WeRise · Policy platform
Mental Health
Key findings
- 4.3 million Australians21.5% of Australians aged 16–85 experienced a mental disorder in the previous 12 months in 2020–22. Source: Australian Bureau of Statistics · National Study of Mental Health and Wellbeing, 2020–2022 · 2024
- 38.8% of young adultsMore than one in three Australians aged 16–24 experienced a 12‑month mental disorder in 2020–22. Source: Australian Bureau of Statistics · National Study of Mental Health and Wellbeing, 2020–2022 · 2024
- 500,000 people left without supportThe Productivity Commission identified an unmet need for psychosocial supports outside the NDIS affecting around half a million Australians. Source: Productivity Commission · Review of the National Mental Health and Suicide Prevention Agreement · 2025
- $13.8 billion spent – yet the system still fragments careAustralian governments spent about $13.8 billion recurrently on mental-health services in 2023–24, demonstrating that the challenge is not only how much is spent but how care is designed and connected. Source: Productivity Commission · Report on Government Services 2026: Services for Mental Health · 2026
Part 01
The Case for Change
Why Mental Health matters
A healthcare system that arrives before crisis
Australia spends billions on mental health – but too many people still have to deteriorate before help becomes available.
Mental healthcare is a test of whether Australia means what it says about universal healthcare. If support is only accessible after a person is in acute crisis, can pay a private gap, qualifies for a narrow disability scheme, or repeatedly proves that they are unwell enough, the system is not designed around dignity. It is designed around rationing.
In 2020–22, 4.3 million Australians aged 16–85 – 21.5% of that population – experienced a 12‑month mental disorder.¹ The burden is particularly sharp for young people: 38.8% of people aged 16–24 experienced a 12‑month mental disorder.¹ These statistics do not mean that every person needs specialist care. They do mean Australia needs a reliable continuum: prevention and early help for many people, brief evidence-based treatment for common conditions, specialist support for complex needs, and long-term social and clinical care for people living with severe or recurring illness.
Australia already devotes major public resources to mental health. Recurrent government expenditure was around $13.8 billion in 2023–24, including $9.0 billion from states and territories and $4.8 billion from the Commonwealth.³ But spending is not the same as access, and access is not the same as recovery. A person leaving an emergency department with a referral they cannot use, a young adult waiting for an affordable psychologist, or a person with psychosocial disability who is ineligible for the NDIS may all be technically “served” by a system while practically unsupported.
The system’s most visible fault line is the gap between clinical treatment and the practical supports that make recovery possible. The Productivity Commission found that around 500,000 people with moderate to severe mental-health challenges need psychosocial support outside the NDIS but do not have access.² This means support with tenancy, budgeting, family connection, social participation, education, work, navigating services and rebuilding daily routines – the foundations that prevent relapse and allow treatment to work.
This failure has consequences across the whole public sector. In 2023, 3,214 Australians died by suicide – an average of about nine deaths each day.¹⁰ Suicide cannot be reduced to mental illness alone, and no single service can prevent every death. But a system that makes early help hard to obtain, disconnects people from follow-up after crisis, and leaves families without support is not using the evidence or public resources as effectively as it should.
A WeRise mental-health policy should therefore focus on a public guarantee rather than an isolated rebate or short-lived pilot: local access without financial barriers; properly funded psychosocial support outside the NDIS; workforce expansion; regional commissioning; culturally safe services; and published performance measures for waits, access, equity, outcomes and continuity of care. This is both a moral and fiscal proposition.
The Productivity Commission estimated that mental illness and suicide cost Australia roughly $200–220 billion annually when direct economic costs, reduced health and premature death are included.⁹ The choice is not between spending and doing nothing. It is between investing earlier in effective care or continuing to pay for preventable distress across hospitals, workplaces, families, schools, housing and justice systems.
Part 02
Evidence and Experience
Mental Health: what other countries show
What accessible systems look like
England · Norway · New Zealand · Scotland
International evidence does not provide a plug-and-play model for Australia: health financing, workforce supply, geography and Indigenous self-determination differ. It does, however, demonstrate several practical principles. England shows the value of national access and outcome standards for psychological therapies. Norway shows that low-threshold, no-referral care can outperform treatment as usual and sustain benefits.
