Yes, the report is a damning indictment of a patchwork of services and programs that are failing to meet the needs of Australians with mental illness and mental health problems and that deliver poor returns on the $14 billion spent annually by Commonwealth, state and territory governments. But such findings were predictable: this is the latest in a long series of reports in mental health and why commission a review if there were not recognised problems?

So the government was presumably not hiding problems and it should not have been shirking actions in response because this report also provides solutions, a roadmap for reform. It outlines strategic directions and practical solutions within existing resources for the next two years, and then for the next decade.

The report speaks with urgency about why a reordering of priorities for mental health funding is imperative, for both social and economic reasons.

The key point is that mental health funds are not spent well. Almost all (87.5 per cent) of the $9.6 billion of Commonwealth funding is spent on acute care and income support programs that are indicators of system failure. An increased focus on prevention and early intervention and a strengthening of the primary healthcare sector would increase access to care, reduce current pressures on hospital services, and help more people stay functional in their communities.

We understand that hospital admission and disability can be prevented for physical illnesses by screening, early intervention and affordable and timely access to community-based medical and support services. The idea of late intervention for cancer, heart disease and diabetes is unacceptable, but with mental illness this is almost the norm. Why has this been allowed to happen? The average cost of a hospital admission for a mental health disorder is $10,000, a sum that could fund community support for a year.

More must be done to close the gaps that mean that people miss out on needed services because of where they live, their income, and their ability to navigate a complex and fragmented array of services. Mental health problems are dealt with in isolation, leading to poorer physical and mental health outcomes.

The current delivery system is driven more by what providers want than by what patients and their families need. The review struggled to assess the efficiency and effectiveness of the array of services and programs because the data is not there. The data that is collected measures activity not outcomes and ignores patient satisfaction altogether.

Tackling suicide must be a national priority. In 2012, more than 2500 Australians (almost seven people a day) died by suicide and more than 25 times that number attempted to take their own lives. It's the leading cause of death for Australians aged between 15 and 44. The report proposes a target to reduce both suicide and suicide attempts by 50 per cent over the next decade with sustainable, comprehensive, whole-of-community approaches.

The situation for Indigenous Australians is far worse; the report describes it as 'dire'. It's a dominant over-arching theme throughout, and there is a recommendation to make Indigenous mental health a national priority and agree an additional COAG Closing the Gap target for mental health.

What emerges from this review is that despite a raft of reports, plans, strategies and commitments, Australia lacks a clear destination in mental health and suicide prevention. There is no 'mental health system' but a collection of services and programs with little evidence of value and with no clarity of roles and responsibilities. The voices of the people with lived experience of mental illness – patients, families, carers and healthcare professionals – have consistently been ignored, misheard and under-valued.

The new system architecture that the report proposes – to 'redesign, redirect, rebalance, repackage' offers an immediate starting point for reform, as was promised by the Prime Minister and presents these opportunities in a context that is suitable for the budgetary times.

So it is telling that the only response from the Health Minister Sussan Ley to date has been to pick one key recommendation (to shift priorities from crisis care to prevention, early intervention and community support), take it out of context (present it as cutting hospital services) and announce emphatically that this will not be done. This, combined with her announcement earlier this month of continued funding for mental health groups for the next year, almost certainly means needed mental health reforms are not in the budget. The voices of the people must be heard if they are to stay on the table for further consideration.

Dr Lesley Russell is an Adjunct Associate Professor at the Menzies Centre for Health Policy at the University of Sydney.