Upstream thinking: Professionals' attitudes on mental ill-health prevention in Australia

• Prevention is key in reducing mental disorder incidence and prevalence • Professionals support increased government responsibility for mental ill-health prevention • Intervening earlier in life is a priority for professionals • Social inequality, housing, and child abuse are key priorities for upstream prevention : The aim of this study was to explore the attitudes of Australian professionals with expertise in mental health promotion and prevention towards prevention of mental ill-health and their support for government action in this area. : Seventy-three professionals with experience in mental health prevention and promotion were recruited through key public health, mental health promotion and prevention membership networks in Australia. An online survey explored attitudes towards the prevention of mental and physical health problems and support for government action. Respondents were also asked to rank the top priority areas and age groups in which the government should invest. : Professionals supported increased spending on mental health prevention, with 58.9% [95% CI: 47.2, 69.7] in support of the government spending equal amounts on prevention and treatment of mental ill-health. Over a third (35.6%, [95% CI: 25.4, 47,4]) supported spending more on prevention than treatment. Compared to physical health, professionals were more likely to assign responsibility for mental health to the government rather than individuals (p<0.001, Cohen’s d – 0.51). Professionals prioritised intervening earlier in life, particularly adolescence and childhood. Addressing social inequalities and reducing child abuse and neglect were rated as the top areas requiring government action. : Our findings reveal strong support among professionals for mental ill-health prevention initiatives and increased government involvement and investment. The alignment between professional opinions and the growing body of evidence supporting prevention interventions earlier in life, particularly those addressing social determinants, highlights the importance of making prevention a core element of mental health policy.