Report reveals persistent cracks in fragmented mental health system

Despite increased spending and higher service use, a new mental health report card has warned access to care remains uneven, workforce shortages are worsening, and patients continue to face significantly poorer outcomes.
 
Labelling the current landscape a ‘complex picture’, the National Mental Health Commission’s report found that despite service use and investment increasing, significant barriers to care remain.
 
Released on Wednesday, the report reveals that in 2025, 14.9% of Australians aged 15 and older experienced ‘high’ psychological distress, and 9.2% experienced ‘very high’ distress.
 
But despite greater investment in the mental health system announced in 2025, and more people accessing support, ‘the impact of this investment is unevenly distributed across society’.
 
‘There are signs that our service system isn’t facilitating access early enough for those experiencing mental health challenges and a workforce projected to continue to fall short of need,’ the report said.
 
It found that people living in major cities use Medicare mental health-related services at a significantly higher rate than the overall population.
 
‘Access to health services remained constrained by increasing demand for public mental health care, long waits in emergency departments, GP workforce pressures, and psychiatrist shortages,’ it said.
 
But Dr Karen Spielman, RACGP Specific Interests Psychological Medicine Chair, said GPs’ central role in mental health care is often forgotten.
 
‘We know that we do a good job because our patients are beautifully loyal, and GPs are booked out, and busy, and needing support, but we need to help GPs do mental health consults in a sustainable way,’ she told newsGP.
 
‘The levels of distress haven’t abated and its more and more bread and butter for GPs, and certainly anecdotally, the levels of distress are higher.
 
‘Often, we’re doing unpaid clinical time and, with the increasing complexity and increasing unwellness, people have a much higher chance of falling through the cracks if it’s fragmented.’
 
Dr Spielman adds that increasing fragmentation continues to impact all GPs, presenting a potentially ‘really risky’ impact on patients.
 
‘It comes back to the college’s advocacy for higher rebates for longer consults – it’s that recognition that GPs need time to do a really thorough job with managing the increasing complexity of mental health,’ she said.
 
‘We need to better recognise that GPs are a part of the workforce and that we can take the pressure off the tertiary system if the rebates are there for patients to access the work we’re trained to do.’
 
Looking forward, the Commission said future reform must focus on prevention, service system improvement, workforce growth, and strong national data to ensure Australia can improve access to the right care at the right time.
 
The Commission’s Chief Executive David McGrath said currently, the benefits of bolstered investment are not being shared equally across the community.
 
‘Where people live and their financial situation can still affect their ability to access the services they need,’ he said.
 
‘Financial strain, housing insecurity, discrimination, and the level of support within communities all play an important role in shaping mental health and wellbeing.
 
‘That vision must be guided by data and insights from people with lived and living experience and what they tell us about need, access and outcomes.’
 
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