Our ‘one foot in, one foot out’ approach to the Future of Mental Health

Imagine a mental health system where diverse and healing-centred responses abound, and co-production is our new business as usual

6 October 2022

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

Our mental health systems are broken

This realisation is important. It can inspire us to mobilise in new and bold ways, and to let go of what’s no longer working. It can help us to learn, where possible, to forgive and heal. 

Within the ‘broken’ rhetoric however, we wish to recognise that when we are talking about systems, we are also talking about people. Yes, there is a lot to improve, overhaul and get right. But we wish to acknowledge the people within the system who have worked and continue to work tirelessly to make our system respond. Theirs are powerful contributions to recovery, healing and hope.

Over the last 12 years, TACSI has worked with people across all facets of the mental health system, from government executives, frontline practitioners, advocates and academics to the people who’ve experienced the system firsthand.

We’ve collaborated with innovators in the community and we’ve seen the changes that can happen when people with lived and living experiences are placed at the centre of mental health responses, and other important stakeholders (those working in or around the system) rally around them as partners to do good work together.

We know the future of mental health can be better

Our ambition is to:

  • Support mainstream services to realise the potential of co-production. Involving people with lived experience creates more effective policy, commissioning, services and organisations.

  • Catalyse and facilitate the uptake of in-community innovations. Australian communities can play a big role in creating protective factors and providing effective responses to mental distress.

  • Build a bridge between innovation in communities and innovation in mainstream services. Sharing of ideas and experiences will help us define and design the future mental health system collectively.

  • Bring the whole system closer together. The mental health system can deliver better outcomes if government, policy, organisations, services and people in the community are aligned in their vision and desired outcomes.

  • Support mental health responses towards ‘structural healing’ rather than ‘structural harm’. The service sector will be more sustainable if it is part of a whole-of-community response and prevention approach.

We’re taking a ‘one foot in, one foot out’ approach

We want one foot in, working to make change in the mainstream service system. This will mean shifting entrenched systems, mindsets and ways of working. It will mean bringing people with lived experience to the centre of decision making.

We also want one foot out, working with innovators in the community and on the fringes. This will mean facilitating new partnerships and bringing community-led innovation into the mainstream.

Our role is to provide a bridge between these two worlds, using everything we’ve learned to put people and community back at the centre of mental health care.

One foot in: What we hope to see inside the mainstream service system

  • Partnerships and trust become the cornerstones of service provision. Co-production and social innovation practices underpin how governments and organisations partner with people. Decisions are made based on a collective understanding of what really supports mental health challenges and wellbeing.

  • People are no longer stuck in ‘receiving and delivery’ cycles of unhelpful services. Instead, we create, design and improve services that:

    • are collaboratively strength-based

    • are culturally safe and inclusive

    • build the protective, preventative and healing capacity of individuals, loved ones and the workforce

    • privilege the perspectives of those most affected by the challenge and response at hand.

One foot out: What we hope to see outside in the community

  • Mental health innovations and alternatives become legitimised as part of the mental health system. Ongoing learning and community-led innovations are recognised and valued in the mainstream service system.

  • New partnerships and greater resources unlock the potential of community-led innovation. New approaches deliver diverse recovery and prevention solutions to challenges previously overlooked or considered ‘impossible’.

The middle bit: What we hope to see when the two worlds come together

The ultimate aim of TACSI’s ‘one foot in, one foot out’ approach is to bring these worlds together, embedding community-led innovation and co-production into mainstream health services.

What we want to see as a result of this connection:

  • Together, the system and the people within it shift from being merely aware or informed about the experience and effects of trauma, towards opportunities for healing in everyday life.

  • Community and mainstream services working together is ‘business as usual’. Each has access to the strengths of the other and both benefit from the exchange of skills, ideas and experience.

  • A whole-of-society effort mobilises to support building and realising the future of mental health. There is widespread recognition that we have a collective responsibility to support each other and our mental health system.

Why now?

The current mental health system is overwhelmed and unsustainable

Our current mental health system is under increasing strain, and our mental health as a population is getting worse. The outcomes of the Royal Commission into Victoria’s mental health system have shown that we need to bring community at the core of mental health services and that specific new foundations are required, including lived experience leadership and a strengthened workforce. In line with the findings of the Royal Commission, we need not only to expand the capacity of mental health services, but also to dramatically change the way they are designed and delivered.


We are living in a time of crises that will continue to take a toll on the mental health of Australians

The rolling crises of climate change, pandemic, social and economic turmoil will continue to affect the lives and livelihoods of Australians for years to come. We need to find new ways to support the mental health of a population in sustained physical, emotional and economic distress.

Community-led approaches are the only thing with the scale and potential to de-escalate the mental health crisis

Services are being embedded in the community like never before, including a network of multiple Adult Mental Health Centres across Australia. These will be invaluable doorways for adults to access mental health information, services and support. We must, however, not confuse these important centres with community-led approaches, which take many forms depending on the needs of diverse communities across Australia. These responses, too, will require support, investment and opportunities to scale.


There is currently a global push to address mental health and a genuine appetite to do things differently

There is a sincere desire for change expressed by federal plans, executive leaders and community conversations. This marks a departure from decades of stated priorities in preventing poor mental health that have not led to action. Now is the moment for change and decision makers are looking for people with the skills and the networks to guide the transition. 

The financial and societal costs of poor mental health are already having a severe impact

The World Health Organisation expects that by 2030, depression alone will cost $6 trillion globally. What will this look like in Australia? A failure to address this challenge now could mean irreversible damage to our capacity to build protective factors in the future.


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