The NSW wages umpire on Friday awarded a special allowance to the state's public psychiatrists, providing a 20 per cent pay bump for 12 months in a bid to attract and retain staff.
It comes after a long-running dispute, which included more than 200 psychiatrists threatening to resign.
More than 60 followed through, while another 70 shifted from staff jobs to potentially more lucrative visiting roles.Â
Even before the mass resignations, more than 140 of NSW's 433 public hospital psychiatrist roles were vacant.
The special case justified a temporary allowance to attract and retain staff specialists, the NSW Industrial Relations Commission vice president said.
"There is an acute shortage of psychiatry staff specialists ... which is causing a deterioration in the quality of mental health care delivered in the public health system," Justice David Chin said.
"The comparatively low pay of psychiatry staff specialists is contributing to this shortage."
The mass resignations heaped pressure on the public health system, with some patients with mental health problems given beds in general wards and crisis meetings held to consider moving lower-acuity patients to the private system.
The shortage only worsened, the NSW chair of the psychiatrists' peak body said.
"Our mental health care system has gone from buckling to broken," Pramudie Gunaratne told reporters after the wage decision.
"This inaction is costing lives and it is tearing families and communities apart."
But the government said it always agreed public health staff deserved a raise.
"What we couldn't agree on is the exact figure," Mental Health Minister Rose Jackson said.
The cost of the interim raise is yet to be determined.
Its purpose of luring more psychiatrists into the system would increase the wages bill, Ms Jackson said.
The allowance will be absorbed in any eventual raise from another wage determination before the commission.
The minister has instructed local health districts to work with psychiatrists who resigned and wish to return.
Other parts of the system also need more support.
"This determination alone is not going to solve the broad challenges that we have in mental health," Ms Jackson said.
Justice Chin noted the allowance was in recognition of a special case being established, not a reward for the "industrial strategy" of threatening mass resignations.
But the resignations were individual decisions made by frustrated doctors, the state doctors' union said.
"Our psychiatry members have, for at least five years, been talking about a crisis in mental health," union executive director Andrew Holland said.
Forensic psychiatrist Ian Korbel initially put in his resignation but is now back at work.
Doctors who threatened to, or did, resign had decided "enough is enough," he said.
"We needed to do something," he told reporters.
Another application seeking a new comprehensive award for all doctors employed in the NSW public health system, including psychiatrists, will start in the commission in late November.
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