The beginning of a structural reform: reorganising the front line of a mental health service.

National and State priorities for mental health services have directed emphasis towards early intervention and prevention. One of the key priorities is to ensure that entry to mental health services is efficient, effective and accountable. This study describes the process of restructuring the front line of a large and complex mental health service. Adopting the total quality management approach, all stakeholders in the service collaboratively developed a single set of protocols and guidelines to achieve standardisation of documentation, assessment of risks and urgency, and to improve the overall quality of the service.