Raewyn Pepper screamed for days when she checked into a Tamworth mental health hospital in 1996, thinking she had been operated on.

By that stage, the then 38-year-old had been suffering from hallucinations and hearing voices in her head for several months.

"I remember feeling like I had been operated on in the Second World War by the Nazis, I could actually feel the pain of all that," she said.

"I was apparently screaming for a couple of days before I had any intervention."

She was diagnosed with schizophrenia, brought on by extreme pressures from her transport business and family life.

"My children, it hurt them a great deal because it's like it lost their mum, they didn't know who they had as a mum," Ms Pepper said.

'It can be quite funny'

According to the Mental Illness Fellowship of Australia, Ms Pepper is one of about 200,000 people affected by schizophrenia.

"It can be quite funny, I've had some interesting voices over the years," Ms Pepper said.

"I had Cathy Freeman, encouraging me to get fit, and I was doing a lot of walking at the time, I felt very enlightened."

But Ms Pepper said some symptoms left her considering suicide.

Support becomes difficult

Ms Pepper said during the 1990s she was able to receive in-home care, with mental health nurses visiting her regularly.

Now she can get medication to help manage lingering symptoms and local services to help with basic living assistance.

But when more severe symptoms emerge she heads to the emergency department.

"Before you could ring the local mental health hospital, or your mental health nurse and they would come and support you," Ms Pepper said.

Her concern with the current system is that people experiencing schizophrenia may not go to hospital on their own because they are unaware of what is happening to them.

"By the time they get noticed they are very unwell," she said.

Mental health services

In a statement, a spokesperson for Hunter New England Health said it had expanded service delivery over the past five years, giving the community access to an enhanced outreach program available after hours. 

The spokesperson said that for people whose problems were more severe and complex "treatment in a hospital inpatient unit may occur for a limited period of time".

Services available in the region include the Safe Haven facility in Tamworth, the Coledale clinic supporting local Aboriginal and Torres Strait Islander people, and the Farmgate initiative for primary producers.

A new mental health unit in Tamworth is expected to open in 2025. 

Mental Illness Fellowship of Australia chief executive Tony Stevenson said mental health had been neglected by state and federal governments for decades.

"Governments promised when they closed psychiatric institutions in the 1980s that there would be support available for people to live well and to live safely in the community," he said.

"That's with housing, employment, just the daily living skills."

Recently, the NSW Legislative Council found the fragmentation of mental health services in NSW had led to extraordinary difficulties for mentally ill people and their carers.

The committee made 39 recommendations.

Committee chair Amanda Cohn said people experiencing mental and emotional distress "either don't know where to go or can't access services".

New funding challenged

The NSW government has announced $111.8 million to support community mental health, including $30.4 million over four years to expand teams caring for those with persistent and complex symptoms.

Premier Chris Minns said the funding would provide about 35 additional mental health positions.

"There will be an additional five people whose specific job will be for outreach mental health housing liaison positions," he said.

But Dr Cohn doubts those roles will be filled.

"We heard through the inquiry that those services have sweeping vacancies across NSW," she said.

"Those positions can't be filled because pay and conditions for health workers aren't acceptable."