The families seeing their loved ones abandoned by a mental health system in crisis

Australia Broadcast Center

5 days ago

Desperate and grieving families say they're living with the consequences of the crisis in New South Wales' public mental health system.
Their loved ones are part of a group the system does not adequately care for, known as "the missing middle" — people with complex mental health needs who are too unwell for a GP, but not sick enough to be admitted to hospital. Without proper support in the community, their health can deteriorate to a life-threatening point where they need the acute care of a hospital.
Doctors say the crisis is only getting worse, revealing the under-resourcing of mental health in the state has led to them turning people away from care and discharging patients before it's safe.
"People might be discharged early, they may have another attempt on their life, which I saw on a number of occasions, and then they'd come back to a hospital," Suzy Goodison, former psychiatrist at Sydney's largest hospital, the Royal Prince Alfred, said.
Four Corners was flooded with responses after asking its audience to share their experiences seeking help for serious mental illness in NSW.
A clear pattern emerged — people spoke repeatedly about how they, or their loved ones, were discharged too soon or denied care when they needed it most, sometimes with devastating consequences.
Warning: This story contains references to suicide and self-harm and may be distressing for some readers.
One father told Four Corners his daughter's early discharge from hospital actively triggered her to self-harm.
"My daughter has had several admissions to hospital for suicidal ideation or suicide attempts.
"In each case, she has simply been discharged after waiting all day (and night, in some cases) in emergency.
"In my daughter's most recent admission to a Sydney hospital, she was again discharged without any further direction provided for her care.
"As soon as she got home that afternoon, she went to her room and attempted suicide. We later found out that the trigger for this suicide attempt was despair at being sent home again, when she knew that she needed serious care but would never receive it.
"Our GP has had to play the role of ad hoc psychiatrist, prescribing and monitoring depression and anxiety medication.
"He personally tried to contact psychiatrists in the public and private system on our behalf, but those either did not reply to his calls, were closed to new patients or were prohibitively expensive."
It costs more than $1,000 a day to stay in a private mental health clinic and only top gold cover private insurance will help pay for it.
After dealing with an overwhelmed hospital system, patients are supposed to be assigned to a mental health team in the community staffed with psychologists, social workers, nurses, and ideally psychiatrists.
The NSW government's own data shows it's likely that almost 60,000 people with severe mental illness aren't getting the community care they need, because the teams are so short staffed.
"It comes down to loss of staffing in community mental health services, they're running on the sniff of an oily rag," said Dr Goodison, who previously worked in the community teams in the Sydney Local Health District.
"These people with really chronic, debilitating mental health issues become unwell in the community, the community team can no longer hold onto them, and so they come to hospital," Dr Goodison said.
This mother said her son was repeatedly told by a community mental health team in Sydney tasked with supporting people at crisis point, that no help was available.
"In mid 2024 our son was admitted three times to the emergency department.
"Then in July, experiencing distress and not wanting to go back to the emergency department, he called the acute community care team and asked for help.
"He was informed there was no assistance available as they were understaffed.
"He put me on the phone to the member of the acute care team who told me that they did not have anyone available to speak with him or come and see him, and that I should call the police or take him to the ED.
"I was later told by a member of this team, that the understaffing and under-resources of this service is the worst it has been for 20 years, and the service is unable to help young people experiencing acute distress or crisis such as my son.
"Our son died late last year, aged 19.
"He was a beautiful, clever, thoughtful, compassionate, perceptive, loved and loving and profoundly sensitive child and adolescent who had struggled — with courage and resilience."
More than 4 million Australians are experiencing a serious mental health challenge and rates of severe symptoms are rising, according to a landmark national survey by Beyond Blue obtained by Four Corners.
But more than half of them are not getting the help they need, when they need it.
The figures reflect the experience of these families, like Penny Leemhuis', whose brother died by suicide last year.
He had presented to a mental health hospital unit three times in three weeks, as well as an emergency department, saying he had thoughts of suicide.
"In March last year, my brother Luke took his own life… [and] a serious adverse event investigation was held.
"The report was over 200 pages long, finding multiple systemic failures and lack of procedures contributed to Luke ultimately taking his life. They were identified as missed opportunities.
"At what point will governments across all levels, recognise and understand that we in Australia have an escalating mental health crisis that is not being adequately addressed?
"Luke was a person. Luke had a life. Luke, like so many others, deserved better."
The NSW government told Four Corners it invested $2.9 billion into mental health services in the last year, including funding for community support programs which reduces pressure on emergency departments.
That includes $102 million for living support programs.
"We acknowledge there is more work to do to address the areas of need, and NSW Health is continuing this important work with stakeholders to further investigate and identify services best suited to addressing identified gaps," a spokesperson said.
Despite government spending, many families have struggled to access services — like this father whose daughter died by suicide last year after consistently being discharged from psychiatric wards before she was ready.
"Alice was a cherished and much-loved daughter and sister.
"In the nine months before she died, she had three separate month-long admissions to psychiatric wards under a schedule.
"The day before her final discharge from the psych ward she said to me, 'I can't wait to get out of here so I can kill myself.'
"I told the doctors exactly what she had said but they discharged her the next day.
"In the final three weeks I took her to the emergency department twice. I pleaded with them to admit her, explained how unwell she was and that she talked of little else but suicide. Each time she was discharged after a few hours. Days later she was dead.
"I believe very strongly that Alice's suicide was due to a complete failure by the health system, a failure in duty of care. There were a sea of red flags, that were ignored, overlooked or minimised."
Testimonies like this along with firsthand experiences from doctors show the current system isn't fit for purpose, according to the NSW chair for the Royal Australian and New Zealand College of Psychiatrists.
"This is a shortfall we would not accept anywhere else in our health sector," Pramudie Gunaratne said.
"The only thing that we are able to actually uphold in our current public mental health [system] is crisis care, and that doesn't actually provide ongoing, good quality care for our patients.
"If all we have is a revolving door where someone comes in under crisis, we are able to kind of keep them in a ward, patch them up, and then send them back out for them only to come back again.
"So I don't think we really have a system at all at the moment."
NSW Health told Four Corners patients are not discharged "unless clinically appropriate".
"We will never turn people away," a state government spokesman said.
"We want to make it very clear — if anyone is in need of mental health treatment they should reach out for help. Our system is designed to provide it, and has continued to, throughout this process."
Watch Four Corners's full investigation, Emergency: The Long Wait for Help on ABC iview.