Introduction by Croakey: As the Opposition puts an election focus on its planned mental health initiatives, will Labor now advance some solutions to the youth mental health crisis?
It’s a question raised below by Associate Professor Sebastian Rosenberg, from the Brain and Mind Centre, University of Sydney, in the wake of a significant gap in the recent Federal Budget.
He puts forward some key criteria for evaluating whether new mental health initiatives will meet the needs of young people with more complex needs, and highlights some concerns and questions about the Opposition’s plans.
Sebastian Rosenberg writes:
Mental health is a “glaring omission” from the 2025-2026 Federal Budget although, to be clear, mental health is accustomed to not figuring prominently in Federal budgets.
In 1992-93 when the National Mental Health Strategy began, mental health accounted for 7.25 percent of total health spending in Australia. This was when the processes and policies of deinstitutionalisation accelerated.
According to the most recent data, from 2022-23, it now accounts for 7.31 percent. In other words, mental health’s share of the national health budget has actually reduced by 0.5 percent since 2013-14.
There have been rare times when mental health has appeared to receive some greater attention.
For example: when then Prime Minister John Howard and then NSW Premier Morris Iemma led a Council of Australian Governments (CoAG) National Action Plan back in 2006; or when then Treasurer Wayne Swan made mental health a centrepiece of the 2011 Budget; or then PM Scott Morrison’s 2021 Budget and associated National Mental Health and Suicide Prevention Plan.
The rare, sporadic and random nature of these investments helps explain the crisis facing mental health in Australia today, as felt by millions of individuals and hundreds of thousands of families, across every region.
The consequences of this inaction manifest not only in colossal personal distress and suffering, but in other real costs to communities and the economy, through the need for increased, often avoidable hospitalisations, social and welfare support, justice services and very significant lost productivity.
Federal Labor’s decision to pass mental health over this time may not be uncommon, but it is clearly out of step with the Australian community, which sees this issue as a critical priority. Labor’s approach is risky.
Opposition policies
It is perhaps in this context that the Opposition has now made two announcements in relation to mental health.
The first is a promise to increase the number of Medicare-subsidised mental health sessions back to 20, after Labor reduced it to 10.
While this sounds appealing, increasing the number of sessions available to an individual may reduce the number of people a treating health professional can see, paradoxically reducing overall access to mental healthcare, rather than increasing it.
Evidence indicates that simply increasing the number of available sessions is not the best approach.
The Coalition’s second announcement is their proposal to spend $400 million, if elected, on establishment of a National Institute for Youth Mental Health and expansion of the existing Early Psychosis Youth Services model from the existing eight sites to 20 across Australia.
With 75 percent of all mental illness manifesting before the age of 25, the Coalition’s proposal warrants serious scrutiny.
Diagnosable mental health conditions have increased by 50 percent in young people between 2007 and 2021. The prevalence of high to very high psychological distress among 18−24-year-olds nearly doubled between 2007−08 and 2022.
The crisis affecting youth mental health has spurred decision-makers into action.
Starting in 2006, the Federal Government has made repeated investments, especially in headspace which currently has 167 operational physical headspace services made up of Centres, Satellites, Outposts and Outreach services.
The Federal Government has a current commitment to 174 headspace services nationally and seven new services are scheduled to commence in the next 18 months.
Headspace has been evaluated in 2009, 2015 and most recently by KPMG in 2020, which presented a mixed picture of success. One of KPMG’s key 2020 findings was in relation to difficulties encountered by headspace services in finding and maintaining the requisite multidisciplinary workforce.
This situation illustrates the complex nature of this reform task – how do we build and maintain an effective and comprehensive response to mental illness for Australia’s young people?
Simply providing new funding into existing models will provide necessarily limited results.
That is why in late 2024 the Federal Government established a consortium to investigate new models of youth mental healthcare, led by Orygen, with many organisations, including the Brain and Mind Centre.
Key components of better care
As part of our work in this consortium, we have identified six key components of a new staged model of care, designed to meet the needs of young people with more complex needs and capable of being scaled to meet demand:
- Standardised initial assessment systems at entry – a comprehensive, standardised assessment at the first point of contact ensures all mental health, psychosocial, and comorbid needs are identified and addressed early.
- Continuous care coordination – ensuring that individuals receive continuous and timely access to the appropriate mix of services while navigating complex care pathways.
- Self-care systems – widely accessible digital tools are available to empower individuals to manage their mental health independently or alongside professional care.
- Direct access to specialist care (medical and psychological) – specialist care is widely and equally accessible without unnecessary delays, improving outcomes for individuals with moderate to severe needs.
- Measurement-based care – routine collection and use of outcome data improve decision-making, treatment personalisation, and system performance.
- System accountability and continuous evaluation – transparent reporting and continuous evaluation ensure the system remains effective, equitable, and sustainable.
The Coalition’s Budget commitment provides very limited detail about the extent to which it will fund youth mental health services which can demonstrate these components. This will be key if Australia is to effectively address the mental health crisis affecting young people.
It will be interesting to see if Labor now moves to match the Coalition or offer their own proposed solutions to youth mental health.
One critical element of this better, fuller response to youth mental healthcare is the strong emphasis on social issues beyond the health system.
Young people with complex mental health needs may well also need a service system that can respond to drug and alcohol issues, housing, employment and of course education. These psychosocial elements have traditionally been neglected in Australia’s response to mental illness.
Investing now in well-designed services, which properly address the complexity of needs faced by young people and take advantage of new and emerging technological advances, can save Australia from massive future costs.
Failure to do so will guarantee not only long term distress for individuals and their families, but also embed costs associated with poor mental healthcare in communities and right across our economy.
• Sebastian Rosenberg is Associate Professor, Brain and Mind Centre, University of Sydney
Further reading
See also comments on mental health and the Federal Budget in other recent Croakey articles:
- The Zap: Charles Maskell Knight
- Everyone knows about the cost of living crisis. But what about “the cost of leaving” crisis?: The Grattan Institute
- Mental health and suicide prevention forgotten: Gayaa Dhuwi (Proud Spirit) Australia
- “A missed opportunity to invest in the mental health workforce”: Victorian Healthcare Association
- Left behind: Mental Health Australia
- Band-Aids for mental health: Royal Australian and New Zealand College of Psychiatrists.
At The Conversation: The Coalition wants to increase Medicare psychology rebates from 10 to 20 sessions. Here’s what happened last time
See Croakey’s archive of articles on the 2025-2026 Federal Budget and health
