Ten years of mental health service reform in Australia: are we getting it right?

We summarise the most recent data available on changes to the public and private mental health sectors from the commencement of the National Mental Health Strategy in 1993 to 2002. There has been substantial service system change in the directions agreed by governments under the Strategy, supported by a 65% growth in government spending on mental health. Despite this there is growing public and professional concern about deficiencies in the mental health service system. We review the current call for change in light of increased community expectations and growth in demand for services. Given broad national and international support for Australia's policy directions, the problems lie with the pace and extent of change and ensuring better outcomes from the increased investment in mental health care.