Over the past 50 years or so, scores of reports and inquiries have documented the need for action to improve the lives of Australians with mental illness.

When the Council of Australian Governments (COAG) committed to national mental health reform in 2006, it began to look as though the stars were lining up. We had top-level political commitment, with pledges of support and money from Prime Minister John Howard and NSW Premier Morris Iemma.

At that point, it was starting to look like governments might actually be prepared to do some of the tough work needed to create the sort of real changes — in health, employment, education, social services and other sectors — that would make a difference to peoples’ lives.

This was always going to be a tough task – not only because it’s complex, but because it requires the political courage to take on the professional and bureaucratic interests that have such a stake in maintaining the status quo.

To improve the services available to people with mental illness, governments have to be prepared to take on the influential groups in psychiatry and general medicine, as well as psychology and nursing. Persuading professionals to change the way they work is not a task for the faint hearted.

A few years later, and the wheels on the bandwagon of national mental health reform are looking dangerously wobbly.

From where I sit, a large part of the blame should be borne by those professional groups and narrow clinical services that have not stepped up to the plate.

Read Professor Hickie’s full report here at Croakey, Crikey’s on-line health forum.