One significant challenge within Australia’s health care system is the rising wait times to see medical specialists. Our research reveals a significant increase in wait times for psychiatric specialist services across Australia, with regional and remote areas facing the greatest challenges.
In recent years, psychiatry has become one of Australia’s most consulted medical specialties outside of hospital settings. Recent data from the Australian Institute of Health and Welfare show that mental health-related services have become one of the most frequently accessed specialist services, with about 4.8 million Australians receiving mental health-related prescriptions in 2022–23. Despite this high demand, little was known about the national picture of wait times for psychiatric specialist services for general outpatients – until now.
Our recent study, published in JAMA Network Open, provides the first analysis of national outpatient wait times from GP referral to first psychiatric specialist appointment in Australia.
What we did and found
We analysed data from the Medicare Benefits Schedule from 2011 to 2022, accessed via the Person Level Integrated Data Asset (PLIDA), and uncovered some concerning trends.
Over the past decade, wait times for an initial psychiatry appointment following a GP referral have steadily increased, with a significant rise since 2020. In 2011, the average wait time was 51 days, extending to 77 days by 2022.
There was considerable variation in wait times among patients. In 2022, a quarter of face-to-face appointments were scheduled within ten days, while the longest waits exceeded 258 days. For telehealth services, wait times that year ranged from 11 to 235 days.
Location also played a significant role, with people in regional and remote areas consistently facing longer wait times than those in major cities, regardless of whether the service was in-person or via telehealth. This urban–rural gap remained consistent over time, except during the early phase of the COVID-19 pandemic, when fewer lockdowns and movement restrictions in rural areas temporarily reduced delays for in-person services.
Our study did not examine the specific reasons behind increasing wait times. However, the rise does not appear to be driven by greater demand, as the total number of psychiatry appointments has remained relatively stable. In 2020, there were 108630 first appointments (both in-person and telehealth), compared to 111718 in 2021 and 104214 in 2022.
Telehealth has often been promoted as a game changer for Australians in regional and remote areas, offering access to psychiatric care without the burden of long-distance travel. Its use surged during the COVID-19 pandemic, with first psychiatry appointments via telehealth rising from just 2066 between 2011 and 2019 to 12860 in 2020, and reaching 27527 by 2022.
Despite this growth, our findings suggest that telehealth largely replaced in-person visits rather than increasing overall service capacity. Since telehealth consultations still require psychiatrists’ time, they did not contribute to reducing wait times.
What are the implications?
The steady increase in wait times over the past decade is particularly concerning for high risk individuals with severe mental illnesses such as schizophrenia, severe depression, and bipolar disorder. Delays in accessing care for these patients can have serious consequences, not only for their own health but also for their communities.
These findings come amid growing strain on mental health services, including:
- prolonged delays for mental health patients awaiting hospital admission from emergency departments;
- a wave of resignations among public psychiatrists in New South Wales;
- persistent nationwide workforce shortages in the mental health sector; and
- significant out-of-pocket costs for psychiatric care.
Ensuring timely and equitable access to psychiatric services remains critical. Now more than ever, sustained focus is needed to address disparities and improve service distribution across Australia.
Dr Ou Yang is a senior research fellow at the Melbourne Institute of Applied Economic and Social Research, University of Melbourne.
Professor Yuting Zhang is a professor at the Melbourne Institute of Applied Economic and Social Research, University of Melbourne, and an Australian Research Council Australian Future Fellow.
Prof Zhang reported grants from Australian Research Council and an Australian Research Council Australian Future Fellowship award funded by the Australian Government (project ID FT200100630) during the conduct of the study.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, theMJAorInSight+unless so stated.
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