For mental health reforms to work, we need to make it mentally healthy work

The Australian mental health system is getting in the way of the very people trying to reform it. What could the future look like if we treated the people making change as “whole people” and prioritised making mental health reform work mentally healthy work?

6 October 2022

Carla Clarence, Principal of Social Health; and Chris Vanstone, Chief Innovation Officer

Bleak new figures confirm the depth of the broader mental healthcare worker crisis

A recent study of over 9,000 healthcare workers during the pandemic found 57% of the workforce was struggling with depression, almost 60% with anxiety, and over 70% with moderate to severe burnout. That’s about 10 times higher than the public average. 

Professor Wilson, outgoing president of the Royal Australasian College of Physicians said a survey by the college had found 87% of doctors were experiencing burnout, and that had major risks for patient safety.

The Australian Medical Association's Dr Sarah Whitelaw recently told ABC’s 7.30 report: “I've never seen the system under as much stress right across Australia as it is right now. We've got this perfect storm of staff shortages, increased demand that we knew was going to come, and then also significantly increased demand in terms of Covid and flu."

In the same ABC  7.30 report, the outgoing president of the Royal Australasian College of Physicians said a survey by the college had found 87% of doctors were experiencing burnout. 

This is the same workforce that, in some states, is taking on the additional workload of mental health reform.

Reform and innovation work can only be successful if we think hard about the wellbeing of the people who have to deliver them

Dr Clare Skinner, the President of the Australasian College for Emergency Medicine, said it best in a recent article for medical journal Insight Plus: “There is a Māori proverb in Aotearoa New Zealand that says, “He aha te mea nui o te ao? He tangata, he tangata he tangata.” It translates as, “What is the most important thing? It is people, it is people, it is people.”

TACSI works alongside remarkable people within mental health services who are giving social innovation or co-design a red hot go. When done authentically, this is a ‘hands on’, ‘heart engaged’ change process. More often than not, these people are changing the way they and their organisation work within current and somewhat unhelpful constraints while holding down full time duties and  or caseloads. This is a tough gig and rarely a smooth ride.

Reform and innovation work can only be successful if we see the people delivering change through the systems as whole people; people who need time and space and care to change well worn habits, imagine alternatives and work against the current paradigm to build an alternative.

Illustration of a person handing papers out of a window to another person

Mental health reform will be more effective if it’s mentally healthy work

Making mental health reform mentally healthy might be the fastest way to the best outcome – and it might also make reform activities a rewarding and transformative experience. 

To do this, leaders of reform need to:

  • Make time and create space for people to do things they haven’t done before, giving people the opportunity to learn the new concepts they’re embracing – such as co-design and co-production – before starting any kind of reform work

  • Pair the work back to the essentials. Reform work is often overly complex and poorly defined. Part of the work is working out what the work is. 

  • Make sure any participatory aspects are appropriate to the time and skills available, can be done with rigour, and matches the complexity of the work.

  • Support healthy cross-organisational partnerships where organisations and teams are given the time to build the actual partnership agreements and infrastructure. This is about giving people permission and time to align on partnership principles, practices, policies and processes. (We’re seeing partnerships needing to work out this complexity as they try to forge forward together.)

  • Support learning and diverse communities of practice and build this into roles and responsibilities. (We regularly see individual people holding ‘transformation’ and ‘lived experience’ roles for large bodies of work, and ending up exhausted and overwhelmed.) 

Read more from TACSI on how to put people at the centre of reform.

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