The National Mental Health Strategy has guided mental health reform in Australia since 1992, the year in which Australian health ministers agreed to the original National Mental Health Policy and the first five-year National Mental Health Plan. Two further National Mental Health Plans followed in 1997 and 2003, and complementary action was guided by the Council of Australian Governments (COAG) National Action Plan on Mental Health 2006–2011. The original National Mental Health Policy was recently revised (see below for more detail). The fourth plan is set in the context of the updated policy, and builds on the work of previous plans. Like its predecessors, it is underpinned by the Mental Health Statement of Rights and Responsibilities.

The National Mental Health Strategy has steered a changing reform agenda over time, and understanding this agenda helps to set the context for the fourth plan. The First National Mental Health Plan (1993–98) represented the first attempt to coordinate mental health care reform in Australia, through national activities. It focused on state/ territory based, public sector, specialist clinical mental health services and advocated for major structural reform, with particular emphasis on the growth of community based services, decreased reliance on stand alone psychiatric hospitals, and 'mainstreaming' of acute beds into general hospitals.

The Second National Mental Health Plan (1998–2003) consolidated ongoing reform activities and expanded into additional areas of focus. It built on the first plan by adding a focus on the promotion of mental health and the destigmatisation of mental illness, with the Commonwealth Government and selected state and territory governments providing funding for major initiatives like beyondblue. It attended to the question of how the public mental health sector could best dovetail with other government and non-government areas (eg private psychiatrists, general practitioners, general health services, and community support services) to maximise treatment outcomes and opportunities for recovery. Whereas the first plan focused largely on severe and disabling low prevalence illnesses that are principally the responsibility of the states and territories, the second plan expanded the emphasis to include the more common illnesses such as depression and anxiety disorders that are treated in primary health care settings.

The Third National Mental Health Plan 2003–2008 set out to consolidate the achievements of the first and second plans, by taking an explicit population health approach and reaffirming an emphasis on the full spectrum of services that are required to assure the mental health of Australians. It focused on mental health promotion and mental illness prevention, improving service responsiveness, strengthening service quality, and fostering innovation.

Both the second and third plans recognised the importance of cross sectoral partnerships in supporting mental health and wellbeing, and in responding to mental illness through an integrated and inclusive service system. The COAG National Action Plan on Mental Health 2006–2011 was developed between governments to provide further impetus to mental health reform and sharpen the focus on areas that were perceived by stakeholders to have not progressed sufficiently under the various National Mental Health Plans. The COAG National Action Plan emphasised the importance of governments working together, and the need for more integrated and coordinated care. It also committed governments to a significant injection of new funds into mental health, including the expansion of the Medicare Benefits Schedule to improve access to mental health care delivered by psychologists and other allied health professionals, general practitioners and psychiatrists. The COAG National Action Plan led to increased investment by states and territories in community based mental health services, enabling them to better respond to consumers with severe and persistent mental illnesses, and their carers and families. It also increased investment in services delivered outside the health sector that are needed by people who live with mental illness, including employment, education and community services.

Alongside these national activities, states and territories have developed their own specific mental health plans or strategies which help set the context for the fourth plan. Consistent with the COAG National Action Plan, state and territory plans and strategies have reflected the shift towards a whole of government, cross sectoral approach to mental health. At a state/ territory level, stronger partnerships have been forged between mental health and other areas within health such as emergency departments, and with programs operating outside the health system, such as community services and correctional services. Models of accommodation and support have been developed in each jurisdiction, as have specific mental health social and emotional wellbeing frameworks to work with people from culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islander communities.