An evidence-based case for the Goldfields

Kalgoorlie Deserves Better

6 beds. 60,000 people. 596 kilometres to Perth.
The Goldfields needs a real mental health facility.
The evidence says it should be voluntary, open-door, and community-led.

We are external advocates for mental health and suicide prevention in the Goldfields. We believe every person in crisis deserves immediate, local, compassionate support — and we believe that support must never come at the cost of a person's autonomy or dignity.

This isn't ideology. Everything on this page is sourced from peer-reviewed research, government data, and real-world programs that have been running for decades. Every claim has a citation. Every number is checkable. We got it wrong? Show us. We'll fix it.

The Problem

The Goldfields-Esperance region covers an area larger than France. It has some of the highest suicide and violence rates in Australia. For acute mental health care, there are six beds.

6
Acute mental health beds at Kalgoorlie Health Campus for the entire Goldfields region
WACHS
43.2
Suicides per 100,000 men in WA Outback — the highest of any region in Australia. National average: 11.8
AIHW 2019–2023
33.9
Suicides per 100,000 Aboriginal and Torres Strait Islander people — 3x the non-Indigenous rate, rising 30% over 5 years
ABS Causes of Death 2024
596 km
Distance from Kalgoorlie to the nearest major mental health facility in Perth. Transfer cost: ~$19,000 per patient
RFDS / PMC 2020
234%
Kalgoorlie-Boulder's violent crime rate above the national average. The suburb itself: 677% above
RedSuburbs 2024
1.9
Psychiatrists per 100,000 people in very remote areas. Major cities have 15.1 — an 8x gap
Looi et al. 2025

What this means in practice

When those 6 beds are full — and they are often full — a person in mental health crisis in Kalgoorlie is flown 596 kilometres to Perth by the Royal Flying Doctor Service. They are separated from their family, their community, their country. For Aboriginal people, this separation can be the opposite of healing.

The region's Aboriginal communities experience suicide at nearly three times the non-Indigenous rate. Aboriginal young people aged 10–19 die by suicide at 4.5 times the rate of other Australians. Self-harm hospitalisation rates for Aboriginal girls aged 15–19 aremore than 10 times the national average.

Meanwhile, 90% of psychiatrists and trainees say workforce shortages are harming patient care. 85% of full-time psychiatrists work in metropolitan areas. The Goldfields relies on telehealth and fly-in-fly-out clinicians — a model the WAAMH's Going the Distance report (2023) called "unsustainable" and "ineffective."

Our Position

Kalgoorlie needs more mental health support. Urgently. But we do not believe the answer is to lock people up.

We advocate for a facility that is voluntary, open-door, and community-led — because that is what the evidence supports.

This is not a fringe position. It is the position of the World Health Organization, the Productivity Commission, and forty-five years of real-world data from programs operating on three continents. Involuntary detention is not just ethically fraught — the research shows it produces worse outcomes on the metrics that matter most: suicide, recovery, readmission, employment, and cost.

What the Research Says About Coercion

The assumption that locking someone in a ward keeps them safe is not supported by the evidence. These are large-scale studies published in the world's leading medical journals.

The Lancet, 2025
Sweden. 72,275 people discharged from involuntary psychiatric care over 10 years.
1 in 64 died by suicide. Risk remained 343% elevated at 5 years compared to voluntary patients.
Involuntary care did not prevent suicide. Suicide risk was highest immediately after discharge and stayed elevated for years.
Frontiers in Psychiatry, 2019
Systematic review of seclusion and physical restraint in psychiatric settings.
25–47% of patients developed PTSD from being restrained or secluded. 70% of those most restrained had histories of childhood abuse.
Restraint re-traumatises people with trauma histories — the very people most likely to be in crisis. The intervention worsens the condition it claims to treat.
Lancet Psychiatry, 2024
Norwegian RCT comparing open-door wards to locked wards.
Open-door wards: 26.5% coercion exposure. Locked wards: 33.4%. No increase in adverse events.
Unlocking the door did not make people less safe. It made staff engage more carefully with patients — because they couldn't rely on a lock as a substitute for care.
PMC, 2023
Study on the impact of involuntary admission on young people's future help-seeking.
Coercive experiences damaged trust and reduced willingness to seek help in the future.
For young people in the Goldfields — where early intervention matters most — a bad first experience with mental health services can mean they never come back.

