March 18, 2026 — 5:00am
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“It is almost certain that there will be a big bill at the end of this process … but I don’t see that so much as a cost to budget as a profound investment in a fairer, more decent Victoria.”
Those were the words of then-premier Daniel Andrews in February 2019, as he announced a royal commission into the state’s “broken” mental health system.
When that commission returned its findings in March 2021, there were tears in parliament. There was also a commitment from Andrews to implement all 74 recommendations and introduce new services and a mental health levy to help pay for them.
Last week it emerged a 31-year-old man at Barwon Health’s Swanston Centre in Geelong may have lost his life for want of a full-length, lockable door between a bedroom and a bathroom that separated him and another patient. Staff there say it is the fifth adverse outcome suffered by a patient in the unit since December.
A patient is accused of killing another patient at Geelong’s Swanston Centre last month.Justin McManus
But this problem is not new: Barwon Health admitted to the royal commission nearly seven years ago that conditions in the centre were so dangerous that the neighbouring University Hospital Geelong had been designated a high-risk public zone by police.
When Swanston Centre workers were surveyed by the Health and Community Services Union after the patient’s death, more than 70 per cent said they were not confident they could provide a unit free from violence or aggression.
What has happened to the promises of 2021?
The good news is that the mental health levy has raised more money than expected. The bad news is that this money does not seem to be making the required difference in outcomes across the state. Patients are still struggling to find beds in the system, and the use of seclusion – which the royal commission wanted eliminated – remains an issue.
What’s more, it is very difficult to scrutinise how this money is being used. The royal commission called for the creation of regional mental health boards to dispense funding, but after being legislated, they were shelved by the government.
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The royal commission also called for a new watchdog for the sector, the Mental Health and Wellbeing Commission. It envisioned the body being “able to initiate its own inquiries into matters that support its objectives”.
The government has instead chosen to scale back its funding and staffing, culminating in the announcement after Helen Silver’s 2025 review of government spending that the Mental Health and Wellbeing Commission would have one commissioner rather than four, and that it should concentrate on responding to complaints rather than investigating whether reforms were being effectively delivered.
Most alarmingly of all, the government’s proposed Entities Bill would allow the health minister to set the objectives of the commission, a body meant to hold the government to account. As a joint letter signed by mental health agencies put it: “Oversight that can be directed, narrowed or muted is not genuine oversight.”
When forensic psychiatrist Dr Rajan Darjee spoke to The Age, he said the tragedy at the Swanston Centre and others like it “occur in a system that is totally unfit for purpose. It’s just going to happen again somewhere else.”
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The royal commission noted that “historically, Victoria’s monetary investment in mental health has been low compared with many other parts of Australia”. Monash University professor Kevin Bell told its commissioners: “Victoria is not like a developing nation where lack of resources is an explanation for underinvestment in health.”
As premier, Andrews was clear-eyed about what failure to reform would mean: “People will continue to die, people will continue to be forever diminished.”
Yet, it now seems that the government’s spiralling debt and its commitments to the Suburban Rail Loop and other elements of the Big Build will end up cruelling the hopes Labor raised.
For the sake of the next patient admitted to a mental health ward in this state and their families, we need to make sure that a “fairer, more decent Victoria” isn’t consigned to the dustbin of history.
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The Age’s View – Since The Age was first published in 1854, the editorial team has believed it important to express a considered view on the issues of the day for readers, always putting the public interest first.From our partners