Introduction
Since the early 1990s, campaigns to enhance public awareness and attitudes towards mental health problems have been a feature of mental health policy and practice. This is based on the understanding that adequate recognition and treatment of mental health problems require more than better clinical care alone. Notable examples include the UK’s 1992–96 Defeat Depression Campaign (Paykel et al., Reference Paykel, Hart and Priest1998), the European Alliance Against Depression, which was formed in 2004 and implemented in 17 European countries (Hegerl and Wittenburg, Reference Hegerl and Wittenburg2009) and more recently, the UK’s Time to Change anti-stigma campaign (Henderson et al., Reference Henderson, Potts and Robinson2019).
In Australia, Beyond Blue, which was launched in 2000, marked a turning point in the national approach to improving population mental health. It is an independent, not-for-profit organisation funded through a combination of Australian Government funding, state and territory contributions and philanthropic and corporate partnerships. Its staff and board include expertise from psychology, psychiatry, public health, communications, community engagement, digital services and lived experience. Its public campaigns are typically developed using social marketing and public health communication approaches, while its service and information content is informed by clinical and research evidence as well as lived experience.
Beyond Blue was formed to respond to growing calls for public engagement, stigma reduction and stronger advocacy to tackle depression. Evidence for this came from a number of areas, including Australia’s first national survey of population mental health literacy, which revealed that antidepressants and psychotherapy were regarded as less helpful for depression than vitamins and minerals and that half the population believed weakness of character was a likely cause of depression (Jorm et al., Reference Jorm, Korten, Jacomb, Christensen, Rodgers and Pollitt1997a, Reference Jorm, Korten, Jacomb, Christensen, Rodgers and Pollitt1997b).
From the outset, Beyond Blue prioritised a systemic approach that involved national awareness campaigns, support for consumers and carers, early intervention, primary care reform and investment in strategic, applied research (Hickie, Reference Hickie2004). Over the last 25 years, Beyond Blue has expanded its focus beyond depression, adding anxiety conditions in 2011 and suicide prevention in 2015. In 2023, Beyond Blue sharpened its focus on earlier intervention and prevention.
Within its first 5 years, Beyond Blue had become a national leader in mental health policy advocacy, the provision of consumer and carer support and the generation and dissemination of knowledge about mental health (Pirkis et al., Reference Pirkis, Hickie, Young, Burns, Highet and Davenport2005). It provides telephone and online support services, which have been shown to lead to greater engagement with health professionals, reduced feelings of distress, increased confidence to cope and less hopelessness (Hawkins et al., Reference Hawkins, Odgers, Reeves and McCoy2020). As an incubator, it has been central to the development, trialling and dissemination of early intervention programmes. Initial investments in school-based programmes (Spence et al., Reference Spence, Burns, Boucher, Glover, Graetz, Kay, Patton and Sawyer2005; Sawyer et al., Reference Sawyer, Pfeiffer, Spence, Bond, Graetz, Kay, Patton and Sheffield2010) have since evolved into the Australian National Mental Health in Education Initiative, Be You, which is freely available to all early learning services, primary and secondary schools throughout Australia (Hoare et al., Reference Hoare, Thorp, Bartholomeusz-Raymond, McCoy, Butler and Berk2020). Beyond Blue also played a key role in changing approaches to workplace mental health in Australia, including through their National Mental Health and Wellbeing Study of Police and Emergency Services (Kyron et al., Reference Kyron, Rikkers, Page, O’Brien, Bartlett, LaMontagne and Lawrence2021). More recent initiatives include The Way Back suicide aftercare service, which led to improved wellbeing and reduced suicidality and psychological distress in service users (Nous Group, 2022), and NewAccess low-intensity therapies for symptoms of depression and anxiety, which led to clinically meaningful reductions in depression and anxiety symptoms (Baigent et al., Reference Baigent, Smith, Battersby, Lawn, Redpath and McCoy2023).
From its earliest days, Beyond Blue has been guided by Blue Voices, a lived and living experience reference group and online community. Now numbering over 3,000 individuals, membership is open to Australians aged 16 or older who have personally experienced a mental health condition, supported someone with one or been affected by suicide. Through surveys, focus groups, advisory and governance committees, co-design of products and services and consultation on policy and campaign design, Blue Voices has played a central role in facilitating consumer and carer participation in planning, delivering and evaluating mental health services and activities to improve mental health literacy and reduce stigma and discrimination (Pirkis et al., Reference Pirkis, Hickie, Young, Burns, Highet and Davenport2005).