What Actually Works

These are not theoretical proposals. They are real programs, running right now, with decades of outcome data. They work better than locked wards on every measure.

Western Lapland, Finland

Open Dialogue

81% had no residual psychotic symptoms at 2 years. 84% returned to work or study. Schizophrenia incidence dropped from 35 to 7 per 100,000.

Treatment begins within 24 hours in the person's home, with their chosen support network present. Medication is a last resort, not a first response. Only 33% needed neuroleptic drugs. Operating since the 1980s.

Trieste, Italy

Trieste Model

In 2016, only 20 people in a city of 240,000 received involuntary treatment — fewer than 7 per 100,000.

Italy closed every psychiatric hospital in 1978. In Trieste, they were replaced by 4 community mental health centres, open 24/7, each with 6 beds and ~26 staff. Open door. No restraint. The WHO designated it a Collaborating Centre. It has been running for 45 years.

California, USA / Berne, Switzerland

Soteria Houses

76% of residents received no antipsychotic drugs at all — and did better than medicated hospital patients.

Home-like environment, non-professional staff, emphasis on relationship and being-with. Founded by the chief of the US National Institute of Mental Health's schizophrenia division. Replicated in Switzerland with equivalent outcomes.

Skokie, Illinois, USA

Peer Crisis Centres (Living Room)

93% emergency department deflection rate. Saved ~$550,000 in one year at a single facility.

Entirely peer-led — run by people with lived experience of mental health crisis. Named after a living room because it's designed to feel like one. Guests report feeling 'more seen, heard, and respected than in conventional settings.'

Eugene, Oregon, USA

CAHOOTS

35 years of operation. 24,000 calls per year. Police backup needed ~2% of the time. Zero people killed.

A medic and a crisis worker respond to mental health calls instead of police. Saves ~$22.5 million annually in public safety and emergency costs. Running since 1989.

Geraldton, Western Australia

Maga Barndi

58% reduction in psychiatric admissions for Aboriginal patients.

Run through the Geraldton Regional Aboriginal Medical Service. Culturally safe, community-controlled, with traditional healers alongside clinical staff. This is not from overseas — it's 600km up the coast from Kalgoorlie, and it works.

What We're Asking For

A purpose-built, voluntary, community-embedded mental health facility in Kalgoorlie-Boulder. Based on models that have been proven to work — including one already operating in regional WA.

1

A 24/7 Community Mental Health Centre

Following the Trieste model: open around the clock, open door, with beds for short stays and a team embedded in the community — not flying in from Perth. Trieste runs 4 of these for 240,000 people. Kalgoorlie needs one for 60,000.

2

A Peer-Led Crisis Space

Based on the Living Room model: staffed by people with lived experience, designed to feel like a home, not a hospital. A place you'd actually go to when things are bad. The data says 93% of people who walk into one don't need the emergency department.

3

Culturally Safe Indigenous Healing

Not an add-on. Not a pamphlet in a waiting room. A program designed and governed by Aboriginal communities in the Goldfields — with traditional healers, on-country programs, and yarning circles as core treatment, not afterthoughts. Maga Barndi in Geraldton proved this reduces admissions by 58%.

4

Mobile Crisis Response

A clinician and a peer worker who go to people in crisis — at home, in the community, wherever they are. Not police. CAHOOTS has been doing this for 35 years. WA is already trialling co-response teams in metro areas. The Goldfields needs one.

5

Expand Step Up / Step Down

The existing 10-bed Neami Step Up/Step Down facility in Kalgoorlie is a good start. The $9.9 million commitment to transition it to a public facility is welcome. But 10 voluntary short-stay beds and 6 inpatient beds for a region of 60,000 is not enough. Double it. Triple it. The cost of a bed is a fraction of the cost of a transfer to Perth.

6

Local Workforce, Not Fly-In-Fly-Out

The WAAMH report said it clearly: fly-in-fly-out mental health services are unsustainable and ineffective. Fund positions that live in Kalgoorlie. Grow the workforce locally — the Goldfields Aboriginal mental health team already does this with all-Aboriginal staff chosen for their community connections. Expand that model.

