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Nineteen of Victoria’s 21 adult mental health and wellbeing services are failing to meet their target for admitting acutely mentally unwell Victorians to a bed within eight hours.
Five years after the state government promised to fix the broken mental health system, data shows more than half of patients are languishing in emergency departments because there are not enough specialist beds to treat them, and most facilities are using seclusion and restraints far more often than they are supposed to.
Medical groups say the Victorian government’s failure to open promised new acute mental health beds and community services demanded by the royal commission is fuelling a crisis for the most unwell psychiatric patients.
In fact, the Department of Health’s quarterly performance data shows the state has gone backwards since the royal commission’s final report was handed down in 2021, when 49 per cent of patients were transferred to a bed within eight hours despite the COVID-19 pandemic. The average currently sits at 46 per cent.
The situation has become so severe that across Victoria only one adult mental health and wellbeing service has consistently met the target of admitting 80 per cent of patients to a mental health bed within eight hours, the figures show. The April to June 2026 data is expected to be published within the next fortnight.
With emergency departments bearing the brunt of wider systemic issues, the Australian Medical Association’s Victorian branch met with Health Minister Ingrid Stitt on August 20 to express its alarm at the situation confronting acutely unwell mental health patients and those trying to treat them.
But AMA delegates told The Age they came away from the meeting confused at the government’s claims it had delivered more new mental health beds than anyone working in the health system can account for.
The 2021 royal commission recommended the government introduce at least 270 new adult mental health beds, but the industry – including the commission set up to monitor implementation of the royal commission’s recommendations – can only account for 174 as being opened.
Stitt, however, told the AMA delegation that 230 new mental health beds had been opened, while refusing to give a breakdown of where the beds were during the August 20 meeting or in the weeks since.
AMA Victoria president Dr Simon Judkins said that regardless of how many new beds had been opened, it was nowhere near enough.
“People just cannot access the help they need, and we are not doing enough for prevention,” Judkins said.
“They come to emergency departments and have to stay for hours and hours in an environment that is completely unsuitable … It is crowded and noisy, and they are stuck there for a long time.”
Australasian College of Emergency Medicine Victorian branch chair Dr Mark Putland said the lack of mental health beds and community services meant people had to become critically unwell before they could get help, often via emergency departments.
Putland said the vast majority of the more than 13,000 people stuck in emergency departments for more than 24 hours over the past year were mental health patients, including many in the greatest need due to concerns of self-harm, suicide and other major episodes.
“We are talking about genuine life and death conditions, just like cardiac arrest, just like heart attack, just like stroke,” Putland said.
“The system has grown very dependent on emergency departments to make up for broader inadequacies. You’ve got to be so unwell before you even get a look in at one of our area mental health services that GPs are having to carry all this risk with people who are really unwell.
“It [an emergency department] is a very difficult place to care for people who are acutely mentally ill. We designed our EDs for assessment and stabilisation, and that’s what we do well. They are not good places for people to stay for a long time.”
As well as an overall lack of beds, medical groups say Victoria’s mental health system fails to keep pace with population growth and workforce availability, with some areas of the state faring far worse than others.
As a result, Casey Hospital’s eight-hour admission from emergency department rate has fallen from 48 per cent in 2015–16 to just 7 per cent in 2024–25. Monash Health’s adult mental health clearances have dropped from 56 per cent to 10 per cent over the same period, while Dandenong has sunk from 66 per cent to 12 per cent.
The latest pre-admission data also shows that three out of four mental health patients had contact with a community mental health service in the week before presenting to hospital, but were still so unwell they needed emergency hospital treatment.
Patients are also continuing to be secluded and restrained at rates far higher than standards recommend. While Department of Health guidelines dictate that adult patients spend fewer than six in every 1000 bed days in seclusion, 14 of the 22 adult mental health units failed to meet the target.
Restrictions on child and adolescent mental health patients are supposed to be fewer than three in every 1000 bed days – but each of the state’s four dedicated 0-12-year-old mental health units used seclusion more often.
In one case, at the North Western Child and Adolescent Mental Health Service, seclusion is used 22 times more frequently than recommended, with young patients spending 67 out of 1000 days secluded.
Mental Health Legal Centre chief executive Charlotte Jones labelled the usage rates of chemical, physical and mechanical restraints as “terrifying”, and something which was not being transparently reported.
“Seclusion is torture. We are clear that it is harmful and, since 2005, all Australian governments agreed to act to reduce this,” Jones said.
“The bed occupancy rate and the transfer to a mental health bed in eight hours reflect the bleak reality of the need to release beds for those waiting. It is a reflection of the system failing to provide adequate resources and support for people experiencing mental ill health and distress.”
The Royal Australian and New Zealand College of Psychiatrists (RANZCP) is also “very concerned” by Victoria’s extreme emergency wait times, which it says is the visible consequence of wider capacity issues across the mental health system.
The college’s Victorian branch chair Associate Professor Simon Stafrace said the state’s failing emergency department performance was not a standard anyone could accept.
“For somebody who is highly distressed, suicidal or frightened, or experiencing psychosis or mania, prolonged waiting can increase anxiety and agitation and can be profoundly undignified. It can also delay access to the therapeutic environment and specialist care the person needs,” he said.
“People experiencing serious mental illness need a pathway towards recovery, not simply eventual discharge from an emergency department. That requires access to continuing treatment, rehabilitation, recovery services and supported housing.”
‘We are not making the difference that Victorians were promised because the workers and the overall system has not been supported to do so.’
Health and Community Services Workers Union Victorian branch secretary Paul Healey
Health and Community Services Workers Union Victorian branch secretary Paul Healey said Victoria needed at least 1800 additional mental health workers to ease access issues, as well as mandated staffing levels.
“The royal commission provided a ray of hope that things were going to get better but through their failures, [the Victorian government’s] unwillingness to listen and collaborate with us, I fear that dream has been crushed beyond repair,” Healey said.
“Look at the outcomes. We have not turned around Victoria’s suicide rate. We have seen spikes in overdose deaths. We are not making the difference that Victorians were promised because the workers and the overall system has not been supported to do so.”
Eating Disorders Victoria this week released new research finding eating disorder-related emergency department presentations climbed to more than 40 a week between March and May 2026 – returning to the levels at the height of the COVID pandemic – with fewer than a third able to access specialist treatment.
A government spokesperson said it was delivering more than 230 new acute inpatient beds across the state, although that figure includes 40 at Thomas Embling Hospital.
The Thomas Embling beds are forensic services that cannot be accessed by general acute patients and are not counted in the royal commission’s recommended 270 mental health bed expansion because they cannot ease capacity issues across the state.
The government also pointed to its work in growing the state’s mental health workforce by a third since 2021, including a 125 per cent increase in its lived experience ranks.
“We know demand for services is high – that’s why we’re continuing to invest in our mental health workforce, infrastructure and dedicated support programs right across Victoria,” the government spokesperson said.
If you or anyone you know needs support, call Lifeline on 13 11 14, or Beyond Blue on 1300 224 636.
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