Globally, among national government-funded initiatives to improve mental health literacy, reduce stigma and discrimination and facilitate help-seeking for depression and anxiety, Beyond Blue stands out for its sustained efforts and evidence of impact. As we reflect on its 25-year milestone, we consider what the landscape might look like had Beyond Blue not existed. To do this, we can draw on Beyond Blue’s five independent external evaluations, which were consistently positive (Pirkis et al., Reference Pirkis, Hickie, Young, Burns, Highet and Davenport2005; Dunt et al., Reference Dunt, Robinson and Pirkis2010; Siggins Miller Consultants, 2018; ARTD Consultants, 2023; Blue, Reference Blue2023) as well as a range of nationally representative surveys on mental health and wellbeing, service use, mental health literacy and stigma.
Awareness of Beyond Blue
From its earliest days, Beyond Blue actively promoted media coverage of depression and directly contributed to an increase in the quality and quantity of information available through media and educational sources (Pirkis et al., Reference Pirkis, Hickie, Young, Burns, Highet and Davenport2005). Community awareness of Beyond Blue was assessed in national telephone surveys from as early as 2001, with 22% of Australians recognising the brand name in that year. No discussion of the early history of Beyond Blue would be complete without mention of the Hon. Jeff Kennett AC, the former premier of Victoria, who founded Beyond Blue and played a central role in securing funds for a mental health advocacy group focusing on depression. The 2003/4 National Survey of Mental Health Literacy and Stigma (Jorm et al., Reference Jorm, Griffiths and Griffiths2005a) included a question asking whether respondents were aware of Beyond Blue, with 24% of people saying yes and a further 9% saying yes when prompted with information about his involvement. While its activities were principally aimed at adults, awareness of Beyond Blue among young people was also relatively high. In a 2006 national survey of young people aged 12–25 years, 44% were aware of Beyond Blue (Morgan and Jorm, Reference Morgan and Jorm2007).
By 2011, recognition of Beyond Blue was 78% (Reavley and Jorm, Reference Reavley and Jorm2011). More recent surveys put this at 94%, and it remains the most recognised mental health organisation in Australia (Beyond Blue and The Social Research Centre, 2025). In 2024, up to one in six Australians had connected with Beyond Blue’s content and services over the previous 12 months. This included visiting the website, reading a brochure, following on social media or engaging with Beyond Blue support services on the phone, via webchat or forums, or the NewAccess programme.
Beyond Blue and improvements in mental health literacy, stigma reduction and increases in access to care
However, high awareness of a mental health organisation counts for little unless it leads to tangible outcomes such as greater mental health literacy, reduced stigma and meaningful engagement with care. Evidence points to the impact of Beyond Blue in these key areas.
Mental health literacy
The last 25 years have seen considerable improvements in mental health literacy in the Australian population (Reavley and Jorm, Reference Reavley and Jorm2012a; Nicholas et al., Reference Nicholas, Pirkis, Jorm, Spittal and Reavley2019; Reavley et al., Reference Reavley, Jorm, Carbone, Tsiamis and Morgan2025). While several efforts are likely to have contributed to these improvements, early evidence of Beyond Blue’s role came from data from the 1995 and 2003/4 National Surveys of Mental Health Literacy and Stigma. Analyses took advantage of the fact that Beyond Blue was rolled out in some states (principally Victoria) and not others (notably NSW and WA), allowing for comparison between high-exposure and low-exposure states. In the former, awareness of Beyond Blue was found to be around twice the level of the latter (Jorm et al., Reference Jorm, Nakane, Christensen, Yoshioka, Griffiths and Wata2005b). Recognition of depression and beliefs about treatments improved greatly at a national level, but slightly more so in the high-exposure states (Jorm et al., Reference Jorm, Christensen and Griffiths2006).
More recent nationally representative studies also point to the associations between awareness of Beyond Blue and higher levels of mental health literacy, including in young people. Surveys in 2006 and 2011 showed associations between recognition of Beyond Blue and more accurate recognition of mental health problems, more favourable beliefs about evidence-based treatments and self-help intervention and beliefs about the helpfulness of first-aid actions that were more closely aligned with professional ratings (Morgan and Jorm, Reference Morgan and Jorm2007; Yap et al., Reference Yap, Reavley and Jorm2012a, Reference Yap, Reavley and Jorm2012b, Reference Yap, Reavley and Jorm2012c).
Stigma and discrimination
Driven by the priorities of consumers, as well as early research findings showing that many people believed in personal weakness as a cause of depression (Jorm et al., Reference Jorm, Korten, Jacomb, Christensen, Rodgers and Pollitt1997b), Beyond Blue has had a focus on stigma reduction since its earliest days. Beyond Blue’s speakers programme plays a central role in its stigma reduction activities, with over 500 speaking and media events per year reaching over 6 million people Australia-wide. As with mental health literacy, there have been changes over the last 25 years. The 2003/4 and 2011 National Surveys of Mental Health Literacy and Stigma included questions about attitudes and willingness to interact with a person with depression. Analysis of changes over that time period showed decreases in the proportions of people believing that a person with depression was personally weak or could ‘snap out of’ the problem, while there were minimal changes in attitudes to a person with schizophrenia (Reavley and Jorm, 2012).
