A discussion from the frontline of workplace mental health.
“I’m not a psychiatrist or policy expert, but from the workplace side, this is what I am seeing.”
Over the past few years, I’ve been working closely with employees who are off on extended leave due to mental health challenges, depression, anxiety, substance use, suicidal ideation, medication complications, trauma.
Many are doing the right things.
They’ve seen their GP.
They’re engaged in counselling.
They’re trying to stabilise.
They’re trying to get back to work and life.
And increasingly, their GP has said:
“You need to see a psychiatrist for a review or re-diagnosis.”
That’s where the wall often appears.
Long waitlists.
Clinics not accepting new patients.
Gap fees that are simply unaffordable.
No clarity on where to go next.
And I keep asking myself, and now I’m putting it out there more broadly:
If this is hard for supported employees with a GP, a workplace, and guidance, what is the everyday Australian doing?
This Isn’t a Complaint. It’s a System Question.
This isn’t about blaming individual psychiatrists or GPs. The evidence is clear; the issue is structural.
1. We Don’t Have Enough Psychiatrists:
- Psychiatrists are medical specialists. The pathway is long:
- 6+ years medical degree
- Internship and residency
- 5 years specialist psychiatry training
- It can take 12–15 years to qualify.
Australia has roughly 3,500–4,000 practising psychiatrists nationally, and many work part-time or are concentrated in metro areas. Rural and regional communities face significant shortages. Workforce expansion takes a decade, not months.
2. Demand Has Increased Rapidly
- Over the past 5–10 years:
- Mental health awareness has grown
- Post-COVID mental health burden has increased
- Anxiety and depression prevalence has risen
- ADHD assessment demand has surged
- Substance use and trauma presentations have become more complex
- Demand has outpaced workforce growth.
That’s not opinion, it’s reflected in ABS data and workforce reporting from the Royal Australian and New Zealand College of Psychiatrists.
3. The Public vs Private Divide
Public services prioritise:
- Severe mental illness
- Acute crisis
- Psychosis, bipolar disorder, high-risk presentations
If you don’t meet that threshold, you’re often referred on.
In private practice:
- You need a GP referral
- There are often gap fees
- Many psychiatrists have closed books
- Waitlists of 3–12 months are common
- For someone unwell, distressed, possibly suicidal, navigating this system is overwhelming.
Medicare rebates do not always cover the full cost. Bulk-billing psychiatry is increasingly rare. If someone is off work, financially strained, and already struggling psychologically, gap fees can become another barrier, not just financially, but emotionally.
Shame, confusion, fatigue, they all play a role.
But Here’s the Bigger Question
The workers I’m supporting often have:
- A GP
- A workplace
- HR involvement
- EAP access
- Sometimes private health
- Someone helping them navigate
And it’s still hard.
So, what happens to the person who:
- Doesn’t understand the difference between a psychologist and psychiatrist?
- Doesn’t know what a mental health care plan is?
- Can’t afford private fees?
- Doesn’t have workplace support?
- Is already overwhelmed and cognitively fatigued?
Mental health literacy is not evenly distributed.
System navigation requires clarity, capacity, and confidence, three things many people don’t have when they’re unwell.
What Needs to Change?
This isn’t about panic. It’s about structural reform and better coordination.
1. Expand Psychiatry Training & Distribution
We need:
- Increased funded training positions
- Incentives for rural and regional practice
- Supervision pipeline expansion
This is long-term, but essential.
2. Strengthen Stepped-Care Models
Not every patient requires psychiatrist-level intervention.
Evidence-based stepped care suggests:
- Psychologists for mild-to-moderate presentations
- GPs with advanced mental health training
- Nurse practitioners in collaborative care models
- Digital therapy and low-intensity interventions
- Psychiatrists reserved for complexity and medication management
- The key is triage clarity, not default referral to the most specialised provider.
Internationally, collaborative care models have shown strong outcomes:
- Psychiatrist consults supporting GPs
- Shared medication management
- Structured case review
- Integrated mental health teams
Australia has been slower to scale these models nationally.
4. Improve ADHD & Diagnostic Pathways
One clear pressure point is neuro-developmental assessment demand.
Options include:
- Streamlined diagnostic frameworks
- Expanded GP prescribing rights in defined cases
- Multidisciplinary assessment pathways
Reducing bottlenecks here could ease pressure across the system.
5. Improve Mental Health Literacy
Workplaces, schools, and community settings need to:
- Clarify the difference between psychologist vs psychiatrist
- Explain when medication review is necessary
- Provide structured referral pathways
- Support navigation, not just awareness
Education without navigation doesn’t solve access barriers.
From a Workplace Perspective
In the companies we support, we’re seeing:
- Employees stuck on leave waiting for psychiatric review
- Medication uncertainty prolonging recovery
- Financial strain compounding stress
- Delayed return-to-work plans due to system bottlenecks
This isn’t just an individual problem. It’s an organisational and economic one.
When people can’t access timely care:
- Recovery is delayed
- Absence is prolonged
- Risk increases
- Costs increase
This Is an Invitation to Discuss, Not Criticise
The psychiatrists I know are stretched, committed and doing complex work under pressure.
GPs are trying to triage as best they can.
The issue is systemic capacity and coordination.
So, I’m putting this out there as a discussion:
How do we:
- Expand access?
- Strengthen stepped care?
- Improve navigation?
- Reduce inequity?
- Support the everyday Australian who doesn’t have resources?
Because the workers I’m supporting are trying.
And they deserve a system that works with them, not against them.
If you work in:
- Health policy
- Psychiatry
- Primary care
- Workforce planning
- Insurance
- Workplace health
I’d genuinely value your perspective. This isn’t about pointing fingers. It’s about building something better.
Dan Hunt MHM CEO
