Victoria batsman Nic Maddinson has withdrawn from the Australia A clash against Pakistan in Perth citing mental health concerns.

Maddinson will be replaced in the Australia A XI by Western Australia batsman Cameron Bancroft, who will likely fill a spot in the middle order with a glut of top-order players already in the side.

The three-day, day-night match at the Perth Stadium – to be live streamed on cricket.com.au and the CA Live app – had largely been seen as a high-stakes 'bat off' for the last remaining spots in the Australian Test top six ahead of the opening Domain Test at the Gabba on November 21.

Ben Oliver, Cricket Australia's executive general manager of National Teams, said Maddinson would be afforded all the time and support he needed to return to full health.

"The wellbeing of our players is always our primary concern," Oliver said. "We are proud that our players are comfortable to speak honestly and openly about how they are feeling.

"We will provide Nic with all the support and care we can and wish him a full and speedy recovery. We also ask that Nic's privacy be respected at this time."

Maddinson's withdrawal is the second time the 27-year-old has put his mental health first and stepped away from the game, and follows the high-profile decision of Glenn Maxwell to step back from the spotlight midway through Australia's Gillette T20 International series with Sri Lanka in late October.

QUICK SINGLE Maxwell withdraws from Aussie team

Maddinson's impressive Marsh Sheffield Shield form had been seen him touted as a smokey to push for a Test berth, with Victoria teammate Will Pucovski and South Australia's Travis Head also vying for a spot in the middle order with Australia A.

In February 2017 Maddinson stepped away from Sheffield Shield cricket with his then-state the NSW Blues as a 25-year-old.

That followed his surprise selection in Australia's Test team the previous November, when he faced a rampaging Kagiso Rabada and South Africa under lights in Adelaide on debut, playing three Tests before he was dropped.

Maddinson recently opened up on his Test selection in a frank radio interview with SEN's Gerard Whateley, candidly admitting he wasn't ready for and may not have been deserving of his initial foray into the top flight.

Now playing his state cricket with Victoria, Maddinson conceded he had found it impossible not to let his thoughts drift to a possible return to Baggy Green against Pakistan after continuing his prolific run-scoring form to open the 2019-20 season.

Full highlights from Nic Maddinson's marathon 224

In eight games for Victoria over the past two seasons, Maddinson had hit four hundreds, including a career-best 224 in their Shield season-opener earlier this month, for a total of 952 runs at 79.33.

"It's hard sometimes to not think a little bit further ahead. I think people probably lie when they say they don't. I definitely have," Maddinson told SEN's Whateley program before Victoria's clash with Tasmania in Hobart, a match the defending champions lost.

"Not just the past week, even the past six months or even before that. When you're doing well you sort of have an eye on the future and where you want to end up as a goal.

"It is about scoring runs at the right time and being in the right place at the right time and when it presents yourself you've got to grab it. That's what I didn't do the last time I had the opportunity in the national team (in 2016).

"I've had to go away (and find) a really good method and game plan that works for me now in four-day cricket. I've just been implementing that.

"Just because you're in the in Australia A team doesn't mean you're automatically a Test selection. But to be involved in that group of players and on the list of batters they possibly could be looking at, that's something I'm pretty proud of."

Alex Kountouris, CA's Sports Science and Sports Medicine Manager, said the governing body was committed to better understanding mental health and supporting players.

"Mental health is a challenge faced by Australian communities and elite sporting organisations and cricket is no different," Kountouris said.

"Like other professional sports we are working very hard to better understand the challenges faced by our players and staff so we can support them.

"We are all proud to work in an industry where players can feel safe to talk about these issues. It goes without saying that we offer all our players the support they need in the difficult times but importantly we are working on education, resourcing and research to better understand how we do this."

Maxwell has given no indication of his return to cricket but may return to the top-flight with the Melbourne Stars in the KFC Big Bash League.

Australia coach Justin Langer lauded Maxwell for his courage in proactively coming forward with concerns over his mental health in the midst of an international series.

"It took great courage for him to tell us he wasn't OK," Langer said last week. "In one way, it's really good for him to do that.

Maxwell to take indefinite break from cricket

"Behind the mask of the great entertainer and the great talent and the great team man and everything we see publicly, a lot of these guys are human and they're hurting a bit."

QUICK SINGLE All in the mind: Silk reveals rough road

Pucovski, Moises Henriques, Jordan Silk and Australian women's international Nicole Bolton are other recent examples of cricketers who have taken time out from the game as the stigma around mental health continues to evaporate.

If you or someone you know needs support, visit https://www.beyondblue.org.au/