Analysis of data from a more recent nationally representative survey shows further changes since 2011, most notably in relation to large reductions in beliefs about the dangerousness of a person with depression (Reavley et al., Reference Reavley, Ross, Green, McNaught and Morgan2026). These changes have not been seen in other countries (Pescosolido et al., Reference Pescosolido, Halpern-Manners, Luo and Perry2021; Schomerus et al., Reference Schomerus, Schindler, Sander, Baumann and Angermeyer2022). Recognition of Beyond Blue was associated with less stigmatising beliefs in this survey and similar findings have previously been seen in young people (Yap et al., Reference Yap, Reavley, Mackinnon and Jorm2013). Further support for the anti-stigma role of Beyond Blue comes from its Australia’s Mental Health and Wellbeing Check Surveys, which were conducted in 2022 and 2024 (unpublished data). Because this survey recruited participants from The Social Research Centre’s Life in Australia panel, 2,500 people took part at both time points, enabling us to conduct longitudinal analysis. Engagement with Beyond Blue’s content in 2022 (such as visiting the website, reading a brochure or following on social media) predicted significantly lower stigma related to seeking professional help 2 years later (controlling for stigma, mental health symptoms and self-reported mental health problems in 2022). While these attitudinal changes are positive, a key measure of success relates to how they translate into improvements in access to care or experiences of discrimination or support. While relatively few studies measure these, evidence from nationally representative studies of experiences of discrimination and support in Australia points to a lack of progress in some settings, such as workplaces (Reavley et al., Reference Reavley, Ross, Green, McNaught and Morgan2026). New approaches are needed, with interventions carefully developed and disseminated based on their ability to bring about tangible behaviour change in their target audiences.
Help-seeking for mental health conditions
A core aim of Beyond Blue since its inception has been to promote help-seeking for mental health conditions, particularly by improving mental health literacy and decreasing stigma related to earlier engagement with support services.
Comparisons based on published data from Australia’s 2020–22 National Study of Mental Health and Wellbeing (NSMHWB) and its precursors in 1997 and 2007 indicate shifts in help-seeking for mental health among Australian adults since the inception of Beyond Blue. In the 1997 NSMHWB, 11% of people said they had consulted a health professional for their mental health in the past 12 months (Meadows et al., Reference Meadows, Liaw, Burgess, Bobevski and Fossey2001); in the 2007 and 2020–22 surveys, these proportions were 12% and 17%, respectively (Harris et al., Reference Harris, Tapp, Vescovi, Sunderland, Diminic, Chapman, Slade, Teesson, Pirkis and Burgess2025). In addition, published data suggest that the proportion of Australian adults who perceived a need for information about mental illness, treatment and services increased from 5% in 1997 to 8% in 2007 and 11% in 2020–22; perceived need for counselling increased from 10% in 1997 to 11% in 2007 and 15% in 2020–22 (Meadows et al., Reference Meadows, Burgess, Fossey and Harvey2000; Meadows and Burgess, Reference Meadows and Burgess2009; Australian Bureau of Statistics, 2023).
In the context of these broader population shifts, other sources of evidence indicate that Beyond Blue has influenced attitudes to help-seeking as well as actual rates of help-seeking. As discussed above, national mental health literacy survey data allowed for comparisons between high Beyond Blue-exposure and low-exposure states. Respondents in high-exposure states showed greater positive change in beliefs about the benefits of help-seeking in general and those related to counselling and medication (Jorm et al., Reference Jorm, Griffiths and Griffiths2005a). More recent data also support the impact on help-seeking attitudes. Beyond Blue’s Mental Health and Wellbeing Check Surveys in 2022 and 2024 showed that engaging with Beyond Blue content or services in 2022 significantly improved attitudes to seeking help for a personal or emotional problem from a mental health professional or doctor 2 years later, controlling for attitudes in 2022. Moreover, in 2024, 27% of participants reported that, as a result of their engagement with Beyond Blue services (e.g. phone support service), they had spoken with their doctor/GP about mental health, 21% reported they had sought professional support from a psychologist or other health professional and 33% reported they had spoken to family or friends about mental health. Analysis of the matched longitudinal sample from the 2022 and 2024 Mental Health and Wellbeing Check Surveys also supports Beyond Blue’s impact on actual help-seeking. Engagement with Beyond Blue in 2022 significantly increased rates of seeking professional help 2 years later, controlling for help-seeking in 2022. Help-seeking rates were 28% for those who engaged with Beyond Blue versus 20% who reported no engagement.
