We acknowledge and give thanks to the Bidjara People, whose lands we were welcomed onto, and where we met as a co-design group to inform and guide the aspirations of South West Hospital and Health Service’s ten-year plan.
The lands and waters within the South West Hospital and Health Service region encompass the following 13 Traditional Owner groups:
Bidjara (bid-jara)
Kooma (coo-ma)
Bidjara (bid-jara)
Kunja (koun-yah) with other interests
Yuwaalaraay/Euahlayi people (You-wal-a-ray/ You-al-e-i)
Boonthamurra (boon-tha-murra)
Kongabula (kong-ga-bull-a)
Gunggari (gon-gari)
Kamilaroi (Car-milla-roy)
Mardigan (Mar-d-gan)
Mandandanji (mand-an-dand-gee)
Kooma (Kamilroi, Mandandanji, Bigambul, Gungarri interests)
Kullilla (cool-lee-lar)
The background
The South West Hospital and Health Service (SWHHS) provides public sector health services to a population of 26,150 across 319,870km of South West Queensland. The service consists of 11 hospitals (including eight multi-purpose health services), three outpatient clinics, two residential aged care facilities and two community health centres.
In 2023, TACSI and SWHHS’s Mental Health, Alcohol and Other Drugs (MHAOD) team worked together to develop a roadmap to change how the service thinks, works and collaborates with the community to achieve better outcomes.
This work built on commitments already made through with Western Queensland PHN and other community and service partners.
Our approach
We started with three big questions:
1. What could enhance community based and community-led wellbeing in the South West look like?
This question starts with a premise: care for people happens within communities and households, and that it’s in these two contexts where wellbeing is localised, personalised and protected.
2. What role could co-design and co-production play as we evolve the way we work with communities and partners?
This question focuses on a fundamental step-change in the way South West Hospital and Health service engages and works with communities and partners, and internally. For example, in co-creating an integrated mental health, alcohol and other drugs framework.
3. What might new, creative and long term partnerships look and feel like?
This question is not just about signalling new partnership approaches for the service, but also demonstrating, via this project, what it takes to create a process that builds trust and paves the way for future collaboration.
These three questions became our 3 Seeds
1. Care and wellbeing happens in the home and in community
2. Services working with people and communities to design, deliver and improve
3. Partnership, connection and collaboration for wellbeing
What we did
We created a “3 Seeds” brand for the project to help spread the word far and wide and to invite people in community to talk to three key ideas
We built a project website to maintain a single point of communications for the wider stakeholder group
We took a strengths based and complexity-aware approach to engagement at community level with the aim of creating safe enough spaces for conversation and to invite unheard voices. We did this by inviting the 3 Seeds conversations to happen without TACSI’s presence in community, but by producing community activity packs and building capability of SWHHS staff and community members to host local conversations.
We encouraged and offered a choice of alternative options to contribute anonymously through audio message and text message as well as email.
We created a parallel process to recruit and host a co-design group in Charleville
Together, we created principles, a framework for learning (off the back of a Monitoring, Inquiry and Learning Framework) and practice development and four big goals for the desired future to inform and prioritise the roadmap.
There were multiple levels of impact
For the TACSI team
For the 3 Seeds TACSI team – Martin Ford, Ash Alluri and Clementine Rocks – This project presented an opportunity to enhance their practice around community involvement in strategies and developing a business case for the Hospital and Health Service.
Specifically, the TACSI team were able to design and implement tools and activity guides to create a platform for complexity-aware decentralised conversations around three big ideas — and instead of trying to pull all those conversations into one report, the conversations stayed alive in communities working at their own pace.
For Martin, Ash and Clem, this was an important step towards designing locally driven change in regional and remote parts of Australia. It allowed Ash to apply complexity principles and complex facilitation methods and principles , and allowed Martin to introduce a new digital tool (VideoAsk) and activity packs to promote diverse means of participation. These experiments will go on to inform future projects.
For the individuals involved
For the client project lead (Director of Mental Health, Alcohol and Other Drugs Services at SWHHS), the 3 Seeds project enabled new and different conversations with her peers, team and senior players in the ecosystem in which the Hospital and Health Service exists. It also allowed her to demonstrate a very different way of working — stretching towards co-design, foregrounding consumer and carer voices throughout a project/initiative’s process, and lay the foundations for a continuous learning culture moving forward
This work puts her in a stronger and more strategic position to speak to the practical needs of running a regional and remote mental health, alcohol and other drug service. It raises the expectation of all partners to attract investment in the service ongoing and should enable her and her team to develop their own capacity and wellbeing to in turn be able to improve services.
For the groups involved
The 3 Seeds project co-design group self-nominated to become the foundation for a new mental health, alcohol and other drug lived and living experiences group in South West Queensland.
While groups have previously been consulted with, the process shared more power and decision making and opened up future possibilities for a stronger consumer and carer voice and higher expectations in participatory processes in the South West.
For the system
The outputs and work of the 3 Seeds project co-design group explicitly called out the role of the ecosystem in which the South West Hospital and Health Service MHAOD service exists, highlighting the role of others to enable and support conditions for change.
For regional and remote services, it can be difficult to apply for and receive funding when populations are spread over a large geographical area. By presenting a business case to Queensland Health that talks to the wider system, partners and players in that system, we’re hopeful that we have made a strong case for continued access to local healthcare services and this models a demonstration for other regional and remote healthcare providers across Australia.
The insights
It’s critical to identify the ‘hot topics’
Through the course of our work in supporting the primary health care network and diverse mental health, alcohol and other drug services, and conversations with local Aboriginal and Torres Strait Islander community controlled health organisations, TACSI identified a range of hot topics that come with trying to re-design and deliver integrated mental health alcohol and other drugs services.
In the specific case of the 3 Seeds project, these hot topics were also informed through conversations with project leads, service partners, project stewards, and a literature scan of what integrated mental health, alcohol and other drugs service delivery needs to look and feel like.
These hot topics underpinned every phase of this project, and will need to be considered throughout SWHHS’ 10 year roadmap towards implementing an evolved MHAOD (Mental Health, Alcohol and Other Drugs) service framework.
It’s critical to identify culturally safe services
With approximately 13% of South West Queensland residents identifying as Aboriginal and Torres Strait Islander people, it’s critical that SWHHS prioritise culturally safe services so they can support communities across the 18 traditional lands and communities in South West Queensland.
We were privileged to be guided by strong Aboriginal voices from Charleville and Western Areas Aboriginal And Torres Strait Islanders Community Health (CWAATSICH) in this project. They helped us call out the need to define specific partnership roles and quarantined funds and resources to make sure that the tough conversations continue and the work gets done to create a network of culturally safe mental health, alcohol and other drug services in South West Queensland and beyond.
TACSI supported the creation of:
A framework to deliver an integrated and connected MHAOD service that details the vision, philosophy and principles by which the SWHHS MHAOD team could evolve.
A roadmap for action, including actions, intended outcomes and first steps across four action areas (attraction and retention of staff; practice excellence; culturally safe and capable services; and partnerships and service innovation
A monitoring, inquiry and learning approach that outlines the way the SWHHS MHAOD team will create change by learning and evolving over the coming ten years.