New Zealand’s Access and Choice program demonstrates how primary-care and community-based support can scale nationally, including through kaupapa Māori provision. Scotland illustrates the importance of stable community funding and practical pathways between general practice and non-clinical support. The transferable lesson is that mental-health reform must fund an integrated service pathway, publish outcomes and build capacity beyond acute care.⁵⁶⁷¹¹
England · 2008–present; current evidence drawn from 2023–24 performance reporting
NHS Talking Therapies – publicly funded, free at point of use psychological therapies for depression and anxiety; no patient co-payment 1.26 million people accessed services in the 12 months to March 2024
- 1.26 million people accessed NHS Talking Therapies in the 12 months to March 2024
- 50.9% of people completing eligible treatment were recorded as recovered in March 2024
- 92.3% of patients were seen within six weeks as at March 2024, exceeding the 75% standard
- 98.7% were seen within 18 weeks, exceeding the 95% standard
- Recovery is measured only among an eligible completion cohort, so it must not be misrepresented as the recovery rate for every referral
Australia should establish transparent national standards for timely access and routinely published outcomes for publicly funded psychological therapies. England also shows the need to report denominators honestly: “recovery” should include clear information on referrals, commencements, completions and attrition – not just treatment completers.
Norway · Pilot from 2012; national expansion continuing through the 2020s
Prompt Mental Health Care (PMHC), a municipal low-threshold service offering short-term evidence-based treatment without GP referral for people aged over 16 with mild to moderate anxiety, depression, emerging addiction problems and sleep problems More than 70 PMHC teams operating across Norway by 2023
- PMHC is available without referral for people aged over 16 with defined mild-to-moderate needs
- More than 70 teams operate across Norway
- A randomised controlled trial found PMHC more effective than treatment as usual in reducing depression and anxiety symptoms
- OECD synthesis estimated an 83% increase in recovery at six months relative to treatment as usual
- Effects were sustained at 12 months and in follow-up evidence at 24 and 36 months
Australia should test a national network of free, no-referral primary mental-health services with a defined scope, stepped-care escalation and strong local links to GPs, social services and specialist care. The Norwegian model is especially relevant to the gap between a GP plan and hospital-level treatment.
New Zealand · 2019–present; monitoring evidence for 2023–24
Access and Choice – free, integrated primary mental-health, addiction and wellbeing support delivered through general practice, community providers and kaupapa Māori services More than 207,000 people seen in 2023–24, equal to 3.9% of New Zealand’s population
- More than 207,000 people received support in 2023–24
- This represented 64% of the programme’s annual aim of 325,000 people
- Users reported improved access and more choice of support
- Providers reported that additional programme capacity reduced time pressure and increased their ability to respond to mental-health and substance-use needs
- The scale shortfall demonstrates that service demand and workforce capacity remain binding constraints
Commonwealth PHNs and state-funded services should be able to commission free, integrated local support at a population scale, including peer, alcohol-and-other-drug and culturally governed services. New Zealand’s experience also cautions against announcing coverage targets without matching workforce, implementation capacity and recurrent funding.
Scotland · 2020–present
Community mental-health and wellbeing funding streams, including £15 million annually for children and young people aged 5–24 and their families; linked primary-care improvement work and community supports More than 300 supports and services; more than 58,000 people accessed them in the first half of 2023
- £15 million per annum funds community-based mental-health and wellbeing support for people aged 5–24 and their families
- More than £130 million had been invested in community-based supports since 2020
- More than 300 supports and services were available nationally
- More than 58,000 people accessed those supports in the first half of 2023
- Scotland’s implementation work explicitly identifies the need to strengthen links between general practice and community services
Early-intervention funding should support services outside specialist clinical thresholds, particularly for children, young people and families. Australia should link schools, general practice, headspace, Medicare Mental Health Centres, Aboriginal Community Controlled Health Organisations and community organisations through funded – not merely aspirational – referral and follow-up pathways.
Part 03
Costs and Trade-offs
The cost of Mental Health
The cost of care – and the larger cost of neglect
Gross program funding is visible; avoided harm and improved participation are real but must be independently measured.
