Participatory leadership in addressing mental health crises: If not now, when; if not you, who?

Around 1513, having been arrested, tortured and exiled; Niccolo Machiavelli wrote The Prince, in the last chapter of which he exhorts the seizure of Italy to free the country from barbarians. In the face of similar systemic challenges, we exhort psychiatrists to provide leadership in freeing us from the crises of mental healthcare in Australia (Looi and Kisely, 2018). In the context of the challenges facing the mental health system, our profession may feel besieged. However, psychiatrists, as expert medical specialists, can and should cleave to the broad role of leadership in policy, service delivery and collaborative care with patients and their communities. Our conception of leadership in day-to-day practice is achievable within the context of ongoing personnel, morale and material resource shortfalls, but is not limited to administrative or managerial roles. We outline practical developmental steps for psychiatrists to reclaim leadership in the mental health system.