The Economic Case

Mental ill-health costs Australia $200–220 billion per year. That's $550–600 million per day. The Productivity Commission found that every dollar invested in reform returns roughly five.

Each aeromedical transfer from Kalgoorlie to Perth costs approximately $19,000. That's the cost of one transfer. A community mental health worker's annual salary would cover a few dozen of them — and would prevent the crises that cause the transfers in the first place.

CAHOOTS saves $22.5 million per year for one city. The Living Room saved $550,000 in its first year at one facility. Peer respite centres produce fewer hospitalisations andlower Medicaid expenditures in the year following contact.

This is not a cost. It is a saving.

A Note on Autonomy

We believe in mental health support. We do not believe in locking people up.

This position is sometimes characterised as naive or dangerous. The evidence suggests the opposite is true. The Swedish Lancet study — 72,275 people over ten years — found that involuntary detention did not prevent suicide. The risk remained catastrophically elevated for years after discharge. Seclusion and restraint cause PTSD in a quarter to nearly half of patients.

Open-door wards are not less safe. They are, according to the Norwegian RCT, more safe — because they force staff to actually engage with patients rather than substituting a locked door for care.

Italy closed every asylum in 1978. Forty-five years later, Trieste — the city that did it first — is a WHO Collaborating Centre, with better outcomes than most locked-ward systems in the developed world.

The people of Kalgoorlie deserve support that treats them as people, not as risks to be contained. That is not naive. It is what the data demands.

How You Can Help

Share This Page

The most powerful thing you can do right now is make sure more people see this. Share it with your local member, your community group, your family. The evidence is on this page — let it do the work.

Contact Your Representatives

The Goldfields sits in the state electorate of Kalgoorlie and the federal division of O'Connor. Write to your member. Reference the Productivity Commission report, the WAAMH Going the Distance findings, and the models that work. Ask why 60,000 people have 6 beds.

Support Existing Services

Neami National runs the Step Up/Step Down in Kalgoorlie.headspace Kalgoorlie serves young people.Hope Community Services provides advocacy.WAAMH advocates at the state level. These organisations are already doing the work — support them.

If You're in Crisis

Lifeline: 13 11 14 (24/7)
13YARN: 13 92 76 (Aboriginal & Torres Strait Islander crisis line)
Beyond Blue: 1300 22 4636
Kids Helpline: 1800 55 1800
Kalgoorlie headspace: (08) 9021 5599

Sources

Every claim on this page is backed by published data. If something is wrong, tell us. We will correct it publicly and immediately.

  1. 1.AIHW — Suicide by regions and local areas(2024)
  2. 2.AIHW — First Nations people suicide monitoring(2024)
  3. 3.AIHW — Regional and remote communities(2024)
  4. 4.WACHS — Kalgoorlie Mental Health Inpatient Unit(2024)
  5. 5.Suicide after involuntary psychiatric care in Sweden — The Lancet Regional Health Europe(2025)
  6. 6.Effects of seclusion and restraint — Frontiers in Psychiatry(2019)
  7. 7.Open Dialogue: two-year outcomes — Seikkula et al.(2006)
  8. 8.Soteria systematic review — PMC(2008)
  9. 9.Trieste open-door no-restraint system(2014)
  10. 10.The Living Room: peer crisis alternative(2013)
  11. 11.CAHOOTS — Vera Institute case study(2024)
  12. 12.Maga Barndi — Indigenous mental health, Geraldton WA(2018)
  13. 13.Open-door psychiatric wards RCT — Lancet Psychiatry(2024)
  14. 14.Peer-staffed crisis respite effectiveness — Psychiatric Services(2018)
  15. 15.RFDS mental health retrieval costs — PMC(2020)
  16. 16.Productivity Commission — Mental Health Inquiry Report(2020)
  17. 17.WAAMH — Going the Distance report(2023)
  18. 18.RANZCP — Workforce shortages risking patient care(2024)
  19. 19.Mental health workforce by remoteness — Looi et al.(2025)
  20. 20.Healing Houses systematic review — Journal of Mental Health(2024)
  21. 21.WA Mental Health Act 2014 — Statutory Review(2024)
  22. 22.RedSuburbs — Kalgoorlie-Boulder crime statistics(2024)