Frontline employees at Westmead Hospital in Sydney's west have been subject to a significant increase in aggression from patients, including one high-profile incident where multiple security guards and a nurse were injured when a 39-year-old patient allegedly slashed at staff.
In the past five years, the hospital has also experienced a 31 per cent increase in presentations where a patient is experiencing mental health or behavioural issues.
These issues are sometimes related to substance abuse and can be exacerbated in an emergency department environment.
But a new six-bed unit could help improve mental healthcare, keep staff safe, and reduce waiting times in the emergency department.
It will be better suited for patients who are at risk of becoming aggressive or agitated and will provide a secure environment to help those experiencing distress.
"Some patients don't deal well in the loud, busy environment of an emergency department, it can cause them to behave in a way that puts the safety of our staff and other patients at risk," NSW Mental Health Minister Rose Jackson said.
"That's why we're building a new, specialist unit to divert these patients away from the ED waiting room."
The problem is not unique to Westmead Hospital, with a NSW Nurses and Midwives' Association report revealing 88 per cent of nurses, midwives and carers had experienced violence in the previous year.
Similar initiatives already introduced at other NSW hospitals have helped reduce the need for sedation and restraint, while cutting the length of stays and waiting times in emergency departments.
Nepean Hospital opened a new short-stay unit in mid-2025 to provide a calm, low-stimulus environment designed to minimise triggers and enable the de-escalation of patients facing mental health and substance abuse challenges.
As of September, it had already helped more than 250 patients.
Prince of Wales Hospital in Sydney's east also opened an emergency department assessment unit in 2024 to provide care for those who are intoxicated or present with behavioural issues related to substance use or psychiatric conditions.
The latest announcement at Westmead has been welcomed by the NSW Nurses and Midwives' Association, whose members worked with the state government on the initiative.
"The unit will strengthen hospital safety, improve patient outcomes, and is a strong investment into the future of our public health system," the union's general secretary Michael Whaites said.
The new unit will begin construction in August with expected completion in early 2027.
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