It's time to end mainstreaming

June 3, 2025

It’s time to admit that mainstreaming mental health patients into public hospitals has failed. Part of the reforms to mental health services in the 1990s and 2000s, mainstreaming was supposed to be a recognition that mental health patients deserved care and support in the general hospital stream. It was intended to break down stigma.

What it has done is left patients untreated in emergency departments for too many hours. In 2012, while working as an agency nurse, I treated mental health patients in EDs. They then had often been there for two days. Now it’s four days and beyond waiting to be seen by overworked psychiatrists.

There are too few acute beds. Any government or health department wanting to take immediate measures to address the mess in mental healthcare must recognise that the first thing that needs to be done is opening more acute beds in public hospitals now. Find the staff. Address the crying needs. No more Bondi Junction stabbings.

This call is not about reinstating stigma . This is about caring for seriously mentally ill patients who are immediately affected when beds close and staff resign from the system.