The main issue for the federal election is that mental health remains the poor cousin in the health bidding war – in that as usual all the focus is on acute health, cancer and other diseases of late adult life. A few crumbs are thrown at mental health around the margins – the usual tokenistic effort.

The Council of Australian Governments mental health reforms initiated by the federal government some time ago have been one new piece in building the jigsaw of a modern service system, however because of the fee for service basis of them and the failure to date of state governments to complement and co-invest, very little has changed in the outer suburbs, and rural and remote areas. Men, and young men in particular, continue to have poor access to care.

The other pieces of the jigsaw are missing. Specialist mental health services remain in serious trouble all around the country. New reform, substantial new investment and genuine federal state cooperation are the solutions to this unacceptable situation.

Much more prominent media and public discussion of suicide and its corrosive impacts and a less sensational approach to illicit drug awareness are needed, as well as honesty about the fact that alcohol and the levels of abuse and dependence associated are by far the major issue in the substance abuse. This is linked strongly to depression in the real world as well as other adverse effects.

Early intervention for depression and other emerging serious mental illness is a key under-explored strategy.

Headspace, the National Youth Mental Initiative, is in need of a review and redesign with additional and secure funding for a sustainable future. This is easily the most cost effective and innovative pathway for future progress in depression and mental health and is a key opportunity for the next federal government to impress and drive progress in the mental health field

Professor Patrick McGorry is Professor of Psychiatry at the University of Melbourne, Executive Director of Orygen Youth Health and Orygen Research Centre, and Chair of the Executive Committee for the National Youth Mental Health Foundation (Headspace). His interests also include the homeless, refugees and torture survivors, youth suicide and youth substance use.