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Australia's National Mental Health Strategy

The University of Queensland, Toowong, Queensland, Australia

BILL BUCKINGHAM, DipClinPsych

Buckingham & Associates Pty Ltd, East Malvern, Victoria, Australia

RONALD MANDERSCHEID, PhD

Center for Mental Health Services, US Department of Health and Human Services, Rockville, Maryland, USA

Correspondence: Harvey Whiteford, The University of Queensland, PO Box 822, Toowong, Qld 4066, Australia. Tel: 617 3871 1037; Fax: 617 3371 1289; e-mail: hwhiteford{at}worldbank.org

Declaration of interest H.W. was Australian Director of Mental Health; B.B. helped draft the National Mental Health Report 2000 and R.M. conducted an international commentary on the Strategy.

Background Australia commenced a 5-year reform of mental health services in 1993.

Aims To report on the changes to mental health services achieved by 1998.

Method Analysis of data from the Australian National Mental Health Report 2000 and an independent evaluation of the National Mental Health Strategy.

Results Mental health expenditure increased 30% in real terms, with an 87% growth in community expenditures, a 38% increase in general hospitals and a 29% decrease in psychiatric hospitals. The growth in private psychiatry, averaging 6% annually prior to 1992, was reversed. Consumer and carer involvement in services increased.

Conclusions Major structural reform was achieved but there was limited evidence that these changes had been accompanied by improved service quality. The National Mental Health Strategy was renewed for another 5 years.

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