Patrick McGorry

Patrick McGorry must be the best known psychiatrist in the country. And it's not just because (as he puts it) he once fluked his way to Australian of the Year.

To borrow a saying from the music industry: it took years of hard work for McGorry to become an overnight success. And he's had to play the game in order to get there.

Prior to the 2004 election, McGorry decided to turn advocate and hire media and government relations advisors to help sell his message of early intervention for psychosis.

Eight years later, the mental health sector is flush with cash, after the federal government allocated $1.5 billion of new funding in the budget last year – much of which has been directed towards youth mental health services championed by McGorry.

"It is a massive fight to actually get things to change," the professor and mental health activist tells The Power Index. "Particularly in areas like health and mental health, the institutionalised status quo is fairly vicious at defending itself."

Observers in the sector say McGorry's been hugely responsible for achieving that change: "I don't think you can underestimate the influence he's had," says former Australian General Practice Network boss Dr Tony Hobbs.

"And clearly his role as Australian of the Year gave him an extraordinary high profile and increased his sphere of influence to the highest echelons of government."

McGorry is a world-leading expert on adolescent mental health. He's been a key thinker in this field for three decades now and runs Orygen Youth Health – an organisation specialising in both clinical and research activities.

As the nation's most visible advocate for mental health reform, McGorry – along with fellow advocates like Professor Ian Hickie – has been integral in turning that community feeling into a commitment from all the major parties to act on mental health reform.

"If we want to influence something like mental health then we've seriously got to engage with those processes ourselves," Hickie explains to The Power Index.

"Not simply leave it to Canberra lobbyists or the professional organisations who really don't have the same credibility."

Of course, they still needed a little bit of assistance from a lobby group. Progressive activists GetUp! were enlisted by McGorry and co to help maintain the rage in the lead-up to budget night and have been identified as important players in the outcome.

But according to those making the decisions, McGorry deserves a lot of the kudos. Politicians praise him for his willingness to talk to all sides of politics (which goes so far that advisers escort him to the offices of their opposite numbers).

"He's one of Australia's most innovative thinkers in mental health," Mental Health Minister Mark Butler tells The Power Index. "His advice during the development of that package was critically important."

"He knows he has to deal with the government of the day but appreciates the moving landscape that is Australian politics," adds opposition mental health spokesperson Senator Concetta Fierravanti-Wells.

When The Power Index meets up for an interview, it's in McGorry's modestly-sized Parkville office, just north of Melbourne's CBD. Orygen is a casual workplace and the white-haired McGorry is wearing chinos and a pink shirt.

McGorry was born in Dublin, but moved around the UK when he was growing up. His father was a tuberculosis physician before working as a coal miner's doctor in Wales.

The family moved to Australia when McGorry was a teenager on what was supposed to be a three-year holiday. They ended up living near the water in Newcastle, NSW. It's there he learned how to surf, a hobby he still enjoys today ("I just bought a new board last week").

He initially thought about a career in general medicine after university, before being seduced by psychiatry.

During the hour-long discussion, the personality traits that have no doubt aided McGorry's public health breakthrough are visible: he's calm, gracious and utterly convinced his crusade is the right one.

When asked about the Australian of the Year award he tells The Power Index modestly he was lucky to win, after a student of one of his colleagues nominated him anonymously.

Still, he rates the award as being very helpful in increasing awareness of his advocacy.

"People would meet with me much more easily and I'd get more invitations and more positive answers," he says. "It sunk a bit once that was over, but not totally. It's still improved."

But it hasn't all been plain sailing. McGorry has experienced some fierce backlash since the funding win.

"You've got to suck it up," McGorry tells The Power Index about how he deals with the criticism. "It had an impact on my family. At that point I thought: 'this is pretty unfair'. But again if you end up being a public figure that's the risk you're exposed to."

McGorry's foes would argue that he's fair game, particular when the government so strongly backs him.

In particular, there has been strong debate of the efficacy of McGorry's focus on early psychosis intervention, which he champions as an important way of identifying psychotic disorders in young people to prevent the onset of more serious mental illness. Others say it is risky and under-researched.

But it's not just his ideas they don't like. Some in the sector are also annoyed that the programs McGorry champions have been heavily funded in the last year's funding boost, while others have been cut.

Headspace, which focuses on helping young people with mild to moderate mental health issues, is one such program that will expand from 60 centres to 90 in the next five years.

Similarly, the Early Psychosis Prevention and Intervention Centre in Melbourne, the service at the forefront of McGorry's "stitch in time" philosophy, is set to be replicated through twelve new centres.

Together, both programs will receive about $420 million over five years: nearly a third of the total new funding for mental health.

One of the programs to be rationalised to make way for that funding is Better Access, which provides Medicare rebates for patients needing access to mild or moderate mental health care.

Those cuts have come under fire from psychologists, health providers and The Greens.

"I personally had nothing to do with that decision ... but I got a lot of the blame for it," McGorry tells The Power Index. "They said: 'why didn't you try and defend Better Access?'. And I said: 'well, the thing was I didn't even know about it until budget night'."

McGorry says the scrapping of Better Access has opened up a gap between the intensive hospital-based care offered by state governments and primary care focus of the federal government. He uses the analogy of the Sydney Harbor Bridge:

"I don't know if you've seen that picture in 1928 or something and they're building one arch on one side and the other ... and you're thinking: 'Shit, is it going to meet in the middle? Is it going to line up properly?' Because there's a huge gap there," he says.

"I think the onus now is on the government not to reverse their decision [on Better Access] but to actually address the needs of those people who are undoubtedly missing out in that mid zone."

McGorry admits that despite having influence he still feels disempowered by having to deal with the competing interests that operate within health, academia and government:

"Everything's about money in the health system these days," he says. "So the sort of things we're trying to do are not being valued to the extent that they should be, because they're kind of subversive. In that sense I don't feel powerful enough."