Globally unique scale and impact
Beyond Blue is globally unique among national initiatives that have aimed to use a systemic and multi-pronged approach to improve population mental health. Beyond Blue’s sustained focus and measurable success in improving mental health literacy, reducing stigma and facilitating help-seeking for depression and anxiety remains largely unmatched. While other countries, including the UK and Canada, have had national anti-stigma or awareness campaigns, these often lack rigorous evaluation of population-level effects or have shown limited impacts on mental health literacy or mental health and wellbeing (Hahn et al., Reference Hahn, Chua, Jones and Henderson2023). An exception might be the European Alliance Against Depression, a multi-component intervention with activities targeted to primary care, the general public, community facilitators and affected individuals and their families. This has been shown to be effective in reducing mental health-related outcomes such as suicidal behaviours in several European countries (Arensman et al., Reference Arensman, Sadath, Callanan, Khan, Leduc, Cully, McTernan, Schnitzspahn, Abdulla, Celik, Hauck, Pina, Giupponi, Roberti, Conca, Nuhara, Lazzeri, Trentin, Tosti, Belfanti, Ferrara, Sola, Allende, Diaz, Székely, Ruzsa, Zsák, Székely, Toczyski, Van Audenhove, Coppens, Fexi, Deredini, Konsta, Arabatzis, Pasho, Tsagaraki, Naydenova, Drobachka, Värnik, Sirg, Sisask, Lillepuu, Mere and Hegerl2026).
In the area of stigma reduction, the UK’s Time to Change anti-stigma campaign, which comprised social marketing, lived experience contact, community and workplace programmes, and which ran from 2007 to 2021, may be the closest example to Beyond Blue. This was evaluated in national surveys, which showed some evidence of reduced stigma and discrimination, but also that sustained effects have been challenging to maintain after the end of the programme (Henderson et al., Reference Henderson, Potts and Robinson2019; Ronaldson and Henderson, Reference Ronaldson and Henderson2024). These findings, along with those showing limited changes in other countries, point to the importance of strategic, multi-pronged and sustained efforts at a national scale of the type that Beyond Blue exemplifies.
Where to next?
As Beyond Blue looks to its next 5 years, it has resolved to sharpen its focus on prevention and early intervention (Beyond Blue, 2023). This reflects the growing evidence that, despite the increased rates of service use seen in the recent NSMHWB, there have been limited reductions in the prevalence rates of depression and anxiety and, in young adults and adolescents, these may even be increasing (Slade et al., Reference Slade, Vescovi, Chapman, Teesson, Arya, Pirkis, Harris, Burgess, Santomauro, O’Dean, Tapp and Sunderland2025). These findings have led to calls to balance a health sector response with a greater focus on prevention, early intervention and mental health promotion (Productivity Commission June 2025). Beyond Blue is well placed to build on its previous work on addressing key social determinants of mental health through campaigns (e.g., the Invisible Discriminator campaign (Beyond Blue, Reference Blue2019)); partnerships with organisations such as Financial Counselling Australia, the Australian Securities and Investments Commission and Adult Migrant Employment Services; and advocacy on issues that present key risks to mental health such as financial distress, racial discrimination, loneliness and the design of social media applications.
Key challenges for mental health systems are also likely to arise from broader societal issues, including the lingering effects of the Covid pandemic, cost-of-living-related challenges, the mental health impacts of climate change and the risks and opportunities posed by artificial intelligence. Improving population mental health may also require engagement with ongoing debates about the expanding boundaries of mental illness and the medicalisation of everyday distress, which may carry unintended risks, including pathologising common emotional responses, encouraging overreliance on clinical services and possibly increasing psychological distress (Foulkes and Andrews, Reference Foulkes and Andrews2023; Reavley et al., Reference Reavley, Jorm, Carbone, Tsiamis and Morgan2025). It is possible that the simplistic messaging included in many public-facing campaigns may have inadvertently contributed to these dynamics, pointing to the importance of designing interventions that pair help-seeking messages with non-clinical support options. There is also some evidence that a focus on depression and anxiety conditions has widened the gaps in mental health literacy and stigma towards people with other conditions, potentially worsening inequalities between people with less severe and more severe conditions (Morgan et al., Reference Morgan, Ross, McNaught, Green and Reavley2026; Reavley, Reference Reavley2026). In recognition of these issues, in recent years, Beyond Blue has moved away from labelling of discrete conditions and is more focused on supporting people to recognise signs of emerging distress and reassuring them that support is available.
At the same time, as a society, we must take care not to further entrench gaps in care for those who meet diagnostic criteria for mental health conditions but remain disconnected from help. Beyond Blue’s strategic, large-scale impactful approaches to improving population mental health position it well to navigate these challenging emerging issues.
Availability of data and materials
Data may be made available on request.
Acknowledgements
AI was not used in the preparation of this article.
Financial support
Preparation of this article was funded by Beyond Blue. The views expressed in this article are those of the authors.
Competing interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
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