A credible mental-health policy must distinguish between an upfront budget appropriation and a net social and economic effect. Australia already spends around $13.8 billion a year on recurrent mental-health services, but that expenditure does not include all costs created when care is inaccessible: lost work, informal caring, housing instability, avoidable crisis presentations, justice-system contact, disability and premature death.³ The Productivity Commission estimated direct economic costs of mental ill-health and suicide at $43–70 billion annually in 2018–19, including health and other supports, lower participation and productivity, and informal care. It estimated a further $151 billion equivalent cost from disability and premature death.⁹
Those estimates do not mean that every dollar spent on prevention or community care becomes a budget saving. Some benefits accrue as better health, greater autonomy, reduced grief or improved family life rather than a cashable reduction in an agency budget. Others may occur across different governments: a Commonwealth-funded service may reduce pressure in a state emergency department, while a state-funded tenancy support may improve Commonwealth employment outcomes. This is why the next policy architecture must include pooled or aligned funding and independent evaluation.
The immediate fiscal task is to cost a defined entitlement: free local assessment; a national psychosocial-support guarantee outside the NDIS; expanded public psychological therapies; workforce and peer-workforce growth; and an integrated data and outcomes system. No verified national costing for that full package was identified in the sources reviewed. The ledger below therefore separates verified current expenditure and quantified problem costs from items that require formal Treasury, Department of Health and Productivity Commission costing before public release.
| Item | Amount | Note |
|---|---|---|
| Current recurrent government expenditure on mental-health services, 2023–24 | -$13.8 billion | Baseline annual public spending across Australian and state/territory governments; not the cost of the proposed reform package. |
| State and territory share of 2023–24 recurrent mental-health expenditure | -$9.0 billion (65.3%) | Demonstrates that any national reform requires states and territories as co-funders and co-designers. |
| Commonwealth share of 2023–24 recurrent mental-health expenditure | -$4.8 billion | Includes Medicare, PBS and other Commonwealth-funded mental-health services. |
| Medicare-subsidised mental-health expenditure, 2023–24 | -$1.6 billion | Largest component of Commonwealth mental-health expenditure; includes psychologists, psychiatrists, other allied health and GP services. |
| Estimated direct annual economic cost of mental ill-health and suicide | +$43–70 billion | Not a budget saving estimate; a measure of the annual national burden identified by the Productivity Commission for 2018–19. |
| Estimated annual equivalent cost of disability and premature death | +$151 billion | Wellbeing and life-years valuation, not a cash budget offset. |
| Psychosocial-support guarantee outside the NDIS | Costing required | A formal service definition, coverage target, unit-cost model and Commonwealth–state cost-sharing agreement are required before a responsible net-cost claim can be made. |
| Net cost estimate row | Not yet costed | WeRise should commission independent costing once benefit design, workforce plan, geographic rollout and co-funding shares are specified; do not publish a net fiscal claim before then. |
The strongest objections to Mental Health
The strongest objection is fiscal: a universal guarantee, expanded psychosocial supports and workforce development will require substantial recurrent public expenditure.
This is correct. Australia should not claim that reform is costless or that every community service creates an immediate budget saving. The Productivity Commission’s national-cost estimates show the scale of harm, but they are not a line-by-line fiscal business case for any particular intervention.⁹ The appropriate response is formal independent costing after benefit design is specified, staged funding, and evaluation that separates cash savings from health, participation and wellbeing benefits.
A second objection is workforce feasibility.
More free services can increase demand faster than supply, potentially lengthening waits or diverting clinicians from existing services. This risk is real, especially in rural and remote areas and in psychiatry. The policy must therefore be phased and accompanied by workforce measures: funded training placements, supervision capacity, rural retention measures, multidisciplinary teams, peer workforce growth and culturally governed workforce pathways. It should not promise a national service guarantee next year without the people required to deliver it.
Third, critics may argue that broader access medicalises ordinary distress.
There is a legitimate distinction between mental disorder, situational distress and the social conditions – poverty, insecure housing, discrimination, violence, isolation – that generate distress. A good policy should not reduce every problem to an individual diagnosis or prescription. The answer is not to withhold care. It is to build a broad model that includes peer support, community connection, housing, employment, family support and prevention, while also pursuing structural policies on income security, housing and workplace conditions.
