The resignation of 55 NSW public-sector psychiatrists - part of a cohort of more than 200 who previously signalled plans to quit - has exacerbated already stretched services in the nation's largest health system.
At least 28 specialist hospital beds have been closed in recent weeks amid the doctors' push for a significant pay rise, as well as improvements in mental health services.
Rose Jackson concedes staff shortages in NSW public hospitals are "not anything new". (Bianca De Marchi/AAP PHOTOS)
Wait times for the emergency department at Westmead Hospital, in Sydney's west, showed a patient with chronic schizophrenia waiting 88 hours for a bed on Tuesday, while another patient with suicidal plans had waited 86 hours.
NSW Mental Health Minister Rose Jackson conceded those conditions were "not anything new" for a system already with a third of specialist psychiatric positions vacant before the mass resignations.
But UNSW associate professor Chris Ryan, who is a working psychiatrist, said patients with significant mental health problems were being given beds in general wards that lacked appropriately specialised staff and suitable conditions.
Pramudie Gunaratne (C) says patients are being placed in inappropriate environments. (Neve Brissenden/AAP PHOTOS)
"They're being admitted under general physicians, not psychiatrists - endocrinologists and drug and alcohol physicians and neurologists, and I've got to say, in some ways that's an even more frightening prospect," he told AAP on Friday.
"The general hospital isn't designed to look after people with psychiatric problems (but psychiatric wards) are, the nurses there are psychiatrically trained ... and of course, they're being looked after by psychiatrists, people that know about psychiatric illness."
Royal Australian and New Zealand College of Psychiatrists NSW chair Pramudie Gunaratne said using general wards for psychiatric patients still added pressure on the overall health network and would leave them being treated by staff who were not suitably equipped.
"It's really frightening the government is willing to go to these lengths to sanitise their numbers," she said.
"(It is) placing patients in inappropriate environments and they don't seem to have a plan for how to actually manage that in a safe way."
NSW Health secretary Susan Pearce insisted no one was being asked to work beyond their scope of practice after the state rolled out a plan to use nurses, psychologists and other allied health staff to help deal with the psychiatrist shortfall.
Susan Pearce says nurses, psychologists and other allied health staff are helping with the crisis. (Dan Himbrechts/AAP PHOTOS)
"(They are) very, very skilled people, they are able to work at an advanced level," she said.
"No one is suggesting they take the role of a psychiatrist, nothing we have done so far in the extensive contingency planning work we've done has indicated that."
Psychiatrists have asked for a 25 per cent pay rise - a figure the NSW government says it cannot afford - claiming that poor working conditions have created the gaping hole in the system.
"Why would people come into a system not only for less pay, but also a system that's just really unpleasant to work in, they're just not going to and they're not," Assoc Prof Ryan said.
The parties will go to the Industrial Relations Commission for a five-day hearing from March 17.
