Professor Jackie Curtis, the Executive Director of Mindgardens Neuroscience Network, has welcomed the recommendations of the NSW State Coroner for mental health system reforms to provide more intensive and consistent care for people living with severe mental illness.

In her final report today in the Bondi Junction Inquest, addressing the killing of six people in 2024, Magistrate Teresa O’Sullivan found that the perpetrator, who was homeless, was suffering a relapse of his chronic schizophrenia when he stabbed the victims at Westfield Bondi Junction, and that multiple mental health system failures meant his deteriorating mental health was not properly detected or acted upon.

Magistrate O’Sullivan recommended that within a year, the NSW Government should prepare to fund and staff, “outreach psychiatric services that can effectively … evaluate and engage people with severe untreated mental illness, including people without housing,” she wrote. She also recommended improving collaboration between private psychiatrists and public mental health services and GPs, to ensure clinicians had a complete understanding of a person’s previous mental health history, called for clearer guidance about when it was appropriate to bring people off their mental health medications, and recommended the establishment of short-term and long-term housing options with on-site mental health care.

Professor Curtis said the recommended actions, “have the potential to improve the quality of treatment for people with severe mental illness, and in turn improve safety for the community and for the people themselves. I extend my deep sympathy to those who lost loved ones at Bondi Junction and others who were injured. Violence is rare among people with psychosis but its consequences can be devastating.”

The effectiveness of the proposed reforms would depend on how they were actioned, said Professor Curtis, who is a psychiatrist specialising in complex mental health conditions. “They will need to be implemented collaboratively with all relevant professional groups, in consultation with people living with mental illness and their family members, and with proper resourcing,” she said.

Professor Curtis said services and research investment in complex mental illness were under-funded in comparison to other health conditions. “People who experience schizophrenia and other psychotic disorders are some of the most neglected and vulnerable in our community, and it is time to focus on providing equitable health care for them,” she said. “By providing health, social and lifestyle supports tailored to the needs to this group, we can keep people engaged in treatment, ensuring their conditions are effectively managed and allowing us to recognise promptly if someone’s health is deteriorating.”

Programs like Keeping the Body in Mind, offered in the south eastern Sydney region to prevent and address physical health conditions in people receiving mental health care, were essential to improving outcomes for people living with psychosis, said Professor Curtis, and could be delivered alongside the assertive care and housing supports recommended by Magistrate O’Sullivan.

“People who experience schizophrenia often face very unstable lives, including inadequate housing, poor nutrition and drug and alcohol use,” she said. “We have a collective responsibility to provide services that are accessible and welcoming to clients who have often experienced barriers with the health system and may find it exceptionally hard to reach out for the support they need.”

“Mindgardens and its partners are committed to advancing integrated, evidence-based care models that improve early intervention, coordination, and sustained support for people with psychotic disorders. The State Coroner’s findings provide an important opportunity to accelerate these efforts.”