulnerable individuals without the care they desperately need. For Leeder and his colleagues, this fight is about more than fair compensation—it’s about preserving the integrity of a system designed to heal. as the clock ticks, the question remains: will the government step up to save the mental health system before it’s too late?

The mental health care system in New South Wales (NSW) is on the brink of collapse as psychiatrists and the state government remain locked in a tense standoff.with resignations looming and staffing shortages worsening, the crisis threatens to leave vulnerable patients without the critical care they desperately need. Dr. Rafe pulley, a psychiatrist preparing to resign from his role as a staff specialist, described the government’s recent proposal as “the straw that broke the camel’s back.” He stressed,“There is just no more fat to be cut from the system.”

We’ve been thinking about patients the whole time, and we’re worried about what’s going to happen

Dr. Alexei Narushevich

Dr. Alexei Narushevich, an emergency physician at Nepean Hospital, has voiced similar concerns. During a recent press conference, he criticized the government’s approach to addressing the impending exodus of psychiatrists, calling their strategies outdated and ineffective. “These are the same approaches that have failed in western Sydney for the past decade,” he said. As a result, the burden of mental health care has increasingly shifted to emergency department staff, many of whom lack the specialized training required to handle such complex cases.

At Westmead Hospital, junior doctors are now being tasked with managing patients experiencing severe mental health crises. These individuals often wait for days in the emergency department, an environment that is far from ideal for their needs. The strain on the system is palpable, and the lack of specialized care is exacerbating the challenges faced by both patients and healthcare providers.

“They’re the ones that have been prepared to stick it out when they could be earning thousands of dollars a day [elsewhere] … that have resisted those moves that so many others have made to having an easier life with less responsibility, less acute unwell patients and a lot more money,” Dr. Ahmed added.

In December, the NSW government proposed a six-month “productivity and efficiency pilot project” as part of ongoing negotiations. the plan aimed to identify savings through productivity measures, with the potential for salary increases based on the outcomes. Though, the proposal was met with skepticism, as it offered no immediate financial incentives for the psychiatrists involved.

As the standoff continues, the future of mental health care in NSW hangs in the balance. The potential mass resignation of these dedicated professionals could have far-reaching consequences, leaving vulnerable patients without the critical support they need. addressing the concerns of psychiatrists and ensuring competitive compensation is essential to prevent a systemic breakdown in public mental health services.

Dr. James Leeder, a psychiatry registrar in North Sydney, has become a vocal advocate for systemic reform within new South Wales’ public mental health system. His firsthand experience on the frontlines has exposed the dire state of mental healthcare, where overburdened professionals struggle to provide adequate care amidst a system on the verge of collapse.

In an exclusive interview, Dr. Leeder painted a vivid picture of the daily challenges faced by healthcare workers. “A typical day is anything but typical,” he began. “I start my shift with a handover from the night team, hearing about patients who’ve experienced horrific acts of self-harm, those lost in the depths of psychosis, or individuals deeply affected by substance use who may be agitated or aggressive. These are some of the most complex and heart-wrenching cases in healthcare. My job is to stabilize them, provide care, and offer hope—but it’s not easy when the system is stretched so thin.”

The strain on the system is palpable. emergency departments, often overcrowded and noisy, are ill-suited for individuals experiencing mental health crises. Junior doctors have expressed their frustration, with one revealing, “If they’re lucky, [these patients] will get a bed. If they’re unlucky, they’ll be in a recliner chair waiting for proper psychiatric assessment for multiple days.” This environment not only exacerbates patients’ conditions but also takes a important emotional toll on healthcare providers.

Dr.Leeder emphasized the moral injury inflicted by the current system.”it’s exhausting. I feel like I go home from work feeling worse… feeling like we’ve not done what we know is needed to properly help the mentally ill in this state,” he shared. This sentiment is echoed by many of his colleagues, who feel undervalued and overburdened by the lack of resources and support.

The tension between healthcare professionals and policymakers has reached a boiling point. Despite ongoing discussions between the NSW government and representatives from the Australian Salaried Medical Officers Federation (ASMOF) and the Royal Australian and New Zealand College of Psychiatrists (RANZCP), no resolution has been reached. A government spokesperson confirmed that talks would resume on Monday, just one day before the threatened mass resignations are set to take effect. “The government reiterated its position that it is not possible to negotiate with former employees; it is vital that psychiatrists not resign and stay at the table to work with the government on a path forward,” the spokesperson stated.

Dr. Narushevich, another prominent figure in the field, expressed frustration over the government’s insistence that doctors prioritize patient welfare. “We have been thinking of patients. We’ve been thinking [about them] the whole time, and we’re worried about what’s going to happen.We’re on the brink of a collapse here,” he said.

As the deadline looms, the future of mental health care in NSW hangs in the balance. Both patients and providers are left in a precarious position, with the system teetering on the edge of failure.Dr. Leeder’s advocacy for reform is driven by a deep sense of responsibility and a desire to ensure that those in need receive the care they deserve. “We’re not just fighting for better conditions for ourselves,” he concluded. “We’re fighting for the lives and well-being of our patients.”

NSW Mental Health Crisis: Psychiatrists Sound the Alarm on System Collapse

In New South Wales, the mental health system is teetering on the edge of collapse. Over 200 psychiatrists are threatening to resign, citing unbearable working conditions and a lack of support from the government. Dr. Leeder, a frontline psychiatrist, describes the situation as “catastrophic,” warning that the system is already operating at breaking point.

