Through a glass, darkly: Providing safe care in an under-resourced mental health system

The coronial inquest into the Westfield Bondi Junction tragedy has raised issues that warrant action to prevent similar events. The inquest has highlighted the inadequacies of the provision of care for people with severe mental illness. While these care shortfalls may now be increasingly understood by the public, there is relatively limited appreciation that there remain substantial limitations on the ability of public and private mental healthcare professionals to effect interventions. Lack of acute hospital capacity, staffing shortfalls, and inadequate accommodation and psychosocial supports undermine comprehensive care. Apportioning of responsibility without ability to act leads to an impasse, where clinicians may exit provision of unsustainable care, unless systemic reforms recommended by the coroner are forthcoming.