Introduction by Croakey: In the wake of its historic election victory, the Albanese Government now has a rare opportunity to pursue “a big, bold reform agenda”, according to policy experts.
Writing in The Conversation, they nominate as priorities: legislative action to advance Aboriginal and Torres Strait Islander peoples’ agendas and rights; climate action; tax reform; and efforts to improve the mental health and wellbeing of all Australians, especially young people.
In the article below, experts from the Brain and Mind Centre at the University of Sydney identify five recommendations for “bold” innovation to ensure a mental health system that is accessible, equitable and effective.
Elements include a standard national intake, continuous care coordination, measurement-based care, expanded early access to effective care, and outcome-driven accountability.
“By the next election in 2028, we want to be talking about the next phases of these innovations to address the next set of problems. We don’t want to still be discussing the same problems that we have been reporting on for the past decade,” they write.
Frank Iorfino, Sebastian Rosenberg and Ian Hickie write:
With the 2025 election behind us, we can now look forward at what an ongoing Labor Government will do for mental health and the closely linked areas of social care and community support.
Labor has pledged $1 billion to expand affordable services, including Medicare-funded centres, more headspace clinics, and new youth specialised mental health hubs. While these front-line service investments are welcome, more new shopfronts closely resemble those initiatives made many times over the last two decades.
The risk now is of getting more of the same, without learning from the past or investing in serious innovation.
In 2025, this would be a missed opportunity. Bold solutions can personalise assessment, improve care coordination, deliver effective care earlier in the course of illness and widen equitable access.
Leveraging digital mental health
When people hear ‘digital mental health’, they often think of meditation apps, telehealth assessment or online therapy. While these are helpful, the real transformation we need is system-wide digital infrastructure.
Australia produces world-class digital health innovations, yet they’re scattered. This leaves people to navigate this space to find what suits them. But variance and inequities affect nearly every point in a person’s journey.
From initial assessment to referrals to treatments, outcomes are too often determined by luck – who you see, where you present, and when you manage to get there – rather than by a consistent standard of care.
Imagine if consumers were guaranteed high quality, specialised assessment, care planning and interventions, no matter where they lived. Imagine if clinicians could access a shared, up-to-date picture of a person’s history and outcomes to deliver effective, tailored interventions. Imagine if policymakers had real-time data on population needs, where services are effective or where demand is rising.
These aspirations are possible now and so here are five priorities the Government can tackle in the next three years to make it happen.
1. A nationally standardised assessment at every entry point into the system
When you, a friend or family member need help for mental health where do you go?
Some go to their GP, some a headspace service, some look online, some call a helpline, and those who wait too long tend to end up at an emergency department.
Currently, the choice of where you present can greatly impact what gets assessed and the decision about what care is appropriate. This is not acceptable.
We need a nationally standardised assessment at the first point of contact for anyone seeking mental health support. This is essential for determining the right mix of services for each person so that regardless of where they present everyone receives the same, high-quality assessment.
The Government’s commitment to a national Initial Assessment and Referral (IAR) tool is a basic multidimensional framework for this. It helps clinicians match a person’s mental health needs with the right level of care intensity.
Though its intrinsic logic is sound, the tool’s utility in its current form is limited and its adoption is uneven. It relies heavily on a major workforce (which is not readily available) who require significant training for consistency. Consequently, it’s not easily scaled to meet demand.
A priority for the next three years should be to leverage digital technologies to build on this established multidimensional framework to scale a smart, user-friendly tool for consumers that can deliver far more consistent, high quality and personalised assessments. No matter where you live in Australia.
2. Establish seamless, digital care coordination for everyone
Even with a better front door, people with ongoing or complex mental health needs struggle to find the right services.
The responsibility of navigating care falls on individuals and their families, who can feel overwhelmed trying to coordinate GPs, nurses, psychologists, psychiatrists, housing support, and more.
People are forced to repeat their story, referrals are lost, coordination of multidisciplinary care is difficult, and transitions between services are complicated. Care tends to be episodic and organised around billing (or who is paying), rather than focusing on what someone needs throughout their care journey.
In 2025, someone presenting for care in rural Australia should have the same level of access to quality care as someone in metropolitan Sydney. New physical hubs do not solve this problem, no matter how well planned the service mapping and colocation plan is.
But digital innovations can solve this by dynamically mobilising workforces to service high demand and link people to the care and supports they need.
A technology-enabled system would facilitate a more continuous and coordinated journey that wraps around the person.
Bringing together Australia’s digital innovations into an interconnected ecosystem that combines with traditional health and social care systems to intelligently arrange care around the person and their needs should be a major focus for policy and reform.
