Mass resignations amid warnings of a crisis and a court's looming decision on psychiatrist pay could force Australia's largest health system to come up with millions of dollars more funding.

The NSW Industrial Relations Commission will hand down its decision on Friday in a wages dispute between the state's public psychiatrists and the government.

The psychiatrists had asked for a one-off, 25 per cent pay rise, arguing comparatively lower pay than in other jurisdictions and the private sector had created staff shortages in NSW.

More than 200 of the state's psychiatry cohort threatened to resign, with more than 60 following through while another 70 shifted from staff jobs to potentially more lucrative visiting roles.

Even before the mass resignations, more than 140 of NSW's 433 public ho

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