The economic burden is going to continue to fall on group insurers and the rest of the country, unless we get in place a more proactive, a more assertive response that’s much more focused on prevention than intervention. Unfortunately, since John Howard’s departure and Morris Iemma’s departure, there’s been a loss of leadership on mental health.

Colin Tate: What is the road block with the Federal Government in particular – it looks like Rudd’s been a great supporter of mental health.

John Mendoza: The rhetoric’s there, the action’s not. The platitudes are there, but we are yet to see any investment. All we’ve heard from the Federal Government to date is about hospitals, hospitals, hospitals, and more recently health. Australia has already one of the highest hospitalisation rates in the western world if not the whole world.

We don’t need more hospital beds, quite frankly. We need more upstream and downstream investment to prevent hospitalisation, in all areas of health, but particularly in mental health.

Pat McGorry: We had an 1890s model until almost yesterday. In the 1990s there was an attempt to start to build a 20th century model and the foundations were laid, but then everyone went on strike. In New South Wales, we had very excellent communitybased services, crisis teams, which have been progressively defunded. These new community facilities were underinvested in.

They faced this huge onslaught of unmet need and buckled under pressure. Then governments started to build the institutions again and the acute beds as a reactive thing. Three per cent of the population has serious mental illness. State services currently cannot even fund one-third of the need in that group. So this is why this reform – the Federal Government financing mental health care – is absolutely vital.

The idea of mainstreaming mental health care into general hospitals and primary care was a nice idea to get rid of stigma, but the system wasn’t designed or engineered in a good way. Young people have the lowest access to care: only 13 per cent of young men with mental health problems get any access to any kind of mental health care. It’s no wonder the suicide rate is appalling.

This is a $30 billion issue: cost effectiveness, value for money, extension of life, quality of life, productivity, returning people to work, paying tax. The more you scale up the system of care, the more the cost effectiveness goes up by a factor of 10. If you have a small investment in youth mental health, it’s not that cost-effective. But if you roll it out in high coverage, you will get a major return on investment from all aspects of government.