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Despite increased advocacy and investments in mental health systems globally, there has been limited progress in reducing mental disorder prevalence. In this paper, we argue that meaningful advancements in population mental health necessitate addressing the fundamental sources of shared distress. Using a systems perspective, economic structures and policies are identified as the potential cause of causes of mental ill-health. Neoliberal ideologies, prioritizing economic optimization and continuous growth, contribute to the promotion of individualism, job insecurity, increasing demands on workers, parental stress, social disconnection and a broad range of manifestations well-recognized to erode mental health. We emphasize the need for mental health researchers and advocates to increasingly engage with the economic policy discourse to draw attention to mental health and well-being implications. We call for a shift towards a well-being economy to better align commercial interests with collective well-being and social prosperity. The involvement of individuals with lived mental ill-health experiences, practitioners and researchers is needed to mobilize communities for change and influence economic policies to safeguard well-being. Additionally, we call for the establishment of national mental wealth observatories to inform coordinated health, social and economic policies and realize the transition to a more sustainable well-being economy that offers promise for progress on population mental health outcomes. [phrase omitted] Malgre une meilleure sensibilisation et des investissements accrus dans A pesar del aumento de la promocion y las inversiones en sistemas de salud mental en todo el mundo, los avances en la reduccion de la prevalencia de los trastornos mentales han sido limitados. En este documento, sostenemos que para lograr avances significativos en la salud mental de la poblacion es necesario abordar las fuentes fundamentales de la angustia compartida. Mediante una perspectiva sistemica, las estructuras y politicas economicas se identifican como la posible causa de los problemas de salud mental. Las ideologias neoliberales, que priorizan la optimizacion economica y el crecimiento continuo, contribuyen al fomento del individualismo, la inseguridad laboral, el aumento de las exigencias a los trabajadores, el estres parental, la desconexion social y una gran variedad de manifestaciones bien reconocidas que perjudican la salud mental. Insistimos en la necesidad de que los investigadores y los defensores de la salud mental se impliquen cada vez mas en el discurso de la politica economica para atraer la atencion sobre las implicaciones para la salud mental y el bienestar. Pedimos un cambio hacia una economia del bienestar para alinear mejor los intereses comerciales con el bienestar colectivo y la prosperidad social. Para movilizar a las comunidades en favor del cambio e influir en las politicas economicas con el fin de salvaguardar el bienestar, es necesaria la participacion de personas que han padecido enfermedades mentales, profesionales e investigadores. Ademas, pedimos la creacion de observatorios nacionales de bienestar mental que sirvan de base a las politicas sanitarias, sociales y economicas coordinadas y permitan la transicion a una economia del bienestar mas sostenible, que ofrezca perspectivas de progreso en los resultados de salud mental de la poblacion. [phrase omitted] A pesar del aumento de la promocion y las inversiones en sistemas de salud mental en todo el mundo, los avances en la reduccion de la prevalencia de los trastornos mentales han sido limitados. En este documento, sostenemos que para lograr avances significativos en la salud mental de la poblacion es necesario abordar las fuentes fundamentales de la angustia compartida. Mediante una perspectiva sistemica, las estructuras y politicas economicas se identifican como la posible causa de los problemas de salud mental. Las ideologias neoliberales, que priorizan la optimizacion economica y el crecimiento continuo, contribuyen al fomento del individualismo, la inseguridad laboral, el aumento de las exigencias a los trabajadores, el estres parental, la desconexion social y una gran variedad de manifestaciones bien reconocidas que perjudican la salud mental. Insistimos en la necesidad de que los investigadores y los defensores de la salud mental se impliquen cada vez mas en el discurso de la politica economica para atraer la atencion sobre las implicaciones para la salud mental y el bienestar. Pedimos un cambio hacia una economia del bienestar para alinear mejor los intereses comerciales con el bienestar colectivo y la prosperidad social. Para movilizar a las comunidades en favor del cambio e influir en las politicas economicas con el fin de salvaguardar el bienestar, es necesaria la participacion de personas que han padecido enfermedades mentales, profesionales e investigadores. Ademas, pedimos la creacion de observatorios nacionales de bienestar mental que sirvan de base a las politicas sanitarias, sociales y economicas coordinadas y permitan la transicion a una economia del bienestar mas sostenible, que ofrezca perspectivas de progreso en los resultados de salud mental de la poblacion., Introduction Mental health systems are under-resourced, fragmented, inefficient and unable to meet the demands of the growing burden of mental and substance use disorders. Despite the intensive advocacy and action [...]

