title: Australian mental health reform: time for real outcomes.
abstract: After 12 years of national mental health reform, major service gaps and poor experiences of care are common. The mental health community reports little progress in implementing its key priorities, such as expanded early-intervention programs, comanagement of people with mental health problems and related alcohol or substance misuse, and widening of the spectrum of acute care settings. We propose new national targets for reducing the social and economic costs of poor mental health; these include increased access to effective care, reduced suicide rates and improved rates of return to full social and economic participation. We detail specific service reforms designed to maximise the chance of achieving these targets, and prioritise youth health and integrated primary care programs. New independent and national reporting systems on the progress of mental health reform are urgently required.
authors.affiliation: Brain & Mind Research Institute, University of Sydney, PO Box M160, Camperdown, NSW 2050, Australia. ianh@med.usyd.edu.au
authors.forename: Ian B
authors.initials: IB
authors.lastname: Hickie
authors.forename: Grace L
authors.initials: GL
authors.lastname: Groom
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.forename: Tracey A
authors.initials: TA
authors.lastname: Davenport
authors.forename: Georgina M
authors.initials: GM
authors.lastname: Luscombe
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000191:economics / Q000534:rehabilitation; D001315:Australia; D002423:Cause of Death; D002648:Child; D003362:Cost-Benefit Analysis / Q000639:trends; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000458:organization & administration; D005544:Forecasting; D018166:Health Care Reform / Q000191:economics / Q000458:organization & administration*; D006292:Health Priorities / Q000458:organization & administration; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration*; D006301:Health Services Needs and Demand / Q000191:economics; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000534:rehabilitation; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration*; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000191:economics / Q000458:organization & administration; D019966:Substance-Related Disorders / Q000191:economics / Q000534:rehabilitation; D013405:Suicide / Q000191:economics / Q000706:statistics & numerical data; D000092864:Suicide Prevention