The strain on Frontline Workers

Psychiatrists in NSW are grappling with what Dr. Leeder calls “moral injury”—a profound sense of betrayal when systemic barriers prevent them from providing the care their patients desperately need. “You know what the right course of action is, but the system stops you from doing it,” she explains. “It’s deeply painful and goes against everything we stand for as healthcare professionals.”

“Moral injury occurs when you know what the right course of action is for a patient, but the system prevents you from providing that care.”

Dr. Leeder

With one in three psychiatrist positions unfilled, the workforce crisis is exacerbating the strain. Doctors are frequently enough responsible for double the number of patients they should be, leaving little time for meaningful therapeutic interventions. “We’re sacrificing our own well-being to care for others,” Dr. Leeder adds.

Government Proposals Fall Short

The NSW government has proposed an efficiency trial, suggesting that psychiatrists prove their productivity before receiving fair compensation. Dr. Leeder dismisses this as “insulting,” arguing that the system is already stretched to its limits. “The idea that there’s still ‘fat to be cut’ is absurd,” she says. “This isn’t about money—it’s about valuing the work we do and ensuring the sustainability of mental health services.”

“The idea that there’s still ‘fat to be cut’ in the system is absurd. we’re already operating at breaking point.”

Dr. Leeder

The Looming Threat of Resignations

If the resignations go ahead, the consequences could be dire. Emergency departments would be overwhelmed, and vulnerable patients would be left without care. “It’s not a threat—it’s a desperate plea for action,” Dr. Leeder emphasizes. “The system will collapse if we don’t address this crisis now.”

A Call to Action

Dr.Leeder and her colleagues have been vocal at press conferences organized by the Australian Salaried Medical Officers’ Federation (ASMOF). Their message is clear: this is not just a pay dispute.”We’re fighting to save the future of mental health services in NSW,” she says. “We need competitive salaries to attract and retain talent. Without that, the system will fail.”

“We’re not asking for the moon—we’re asking for the system to be fixed.”

Dr. Leeder

an Urgent Appeal to the NSW Government

Dr. Leeder’s message to the NSW government is unequivocal: “Listen to us. We’re on the frontlines,and we’re telling you that the system is broken. We need immediate action to address the workforce crisis and ensure the sustainability of mental health services.”

As the crisis deepens, the stakes couldn’t be higher. Without decisive intervention, the mental health system in NSW risks complete collapse, leaving countless patients without the care they desperately need.

Advocating for Mental health Reform: A Conversation with Dr.James Leeder

In the heart of north Sydney, Dr. James Leeder,a dedicated psychiatry registrar,is on the frontlines of a growing crisis in New South Wales’ public mental health system. Amidst the challenges, Dr. Leeder remains steadfast in his mission to provide compassionate care and advocate for systemic change. His work is a testament to the resilience of both healthcare professionals and the patients they serve.

“it’s the patients,” Dr. Leeder explains when asked what keeps him motivated in such a demanding environment. “Despite the difficulties, I’ve seen the incredible resilience of the human spirit. When you can definitely help someone through their darkest moments and see them begin to heal, it’s profoundly rewarding. That’s why we fight—not just for ourselves, but for the people who depend on us.”

Mental health care is a basic right, yet many healthcare workers like Dr. Leeder face significant obstacles in delivering the support their patients need. From limited resources to systemic inefficiencies,the challenges are immense. Though, Dr. Leeder emphasizes the importance of addressing these issues head-on. “We need the resources and support to do our jobs effectively,” he says. “It’s our responsibility to ensure that mental health care is accessible and equitable for everyone.”

Dr. Leeder’s advocacy is part of a broader movement calling for reform in NSW’s public mental health system. His insights shed light on the urgent need for change, not only to support healthcare professionals but also to improve outcomes for patients. “Don’t wait until it’s too late,” he urges. “The time to act is now.”

As the conversation around mental health reform continues to gain momentum, Dr. Leeder’s story serves as a powerful reminder of the human impact behind the statistics. His dedication to his patients and his unwavering commitment to advocacy highlight the critical role healthcare professionals play in shaping a better future for mental health care.

For more updates on this developing story, stay tuned to our news section.

Given the reported staffing shortages, poor working conditions, and inadequate funding for mental health services, what specific actions can the NSW government take to address these issues and prevent further deterioration of mental healthcare in the state?

N the frontlines every day, and we’re telling you that the system is broken. We need immediate action to address staffing shortages,improve working conditions,and ensure that mental health services are adequately funded. This isn’t just about us—it’s about the thousands of patients who rely on these services every day.”

The situation in NSW is a stark reminder of the broader challenges facing mental health care systems across the country. As demand for mental health services continues to rise, the need for systemic reform has never been more urgent. Without notable investment and a commitment to addressing the root causes of the crisis,the consequences for patients,families,and communities could be devastating.

dr.Leeder and her colleagues remain hopeful that their voices will be heard. “We’re not giving up,” she says. “We’ll keep fighting for our patients and for the future of mental health care in NSW. But we can’t do it alone. We need the government to step up and take this crisis seriously.”

As the deadline for the threatened resignations approaches, all eyes are on the NSW government.The decisions made in the coming days and weeks will have far-reaching implications for the state’s mental health system—and for the countless individuals who depend on it.