The Bondi Beach Massacre and NSW Mental Health — A System Unprepared for the Aftermath
When mass violence meets an already failing mental health system, who will care for the community's trauma?
Two weeks ago, the community who consider Bondi in NSW to be their home directly experienced a horrific act of violence that will impact many for years to come. It is likely that some clinicians and health care professionals from this community were caught up and connected to the suffering in a very direct way. The same clinicians that other victims will attempt to rely on for the distress they experience. Some victims will need long term treatment and care, but we know that many will be turned away from a system that has been deemed entirely unfit for purpose by many key leaders and advocates, especially in recent times.
Mass violence and loss of life has the ability to wreak havoc on the communities that were targeted. There have been many statements made about the need for support, and the importance of coming together, demonstrating resilience, connection and bravery like never before. While these are well intended acts and ambitions, many of those affected are going to need intensive therapeutic care to get to that place.
NSW Health has been in the spotlight for all the wrong reasons this year, like many other health care systems around the world, with claims of understaffing, lack of resources and a loss of a vital workforce. While actions to target future gun violence in Australia, and a call for a Royal Commission are well meaning and valuable, we also need answers now about how NSW Health is going to manage the huge influx of demand, apart from short term one-off crisis services. An initial barometer of need was demonstrated by the crisis hotline Lifeline, a national service recording more than 4,300 calls in their busiest day of the year, in the 24 hours after the shootings occurred. Timely and accessible crisis responses are crucial, but they are not holistic and will not address the longer term needs of many victims of the Bondi tragedy.
In 2025 the NSW Government was forced to provide a pay rise and a 12 month cash injection to public sector psychiatrists by the Industrial Relations Commission (IRC).Psychiatry advocates lobbied extensively and in the end were awarded a pay rise to attempt to create pay parity with other states, which would mean a tangible way to stem the losses of the psychiatry workforce. It was an attempt to improve retention rates, as many move to the private system, relocate to another state or leave their profession. Extensive media coverage highlighted that numerous services making up the NSW mental health system have indeed “shut up shop”.
Despite the extra funding for psychiatrists, little has been said about how this pay rise has led to actual change or improvement. We don’t know how many psychiatrists have made a commitment to working in the public mental health system because of the improvements in pay parity compared with other states, and if this has been enough to open closed doors. We also don’t know how many psychiatry trainees have had disruption and delay to their journeys due to lack of supervision by psychiatrists. We absolutely don’t know if a person presenting for therapeutic care will receive a tailored response, that is not time limited and provided by a clinician with the wrong skill set for the role. What must be disclosed is whether this action resulted in more psychiatrists being available to pick up the overwhelming demand that will be seen over months and not hours or days following December 14, 2025.
In addition, the findings of the coronial inquest into the Westfield Bondi stabbing attack were due to be released at the time the Bondi massacre occurred, but they were withheld out of respect until 2026. But preliminary findings have already revealed some of the shortcomings and failures of the NSW mental health system, supporting many of the claims made by psychiatrists to the IRC. While a lot of anger was directed at the perpetrator’s former treating psychiatrist, it was confirmed that many experiencing acute mental illness are falling through the cracks and left to fend for themselves when they are the most unable to, and the most vulnerable.
Those of us who work with victims of abuse or violence are aware that people who have directly experienced a life threatening event, whether being present and physically wounded, nearby and fearing for their life, or who witnessed the tragedy unfolding on endless newsreels, can go on to develop post traumatic stress disorder, PTSD. We know that those who have developed PTSD from other life threatening events such as the Lindt cafe siege, can experience a return or exacerbation of symptoms of PTSD when they experience further life threatening events. It is poignant to remember that the Bondi Beach massacre occurred on the 11th anniversary of the Lindt Cafe siege. People can have what are called “anniversary reactions” where they notice more distress as they are reminded of the event on a significant day such as an anniversary. Many will be struggling even more with both the anniversary and the details of the massacre being spoken about on all forms of media.
In addition, it is crucial to remember that victims can develop different symptoms or disorders. Some may not even be aware they are affected, with their distress experienced as a relapse into substance use, anger, or disturbed sleep. They may not present for help as they don’t feel worthy of the help, deeming others who were directly injured more deserving. Family members may notice a difference before they do. The take home message is that so many come to the attention of clinicians via various means and with varied presentations that are not simply the need to talk to somebody about how they are feeling as “once-off”.
It seems probable that the NSW mental health system will not be able to cope with the increase in demand as those coming forward seek help. The community of Bondi will need its own approach to improving accessibility as clinicians there deal with their own distress. It is unknown as to what improvements to the system were made by giving psychiatrists a pay rise this year. And we have already been informed by the recent NSW coroners inquest that many with mental illness which was present before both these tragedies in Bondi were simply not being given timely and tailored care.
This is an opportunity to lean on this knowledge and be proactive. An opportunity I envisage will be missed demonstrating again that those with mental illnesses are not supported at times of need, despite all the evidence and insight we have to do things better.