Restoring rights and realities: Reforming mental health policy for women and girls in NSW

The mental health crisis facing women and girls in NSW is urgent and largely ignored by current policy frameworks — and so the NSW Women’s Action Alliance has submitted a comprehensive response to the NSW Mental Health and Wellbeing Strategy consultation, calling for reforms that actually address the root causes of women’s mental distress.

The national crisis we are facing

The statistics show a devastating picture. In 2024 alone, 78 women were killed by men according to the Counting Dead Women project – up from 64 in 2023. The Prime Minister declared Australia faced a “national crisis” of male violence against women, with men killing women every four days.

But the crisis goes deeper than these headline figures. One in four women in NSW has been the victim of violent men from an intimate partner or family member since age 15 and men’s violence is a leading cause of homelessness, with women making up 75% of those seeking specialist homelessness services due to violent men.

For women in NSW correctional facilities, the statistics are even more harrowing: up to 98% have been victims of physical abuse, over 70% have lived with violent men in the home, and up to 90% have been victims of sexually violent men or survived childhood sexual assault.

The problem with current mental health policy

Despite these realities, current mental health strategies fail to adequately address the specific needs and vulnerabilities of women and girls. Three critical issues are undermining women’s mental health and safety:

1. The ongoing crisis of male violence. While NSW has well-developed systems, violent men continues to severely impact women’s mental health. Yet mental health policies consistently fail to address this as the systemic issue it is, instead treating it as an individual problem requiring individual solutions.
2. The erosion of female-only services. Policies that prioritise gender identity over biological sex have compromised services vital for trauma recovery. Research demonstrates that trauma-informed care for women requires safe environments free from further distress – yet services are increasingly repurposing themselves as general rather than female-only to pre-empt funding restrictions and backlash. This particularly impacts women in correctional facilities, where credible reports indicate jurisdictions have allowed male-bodied individuals to be housed in women’s prisons based on self-declared gender identity, with female prisoners expressing fear and retraumatisation.
3. Problematic policy frameworks that prioritise ideology over evidence. Young people with gender dysphoria face restricted therapeutic options due to conversion therapy bans that may be misapplied. While well-intentioned in preventing harmful practices related to sexual orientation, banning exploratory therapy may unintentionally push young people towards irreversible medical treatments with serious risks including infertility and sexual dysfunction.

Growing numbers of health authorities worldwide now mandate exploratory psychological interventions rather than blanket affirmation for young people with gender dysphoria, recognising the need for evidence-based approaches.

Areas that need reform

The NSWWAA submission outlines four key areas requiring immediate reform:

1. Restore and protect female-only spaces and services. The mental health system must recognise that female-only spaces and services are necessary for effective treatment of women, particularly those who have experienced male violence. Legal reforms may be required to ensure the legality of such services.
2. Implement evidence-based approaches to supporting young people. NSW should ensure young people navigating complex gender identity issues have access to a full range of therapeutic options. Professional psychological services should be excluded from conversion therapy bans for gender dysphoria.
3. Establish accurate data collection systems. Accurate sex-disaggregated data collection is essential for understanding who accesses female-only services and who perpetrates violence against women and girls. Current policies allowing sex self-identification obscure crucial data, undermining our ability to provide appropriate services.
4. Address the eating disorder crisis. Eating disorders impact more than 1.1 million Australians, with 27% of cases among those aged 10–19. In NSW, anorexia nervosa is among the most lethal mental health conditions impacting girls. Social media and pornography contribute to these disorders by normalising unhealthy body image standards.

The broader picture

Our submission also addresses critical issues often overlooked in mental health policy:

• Lesbians and same-sex attracted women face particular challenges as the shift to prioritise gender identity has disrupted communities and spaces, forcing them underground and leading to increased isolation and mental health impacts.
• The impact of harmful content targeting girls through social media algorithms that amplify content related to eating disorders, suicidal ideation, and gender dysphoria requires urgent attention.
• Perinatal mental health support needs strengthening, given that nearly one in five women experience mental health challenges during or after pregnancy.

The mental health and wellbeing of women and girls in NSW depends on policy-makers having the courage to address the real causes of our distress: male violence, discrimination, and the erosion of our sex-based protections and rights.

We call on the NSW Mental Health Commission to demonstrate leadership by:

• Protecting women’s access to female-only mental health services and spaces
• Ensuring conversion therapy bans do not prevent appropriate psychological support for young people with gender dysphoria
• Advocating for evidence-based approaches that prioritise women’s and girls’ safety and wellbeing
• Collecting and maintaining accurate sex-based data to inform policy
• Engaging in meaningful consultation with women’s organisations rather than tokenistic processes

Respectful, evidence-based dialogue is essential for shaping mental health policy in NSW. We urge policy-makers to listen to women and girls, prioritise our safety, and ensure our sex-based protections and rights are at the forefront of reform.

NSW must foster respectful debate on sensitive issues surrounding women’s rights and gender identity that does not mischaracterise legitimate concerns about women’s safety and wellbeing. We advocate for balanced, rights-based dialogue that considers conflicting rights guided by proportionality and open dialogue principles.

The strategy should recognise that addressing root causes requires courage to challenge narratives that may inadvertently harm those the mental health system seeks to protect.

The way ahead

Mental health reform that genuinely serves women and girls is possible – but only if we demand it. Our submission provides a clear roadmap for change that prioritises evidence over ideology, safety over political correctness, and women’s rights over institutional capture.

The question now is whether NSW will have the courage to implement the changes women and girls desperately need. We will be watching closely to see if the Mental Health Commission demonstrates the leadership required to address the real causes of women’s mental distress.

Read our full submission, below.