Australia's mental health system is failing young people. Calls for accountability, strategic long-term policy planning, and regional leadership have been identified as solutions to guide mental health reform. Developing system dynamics models using a participatory approach (participatory systems modelling (PSM)) is recognized as a useful method that can support decision-making for strategic reform. This paper reports evaluation findings of a youth mental health PSM process conducted in the Australian Capital Territory (ACT). Baseline and follow-up mixed-methods evaluation data were collected in 2022 across diverse stakeholder groups to investigate the feasibility, value, impact, and sustainability of PSM. Although youth mental health system reform was viewed as desirable and a necessity across all stakeholder groups, shared perceptions of disabling powerless was observed regarding their ability to influence current decision-making processes to improve the youth mental health system. This suggests greater accountability is required to support systemic reform in youth mental health. PSM offers promise in improving transparency and accountability of decision-making for youth mental health, as exemplified in the ACT. However, more support and time are required to facilitate transformational change. Future research should investigate empowerment strategies to complement the implementation of findings from dynamic models developed through PSM, as well as the effectiveness of regional youth mental health policy decision-making supported by systems modelling. [ABSTRACT FROM AUTHOR]

This analysis identifies the significant problem of ambiguity, variation and vagueness in relation to the intervention described as 'psychotherapy'. Its purpose is to raise international awareness of this problem and alternative solutions. [ABSTRACT FROM AUTHOR]

Introduction: This presentation will report on the journey taken in the Australian Capital Territory (ACT) towards development of an integrated regional plan for mental health and suicide prevention. Description of Policy Context and Objective: Despite some apparent natural advantages (limited size and population), mental health care in the ACT is more fractured than integrated. Our health system is under enormous pressure and currently subject to formal, independent inquiry. Our mental health services are fragmented, too often leaving people to fall into the gaps between services. Yet the ACT has the second highest expenditure on mental health services per capita in Australia. To address this situation, the Capital Primary Health Network and the ACT Health Department have invited the community to contribute to a process of co-designed reform. This has involved consumers and carers, as well as public and private health professionals from primary, secondary and tertiary services. It has also engaged people from outside of health in a broader conceptualisation of change in relation to the social determinants of health: housing, education, employment, community services, the police, prison services and others. Target Population: The entire Canberra community, as well as the broader region. Highlights (innovation, impact and outcomes): Our method began with identification of key archetypal case studies which account for around 80% of all mental health business in the ACT. We invited the Canberra community and experts to test these case studies. We asked people what would fundamentally shift the trajectory of these typical consumer journeys towards better outcomes? Responses came at different levels; some were immediate and practical short-term ideas for service improvement; others were longer term and more complex solutions to enhance integrated care - for example to shift from fee for service models of financing to other models. The level of public engagement in thinking about the future of mental health in the ACT is unprecedented. Working groups have been established, public consultation has occurred, and online feedback has been secured. A new plan is emerging from this work. But the future is uncertain. Federal and Territory governments seem to support separateness rather than integration. There are competing policy and funding paradigms - individual choice vs population-based rationing. Staff under pressure working in public services struggle to engage in processes of reform. Perspectives on priorities differ considerably between stakeholders. Comments on Transferability: The experiences of the ACT tell a story of universal interest about local change and reform. Conclusions (key findings, discussion and lessons learned): Even in a small place, where key stakeholders know each well, integration is by no means obvious or straightforward. Policy reforms must be supported by sustained effort to drive the culture of integration. With consumers and their families at the centre of this integration, care must be taken to nurture inter-disciplinary recognition and respect. This is the wellspring of genuine integration. Without this, a rich country like Australia risks wasting resources and leaving people vulnerable to poor care. [ABSTRACT FROM AUTHOR]