Heartily agree that general practice, preferably enhanced by adding a psychologist as a member of the practice staff, should be the cornerstone of mental health. It should also become more proactive by earlier intervention especially to patients at risk. Interestingly I once took part in developing models of care for mental health for a state health service and asked the mental health professionals how we could prevent mental illness. I was shocked that they could not identify even one strategy much less an integrated approach to prevention. We have a long way to go.

A fantastic article and I whole heartedly agree that mental illness should be tackled head on. But I have to ask what can be done? The health system as it is is a massive draw on money, rightly so, but it still is a massive draw. Mental health which has been neglected by both sides of politics can draw a significant amount as well. Yet the pot is only so deep. It seems to me that to truely tackle this issue we all may have to give up on somethings, like new sports stadiums or new waterside developments, to pay for it. But I seriously have to wonder how many would actually be prepaired to give up a pleasure activity to help someelse in need?

Andrew Leigh
So, “A whole-of-life approach to mental health requires a primary health care system that is better integrated, and in which doctors and nurses are trained to deal with mental disorders.”

Pinned on the wall facing me above the computer screen where I am typing this comment is the picture, cut from the Melbourne’s “Herald-Sun’, of a gigantic police sergeant in his way out of court at the inquest on the death of a tiny 15 year youth, holding two ‘large’ kitchen knives, Tyler Cassidy.

The caption read: “I had no choice”. The statement was: “I kept firing at his chest until he went to the ground”.

The Police sergeant Colin Dods was not alone. There were other of his colleagues there equally armed.

The ways of academics turned politicians are orderly, constitutional, imperative and, like any other government…inhumane.

There must be something wrong with a society where people are trained to shoot in order to protect authoritative governments; especially when the government is called democratic and include members of impeccable convictions

“A whole-of-life approach to mental health requires a primary health care system that is better integrated, and in which doctors and nurses are trained to deal with mental disorders.”

Doctors and Nurses are already trained to deal with mental disorders to a certain degree, and of course there are those dedicated to mental health care as their main area of expertise.

Unfortunately, most mental health units these days are packed with people who have substance abuse problems as well... particularly mind-altering, aggression provoking drugs like Ice.

So, many health professionals don't want to do this sort of 'caring', especially if they are much more likely to get the c##p beaten out of them in their workplace nowadays than ever before.

We need many more big, strong security personnel in emergency departments and mental health facilities than we do health personnel!

Great article Andrew. But you are wrong about headspace: there was no matched treatment group, or any sort of control group. The independent evaluation http://www.headspace.org.au/_uploads/documents/Submissions_and_%20Publications/Final_Independent_evaluation_of_headspace_report.pdf reported: 'Inclusion of a control group was precluded by the timing, budget and funding requirements for the evaluation, coupled with the introduction of the new model and delayed implementation of the initiative. This limits the validity of the outcomes because it is not possible to determine what would have occurred if young people had not received the headspace intervention' (p. 134).
Headspace is not evidence-based, despite claims to the contrary http://www.patmcgorry.com.au/blog/pmcgorry/mental-health-rudds-inaction-and-neglect. The headspace evaluation concluded: 'there is little tangible evidence to conclude the extent to which services are evidence based' (p. xv).
However, it found that 'headspace has been effective in promoting and facilitating improvements in some young people's mental and physical health, AOD use and their social and economic participation' (p. xix).
So headspace should be regarded as a promising model with a very weak evidence base, but not as a proven model, and it does not warrant the extra $226 million of scarce funding advocated in the Including, Connecting, Contributing blueprint http://sydney.edu.au/bmri/docs/260311-BLUEPRINT.pdf on the basis of the existing evidence.
Melissa Raven
Psychiatric epidemiologist and policy analyst