Australia’s mental health leaders face a challenge
Our mental health systems are not designed to cope with the scale and demand that Covid-19, the recession, and the ongoing climate crisis will create. We can expect outcomes to fall, and the cost to government, businesses and families to rise.
But it doesn’t have to be this way
Key to effective and economically viable transformation will be harnessing the latent resources in communities, including people who have themselves experienced mental ill-health, distress and trauma.
Our experience consistently points to four priority actions:
- Do co-production authentically, so services better meet needs of those they serve.
- Build a mental health system fit for the future.
- Address the structural drivers of mental health.
- Support communities to innovate and create new mental health roles and responses for themselves.
If you’re excited by these opportunities and interested in partnering with us or learning more, we’d love to talk to you.
There’s national recognition that our mental health system needs to be more person-centred, but mental health organisations vary greatly in their confidence and readiness to do this.
Being truly person-centred means professionals sharing power with community members to partner on decisions about policy, commissioning, design and delivery. This takes changes in culture, capability and structures. It takes time and money. It takes practice.
Co-production done well leads to services that better meet the needs of the people they serve, yet co-production done poorly can be costly, slow, ineffective and even damage relationships with the community.
We recommend that organisational leaders invest in building the conditions for co-production.
For example by
- Building trusting relationships with community members
- Intentionally shifting internal cultures
- Learning from others who have done it before
- Running demonstration projects that build capability while showing what’s possible
- Developing specialist teams and processes
We recommend system leaders invest in appropriately resourcing and incentivising changes in culture and capabilities. For example, through capability building funds, creating new institutions to build capability, funding flows that encourage co-production, and awards for excellence in person-centred decision making.
Communities are at the front line of mental health in Australia, but community responses have not received anything like the same investment in their development as professional and medical responses have.
We’ve seen in our work that funders and commissioners rarely have formal routes into community, and communities themselves often need support to understand mental health, and to make evidence informed decisions.
We’ve also seen that with the right resources, and support, communities are perfectly capable of developing solutions that surprise professionals in their ingenuity and relevance.
We recommend that organisational and system leaders support communities to develop innovative roles and responses to mental health needs.
This could include raising communities’ awareness of potential roles and responses, building community capability for mental health innovation, funding experiments and providing professional expertise to community-led work.
Prior to 2020, 1 in 2 Australians could expect to experience a mental health episode in their lifetime. Covid-19, the recession, and the ongoing climate crisis are expected to increase this need even further, change the nature of demand, and create an increasingly unpredictable future.
Any future-relevant mental health system will need to:
- Meet increased demand by mobilising community responses and integrating them with professional responses
- Meet changed demand by increasing focus on prevention and early intervention
- Meet rapidly changing conditions by designing in capabilities for innovation and adaption
In our work, we’ve seen breakthroughs in collaborations when community and service system conversations put community in the driving seat, acknowledge professional expertise, and build a shared awareness of local conditions.We’ve also seen how resources, dedicated teams and structured pathways for innovation help systems respond quickly to a changing context.
We recommend that organisational leaders work on strengthening local ecosystems for mental wellbeing. The work should include collaborations between commissioners, providers, and community members to build a shared understanding of the current state of the ecosystem, imagine a preferred future state, and take action to get there. We recommend that system leaders should support these local activities, and work on creating a national R&D system for mental wellbeing.
For example, by incentivising and resourcing local collaborative action, joining up learning between localities, funding early stage development of new responses, and scaling what works.
Many of the structural drivers of mental ill-health such as housing, racism, poverty, and the climate emergency are beyond the ambition of current mental health reforms. These drivers create demand for mental health responses, and limit the effectiveness of existing activities.
So why not try to change them?
In our work, we’ve seen initiatives through which communities regenerate themselves, transitioning to a new and healthier way of living. They reduce carbon outputs, strengthen social capital, build more inclusive economies, strengthen social supports, and as a result improve people’s overall wellbeing.
What if we did this in Australia? It would take funders willing to think long term, and require mental health leaders to work beyond mental health and in partnership with regenerative economists, ecologists and community leaders. What if we looked at the crisis as a catalyst to transform our way of living?
We recommend organisational and system leaders do what they can to address the structural drivers of mental health. This should include supporting communities to make holistic transitions of how they live and function by funding and participating in grand experiments to create resilient, future-fit ways of living.
What other option do we have?
