July 22, 2026 — 5:47pm
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Fifty per cent of all mental health disorders emerge before the age of 14, yet access to early specialist care remains appallingly limited, with services increasingly focused on adolescents in acute distress.
Ethan Annetts is emblematic of the crisis facing many. He was 11 when he started self-harming and spent years on assessment waitlists, trapped in a cycle of hospital presentations and discharges with no ongoing care until, as a desperate and suicidal adult, he finally saw a psychiatrist.
Many children with mental health problems don’t get the professional attention they need.Fairfax Media
Ethan’s story, as told to the Herald’s health reporter Rachel Rasker, is the victory of the human spirit at a time when the well-being of Australia’s young people is declining, with depression and anxiety diagnoses skyrocketing and suicide now the leading cause of death for young people. More than 300 die annually.
A new report from the Royal Australian and New Zealand College of Psychiatrists finds too many children are missing out on specialist mental health care until they are older, sicker and in crisis.
About one in seven children is living with a mental health disorder, and the college predicts a shortfall of at least 230 child and adolescent psychiatrists by 2028.
NSW has the worst child and adolescent psychiatrist shortage in the country. The college said 64.3 full-time child and adolescent psychiatrists are needed just to meet the current demand of families across NSW. By 2048, that shortfall is projected to grow to 119.
The state’s psychiatrist shortage is almost triple that of Victoria. Nationwide, there is just one specialist for every 571 children with moderate to severe mental illness.
NSW community mental health teams receive the lowest state government funding per capita of any Australian state. The dire situation has also been exacerbated by the flight of some child psychiatrists into private medicine since 2024, when more than half of the state’s staff specialist psychiatrists resigned in protest over pay rates in an attempt to save the state’s failing mental health system. Not all have returned to the public system.
Potentially adding to the crisis, the federal government’s Thriving Kids policy will move children with mild to moderate developmental delays or autism off the National Disability Insurance Scheme and into state-based mental health systems.
Details about the transition have yet to be finalised despite its rollout date of October 2026. But Professor Valsamma Eapen, who led the RANZCP report, said resourcing constraints meant children could access help only after their condition became severe, and Thriving Kids could “add more pressures onto the already stressed system”.
NSW Mental Health Minister Rose Jackson said in a statement she recognised the growing demand and acknowledged there was “always more work”, adding her government had invested in recruitment, training and new models of care to strengthen the mental health workforce and improve access.
Clearly there is a disconnect between the state and the profession. But child psychiatrists are not optional extras. They are professionals essential to the mental health system. The government needs to make sure there are enough of them to do it.
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