Fourth, the evidence base has limits.
The English Talking Therapies recovery rate is calculated among eligible treatment completers, not all people referred; it should not be presented as proof that half of all referrals recover.⁵ International results may not transfer automatically to Australia because of different funding systems, populations and workforce conditions. The Norwegian, New Zealand and Scottish examples should inform Australian design, not replace Australian trials, Aboriginal and Torres Strait Islander co-design, local evaluation or service-user leadership.
Fifth, there is a risk of Commonwealth–state blame shifting.
The current system already suffers from fragmented accountability. A new guarantee could worsen this if governments create another agreement without enforceable obligations. The Productivity Commission’s 2025 review found the current National Agreement ineffective, which is a warning against merely relabelling existing arrangements.² Reform needs published responsibilities, multiyear funding, transparent service standards, independent review and mechanisms to prevent one government from reducing its contribution when another invests.
Finally, community-sector organisations may fear that national standards create excessive compliance costs or crowd out local innovation.
This concern is reasonable. National standards should set minimum rights – timely access, safety, cultural security, continuity and outcomes – while allowing communities and regions to determine how those rights are delivered. Co-design must be funded, not treated as a consultation exercise after decisions are made.
Part 04
The Australian Design
How Mental Health would work in Australia
A National Mental Healthcare Guarantee
Free local access, sustained community support and clear responsibility across governments.
Australia should establish a National Mental Healthcare Guarantee: a legislated, jointly funded commitment that a person can obtain timely, free and culturally safe support at the level of care they need, without having to deteriorate into crisis or qualify for the NDIS. The guarantee should sit above – not replace – existing Medicare, public hospital, Aboriginal Community Controlled Health Organisation (ACCHO), headspace, Medicare Mental Health Centre, PHN and state community-service arrangements.
The Commonwealth should fund and set national access standards for three elements: free low-intensity and moderate-intensity psychological therapies; a psychosocial-support guarantee outside the NDIS; and national data, workforce and quality infrastructure. States and territories should co-fund and deliver specialist community care, crisis alternatives, hospital discharge follow-up and acute services. PHNs should commission integrated local systems, but with transparent population-need formulas, national minimum standards and meaningful community governance. This matches the reality that the present system is split across Commonwealth Medicare and PHN funding, state and territory specialist services, PBS medicines and NDIS supports.⁸
A first implementation phase should guarantee a free initial assessment and navigation appointment through local services, telehealth or ACCHOs; no-referral access for common anxiety and depression presentations; and rapid escalation routes for people whose needs are complex or acute. The service model should incorporate peer workers, social workers, alcohol-and-other-drug practitioners, family and carer support, housing and employment referral – not just clinical consultations. England and Norway show that access, waits and outcomes can be measured transparently in publicly funded psychological-therapy systems.⁵⁶
The second phase should establish the missing psychosocial tier. The Productivity Commission identified a gap affecting about 500,000 people outside the NDIS.² A national agreement should define eligibility based on functional need rather than a permanent-disability test; guarantee flexible supports such as tenancy maintenance, skills for daily living, peer connection, family support, education and employment participation; and prevent arbitrary exit when a person’s condition fluctuates.
The third phase should address workforce and accountability. Australia provided 9.6 million Medicare-subsidised mental-health services through psychologists, psychiatrists and other allied-health practitioners in 2024–25, plus 3.6 million GP-specific mental-health services.³ This activity illustrates both need and dependence on a limited workforce. Government should fund training places, rural incentives, supervision capacity, peer-workforce development and Aboriginal and Torres Strait Islander-led workforce pathways. It should publish national performance data on access, waiting times, gap fees, service continuity, outcomes, equity and user experience.
A realistic timeline is two years to legislate the guarantee, negotiate funding and begin workforce expansion; three to five years to roll out the psychosocial-support tier nationally; and five years to independently evaluate outcomes and revise the funding formula. This is demanding, but it is more realistic than expecting short-term pilots to repair a system decades in the making.
Part 05
People and Transition
Who Mental Health affects
The people behind the waiting lists
Mental healthcare is an equity policy because access to recovery should not depend on income, postcode or eligibility labels.
