About $600 million a year would be needed to fix the state’s shortfall of frontline public mental health staff, a confidential ministerial briefing note says, a figure NSW Health warned could cause reputational damage to the Minns government if revealed.
An infrastructure investment well above $700 million would also be necessary to support the expanded workforce, says departmental advice to Mental Health Minister Rose Jackson in late 2024, contained among hundreds of documents released through parliament.
The estimates mark the first time the government’s assessment of unmet demand in the mental health sector has been released publicly, and come after years of crisis in the sector which included the mass resignation of psychiatrists. The documents also illustrate the efforts to obscure the findings of a landmark report into the funding of mental health services.
More than three years after announcing the investigation to identify mental health service resources and gaps in NSW, Jackson released the Review and Planning for Mental Health Services (RaP-MHS) report in late August. However, there were allegations the report obscured the true extent of staff and resource shortages affecting the vulnerable.
A NSW Health briefing note captured in a parliamentary call for papers reveals the minister’s office requested advice on the risks of releasing a gap analysis that highlighted the shortfall between the current provision of mental health services and total unmet demand.
The advice, signed on December 17, 2024, provided a preliminary, high-level estimate of between “$550 million and $600 million” each year to engage the clinical and support staff necessary to close the demand gap.
This figure only covered staffing and excluded “broader operational costs or necessary infrastructure” to support the expanded workforce, the department said. While detailed modelling was not completed, the investment in infrastructure “would safely exceed” $700 million – “the largest mental health infrastructure commitment in NSW over the preceding decade”.
“Releasing the full quantum of the gap could require NSW to deliver one of the largest expansions of mental health services (and infrastructure) in recent history,” it stated.
The state government’s budget in June allocated $112.3 million for mental health and suicide prevention services, but mental health advocates said $108 million of this funding was simply re-announcements of previous commitments.
The department argued releasing the gap figure publicly would be out of step with “established practice and use of the tool by NSW Health”. Moreover, releasing the information could create pressure to “deliver a large and unprecedented increase” in mental health funding without first identifying the staff or infrastructure needed to support the expansion of services.
“Release of the full quantum of the gap may potentially cause reputational damage to the government and NSW Health, even if investment were available, should required staffing be unable to be recruited or retained,” the December briefing note stated.
In response to questions, Jackson said the report released by the government was comprehensive and already being applied to direct resources to community services, which she described as the “most important thing we can do for people who need quality mental health care”.
She said the report was released to better understand the gaps in mental health care in NSW, but “the work is certainly not over”.
“If there is still a desire to proceed with another stage of quantum analysis then I’m open to that.”
Emails show a NSW Health director warned in February 2025 that undertaking a more comprehensive analysis of the state’s demand gap would “suggest the need for a budget many times greater than the existing [mental health] budget to address those issues”.
“The psychosocial work is already indicating that we’d need to double the budget [to] meet those unmet needs,” she wrote.
Amanda Cohn, the Greens spokesperson for mental health, said the documents put a dollar figure on the gap that “anyone who has needed or works in mental health care knows exists”.
“Public mental health services are so stretched they are only able to provide reactive crisis care, rather than the long-term care people need in the community before they become really unwell,” she said.
“There is evidence that the Minns Labor government tried to bury the extent of gaps in mental health services rather than repair them.”
RANZCP NSW branch chair Dr Ian Korbel said it was “deeply disappointing” that the recurrent funding shortfall was not shared publicly.
“It would give us something to aim for,” he said. “It tells us what we need to be doing ... to adequately service community mental health needs.”
A briefing note from NSW Health shows Jackson was advised in April 2024 that detailing the extent of under-funding carried “the potential for criticism and misrepresentation”.
Instead, NSW Health staff advocated for what they called a “new, innovative approach to reporting” which would compare statewide and Local Health District-specific resource gaps with the state or national average, rather than using a target benchmark.
Korbel said this method – which was used throughout the final report – essentially obscured the data: “All it does is show that you’re doing as badly as everyone else.”
Giancarlo de Vera, the chief executive of BEING Mental Health Consumers, said the government should complete and publish the full gap analysis.
“The department worked out what it would cost to staff its own mental health services to the level the national framework says people need. Then it told the Minister the public should not see the number because of the pressure it would create,” de Vera said. “The public has a right to know.”
NSW Health did not respond to a request for comment by deadline.
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