Objective: To describe the key features of the āBetter Outcomes in Mental Health Careā initiative (2001-2005) and to detail some of the conceptual, community, professional and epidemiological forces that shaped its content. Conclusions: The āBetter Outcomes in Mental Health Careā initiative represents a major development in mental health care in Australia. It recognises the central role of primary care, promotes integrated medical and psychological care, rewards treatments that occur over an episode of illness, promotes active purchasing of non-pharmacological interventions earlier in the course of illness, and attempts to better link general practitioners, non-medical mental health specialists and psychiatrists to meet population-based mental health needs. Central to its development has been a commitment by general practitioners to develop progressively better mental health skills and measure both individual consumer and system-related outcomes.