A looming crisis in mental health services is unfolding across New South Wales as over 60 psychiatric beds in public hospitals have begun to close and leaked internal memos reveal hospitals’ dire plans to handle the mass resignations of psychiatrists. The closures and resignation plans come as more than 200 public sector psychiatrists threaten to quit amid failed pay negotiations with the state government.
Documents obtained by The Guardian show the drastic measures hospitals are being forced to take, including limiting psychiatric assessments, relying on junior doctors and non-medical staff to make critical patient decisions, and transferring high-risk patients to already-burdened private facilities. The plans have raised alarm among senior psychiatrists, who warn of dangerous knock-on effects across the health system.
Beds Close as Resignations Loom
The crisis has been brewing for months as psychiatrists, fed up with stagnating wages and worsening work conditions, demanded a 25% pay rise from the NSW government. With talks at a stalemate and resignations set to take effect, hospitals are now facing the grim reality of operating mental health units without enough senior doctors.
At least 60 mental health beds have already been temporarily closed, including 20 at Cumberland Hospital’s Riverview unit, 20 at its Willow Cottage, and 8 mother-and-baby psychiatric beds at Westmead Hospital. But with 43 confirmed resignations so far and nearly 100 more expected, doctors fear far more drastic cuts are imminent.
Hospitals’ Crisis Plans Under Fire
As resignations loom, hospitals have been scrambling to develop emergency plans to plug the gaps left by departing psychiatrists. But the leaked memos detailing these plans have sparked serious concerns among doctors.
In one memo, the Royal Prince Alfred Hospital outlined an “escalation pathway” to limit when psychiatrists would be called to assess emergency patients overnight, instead leaving decisions to non-doctors. A senior psychiatrist slammed the plan, warning it would mean “people who often have no experience in clinical medicine will now be making health-related decisions.”
Other hospitals are planning to lean more heavily on junior doctors, deploy a “consultant liaison model” where psychiatrists merely advise other teams, and transfer more patients to private providers – plans experts say are unsustainable and will lead to poorer outcomes and bed-block across the system.
Last-Ditch Negotiations as Crisis Deepens
With the system teetering on the brink, the NSW government has launched eleventh-hour talks to avert the resignations and stem the bleeding. But doctors say the 5% pay offer now on the table is still far short of what’s needed to retain staff and attract new psychiatrists to the public sector.
My community will be suffering with these bed closures and there will be flow-on effects for years to come with increased presentations to the emergency department, increased suicide rates and increased acute presentations due to people not getting the care they need.
– Anonymous NSW psychiatrist
As both sides dig in and the standoff continues, patient advocates and clinicians are urging the government to end the brinkmanship and deliver a fair deal before it’s too late. With every passing day, more beds close, more staff leave, and the state’s mental health patients bear the brunt of a system in turmoil.