Mental-health service gaps do not affect Australians evenly. The ABS found that 24.6% of females aged 16–85 experienced a 12‑month mental disorder in 2020–22, compared with 18.3% of males.¹ Young people faced the highest measured prevalence: 38.8% of people aged 16–24 experienced a 12‑month mental disorder.¹ These figures do not establish that one group’s experience is more important than another’s; they demonstrate why a one-size-fits-all service model is inadequate.
People living in rural and remote communities can face limited local workforce supply, long travel distances and fewer specialist options. Aboriginal and Torres Strait Islander peoples require services led or governed by communities, grounded in culture and social and emotional wellbeing – not a generic system applied without regard to history, racism, family, Country and self-determination. People with disability, people leaving hospital, people experiencing homelessness, LGBTQIA+ people, refugees and migrants, carers, and people in contact with the justice system may require both mental-health treatment and supports that conventional Medicare appointments cannot provide.
Case study
A 20-year-old university student in regional Queensland begins experiencing panic attacks and depression. They can obtain a GP appointment, but the nearest psychologist with an affordable gap has a long wait. They do not meet the threshold for acute public services, and their distress begins to affect study, casual work and housing security. Under the guarantee, they could access a free local or telehealth assessment, evidence-based brief therapy, peer support and timely escalation if their condition worsened – without having to prove crisis.
Case study
A 46-year-old renter is discharged from hospital after a severe depressive episode. Medication and a psychiatric follow-up are arranged, but they have no support to manage rent arrears, reconnect with their children, attend appointments or return to work. They are not eligible for NDIS support. Under the proposed psychosocial guarantee, a local worker and peer practitioner would provide recovery planning, tenancy and employment coordination, and ongoing support calibrated to functional need.
The absence of reform harms families and carers as well as service users. The Productivity Commission estimated informal care by family and friends as part of the direct annual economic cost of mental ill-health and suicide.⁹ It also harms public systems: people may cycle through emergency departments, hospitals, police responses, homelessness services and income-support systems because the less intensive, recovery-oriented alternative is missing.
Opposition is likely to come less from a principled objection to care than from concerns about fiscal cost, workforce availability, state–Commonwealth cost shifting and whether universal services will displace people with the highest needs. Those concerns warrant serious attention. The design response is staged rollout, protected specialist funding, transparent co-funding and independent outcome reporting – not retaining a system that already costs people their health, income, relationships and housing.
Part 06
Related policies
Mental Health sits within a wider set of WeRise policies.
- Foundations of Dignity: more WeRise policies in this pillar
- WeRise: all 29 policies across seven pillars
Notes
Sources and Supporting Documents
- Australian Bureau of Statistics. National Study of Mental Health and Wellbeing, 2020–2022. ABS. 2024. www.abs.gov.au
- Productivity Commission. Review of the National Mental Health and Suicide Prevention Agreement. Australian Government. 2025. www.pc.gov.au
- Productivity Commission. Report on Government Services 2026: Services for Mental Health. Australian Government. 2026. www.pc.gov.au
- Australian Government Department of Health, Disability and Ageing. Speech from Assistant Minister McBride, Mental Health Australia Members Policy Forum – 14 May 2026. Australian Government. 2026. www.health.gov.au
- NHS England. Performance Report 2023–24. NHS England. 2024. www.england.nhs.uk
- NHS England. Annex: Operational Performance Update. NHS England. 2024. www.england.nhs.uk
- Mental Health and Wellbeing Commission. Access and Choice Programme Monitoring Report 2025. New Zealand Government. 2025. www.mhwc.govt.nz
- Australian Institute of Health and Welfare. Australia’s Mental Health System. AIHW. 2024. www.aihw.gov.au
- Productivity Commission. Mental Health, Inquiry Report No. 95, Volume 1. Australian Government. 2020. assets.pc.gov.au
- Australian Institute of Health and Welfare. Suicide and Self-harm Monitoring: Summary. AIHW. 2024. www.aihw.gov.au
- Scottish Government. Mental Health in Primary and Community Care: Report – December 2024. Scottish Government. 2024. www.gov.scot
- National Mental Health Commission. National Report Card 2025: Monitoring and Reporting Australia’s Mental Health System. Australian Government. 2026. www.mentalhealthcommission.gov.au
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