Changing the face of mental health care through needs-based planning.

Mental disorders contribute to the burden of human disease. The National Survey of Mental Health and Wellbeing revealed low participation in treatment. The Tolkien II report provided evidence that a mental health service that utilised needs-based stepped care was likely to be effective and affordable to the point that a 30% increase in budget would treat 60% more people and produce a 90% increase in health gain. Five priorities were identified: Solve the crisis in psychosis by providing more step-down beds for people with schizophrenia who need long-term accommodation. Educate the workforce by providing a nationwide web-based basic curriculum. Use clinician guided, step-down web-based therapy for patients who are mild or moderate, and web-based education to enhance clinical treatment for patients who are more severe. Educate patients and their families about treatments that work and about lifestyle changes that facilitate these treatments. Reduce the onset of common mental disorders by using proven web-based prevention programs in schools. With resources such as these in place, changing the face of mental health care might just be within our reach.