LAUSR

141 justified on cost-effectiveness alone, with many more required for full national coverage. Each region of Australia needs a cluster of headspace entrylevel portals seamlessly linked to transdiagnostic specialized care integrating mental and physical health with alcohol and other drugs expertise, vocational interventions and online/ digital health platforms. Assertive and intensive home-based care, and clinicians with expertise in complex syndromes (such as borderline, eating, mood and psychotic disorders) are missing elements, and interface with hospital-based services is therefore needed. Strong national oversight to assure integrative commissioning, stronger financial models, additional funding streams, longer tenure and greater depth of expertise will strengthen the capacity of the model. The youth mental health paradigm is in its infancy and will be driven by a dynamic blend of grassroots and professional leadership. Early adopters, inspiring leaders, philanthropic visionaries and patrons have emerged in progressive regions of the world, notably Ireland, Canada, Denmark, Israel, the Netherlands, France, Singapore, and parts of England and California. Child and adolescent psychiatry, still a seriously undersized speciality, has begun to recognize the need and opportunity for a paradigm shift, which it has labelled “transitional psychiatry”. Momentum within and beyond the mental health field is building and could be decisive in paving the way for a wider revolution in mental health care.