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EDITORIAL mental health. We contend it represents the best value for money for new investment in the mental health arena. Services for young people affected by mental health and related substance use disorders tend to be threadbare and split across multiple levels of government, multiple program areas, and myriad cash-strapped service providers. In addition, spending in the area remains poor, and service access and tenure are actively withheld in most specialist mental health and substance misuse service systems until high levels of risk or danger are reached, or severe illness, sustained disability and chronicity are entrenched. While primary care services encounter many young people with mental disorders, the detection and treatment rates are extremely low and poorly supported by specialist services. 23, 24 The consequences of this structural weakness in both primary care and specialist services, as well as the under-resourcing and poor coordination, are enormous. Just when mental health services are most needed by young people and their families, they are often inaccessible or unacceptable in design, style and quality. Numerous young people with distressing and disabling mental health difficulties struggle to find age-appropriate assistance (see Rickwood et al, page S35 and Hickie et al, page S47). Young people with moderately severe non-psychotic disorders (eg, depression, anxiety disorders and personality disorders), and those with comorbid substance use and mental health issues, are particularly vulnerable. Without access to appropriate treatment, many young people present in repeated crisis to overstretched hospital …