3. Make measurement-based care the norm
When people’s needs or circumstances change, so should the care their receive. For this, we must embed digital measurement-based care into everyday practice, across the system. This means every mental health service or provider should be involved in monitoring the needs, symptoms and functioning of consumers throughout treatment.
Compared to usual care, measurement-based care improves clinical decision-making, functional outcomes and quality of life, particularly for those who are not responding or getting worse. Clinical response rates increase to 86.9 percent (compared to 62.7 percent in standard care), remission rates increase, and response is achieved about twice as quickly.
Australia has pockets of success, but no national approach. Digital tools enable routine outcome monitoring across services at scale to ensure people are getting what they need.
They also empower young people to engage in their care, boosting trust and transparency.
When measurement-based care is combined with care coordination, we then have a powerful approach capable of effective indicated prevention and early intervention that continuously responds to people’s needs.
4. Enhance direct and timely access to effective care
Limiting specialised care only to more severe cases or those who fail primary care risks delaying access to more effective interventions.
Early access to specialised care is linked to a decrease in overall progression to more severe illness and fewer people disengaging from services.
Yet currently, long wait times for psychology or psychiatry and referral hurdles are the norm.
Such delays are unacceptable for someone with severe depression, psychosis, or suicidal behaviours. We need to ensure direct and timely access to effective care by boosting best use of the specialist workforce, streamlining referral pathways and leveraging technology.
Boosting the share of the total budget allocated to effective care option improves aggregate outcomes, as long as direct referral to specialised care is an option.
Training more psychiatrists, clinical psychologists, mental health nurses and other mental health professionals requires many years, and considerable investment and planning. But the data shows that every step towards expanding the specialised workforce can create ripple effects throughout the system.
Expanding effective care capacity also has a new meaning in the digital age. Artificial intelligence (AI) and other digital tools are rapidly changing how we collect, analyse and provide care.
Enhancing specialised capacity also means leveraging new technologies to enhance the primary care workforce with specialist capabilities and using AI technologies capable of providing safe and effective care.
5. Build a real-time learning health system for continuous improvement
A modern health and social care system must learn and adapt continuously, holding itself accountable for improving people’s lives.
This means collecting and using data to improve service delivery. That means routinely measuring outcomes – not just how many sessions are delivered or dollars spent, but whether people actually get better.
Real-time dashboards could help track distress, suicide, self-harm hospitalisations, functional impairment, and rates of disorder. This can tell us about the ‘health’ of the system, identify gaps in care, and allows us to redirect health care and social support resources quickly.
This approach is focused on accountability, transparency and smart planning. Other countries have shown it’s possible. Even in the UK, with all the pressures on the NHS, outcomes are reported, enabling transparency and accountability.
Australia’s Productivity Commission has urged the creation of a robust evaluation culture focused on outcomes that matter to people, with results reported at the service-provider level to drive quality improvement.
It is time Australia established a learning health system for mental health and social care that facilitates quality improvement and rapid translation of research innovations.
By 2028
Australia has been in a long process of mental health reform for three decades. But the challenges we face in society today demand us to do much better.
Rising inequality, economic uncertainty and major advances in possible care options mean we can’t afford to fall further behind.
Many struggle to access basic services, experience long waits, and don’t ever receive health or social care that meets their needs. This underscores the need for real innovation that go beyond minor tweaks.
In 2028, if Australia’s mental health system looks largely the same as it does today, we will have failed.
A standard national intake, continuous care coordination, measurement-based care, expanded early access to effective care, and outcome-driven accountability together form a blueprint for a mental health system that is accessible, equitable and effective.
By the next election in 2028, we want to be talking about the next phases of these innovations to address the next set of problems. We don’t want to still be discussing the same problems that we have been reporting on for the past decade.
Author details
Dr Frank Iorfino is a Senior Research Fellow at the Brain and Mind Centre, University of Sydney
Dr Sebastian Rosenberg is a Senior Lecturer at the Brain and Mind Centre, University of Sydney
Professor Ian Hickie is the co-director of Health and Policy at the Brain and Mind Centre, which operates early-intervention youth services at Camperdown under contract to Headspace. He has previously led community-based and pharmaceutical industry-supported (Wyeth, Eli Lily, Servier, Pfizer, AstraZeneca, Janssen Cilag) projects focused on the identification and better management of anxiety and depression. He is the Chief Scientific Advisor to, and a 3.2 percent equity shareholder in, InnoWell Pty Ltd, which aims to transform mental health services through the use of innovative technologies.
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Calling for national leadership to address workforce shortages in community mental health services
Improving mental healthcare for Aboriginal and Torres Strait Islander people: new research findings
See Croakey’s archive of articles on mental health matters
