Transdiagnostic stepped care in mental health.

A component of Australia's recent national reform agenda for mental health services is the directive to the Primary Health Networks to develop and implement stepped-care models of service delivery. The current guidance proposes that interventions are aligned to mild, moderate and severe illness categories. Other models in operation are tied to single disorders, such as depression. Both approaches have a number of limitations when applied to real-world, complex clinical practice, especially in primary care. This article outlines some limitations of these models and argues for the development of a transdiagnostic model, based on developments in our work in primary care youth services, which can be generalised to adult populations. Such models aim to ensure that consumers receive the right intensity of care at the right time. The adjunct use of technology within services could also improve service accessibility and outcomes monitoring, and help to improve the efficiency of resource allocation based on consumer need.
Competing Interests: IH receives money from the National Mental Health Commission for his role as a Mental Health Commissioner and from Medibank Private as a member of its Medical Advisory Panel. He has previously received payment as a member of the Bupa Australia Medical Advisory Board, and for lectures from Servier, Janssen, AstraZeneca and Pfizer.