Mental Health reform needs a Collective Impact approach

Yesterday was an important day for the estimated 3.2 million people with a mental health or suicidal difficulty, some of whom engage with mental health services and the many that don’t.  The National Mental Health Commission released its first report card – A Contributing Life – that provides an independent review of how the disparate parts of our social systems such as housing, employment, mental health services, crisis support services and physical health services still fail most Australians experiencing a mental health or suicidal difficulty.  The report makes ten system-improving recommendations with 19 associated actions.  Many of the recommendations rely on compelling data points that clearly articulate the urgency of the change required.  And many of the actions call for additional data to be collected, targets to be set, or previously set targets to be better reported on.  This reliance on data to set and report on targets is a hallmark of the Collective Impact approach to social change.

Collective impact is a framework for multiple organisations or entities from different sectors to work together to tackle large-scale complex social challenges. The Framework has five key elements – a common agenda, shared measurement, mutually reinforcing activities, continuous communications, and a backbone organisation.  Backbone organisations undertake functions such as providing overall strategic direction, facilitating effective dialogue between partners, coordinating the alignment of partner activities, and managing data collection, analysis, and reporting.

We believe that the urgent systemic reforms still needed for people with mental health or suicidal difficulties would be substantially aided by the adoption of the Collective Impact approach.  Moreover, we already see many of the elements of Collective Impact in existence – but, like services, they are disconnected from each other.

To explain – if yesterday’s Report Card provides the basis for shared measurement within the Collective Impact framework, then the meeting of 90 mental health organisations – called the Council of Non-Government Organisations (CONGO) on Mental Health – in October provides the common agenda.  At that meeting CONGO committed to ‘establishing a national vision for Australia to lead the world in mental health by 2022, so that within 10 years Australia is acknowledged internationally as the world leader in mental health services, programs, and outcomes’.  This collective leadership is highly commendable, but we have too-often seen that leadership is not enough.

There is much hard work to be done to align the many different, siloed and fragmented systems so they meet the holistic needs of people experiencing mental health or suicidal difficulty.  As Minister for Mental Health Mark Butler said in his statement yesterday “…what is clear from this Report Card is that there is more road ahead of us than there is behind us.”  In charting the road ahead, the Minister urged that we “take up the challenge of working together to build a better service system – a more inclusive society – for people with mental illness”, and that “meaningful and strategic progress will require partnership between consumers, carers, all governments, NGOs and mental health professionals.”

In our view the Minister is calling for a systemic perspective to be taken to the reform process.  A Collective Impact approach would do just that.  The existing elements of Collective Impact – CONGO’s common agenda and the National Mental Health Commission shared measurements – need to be brought together and married with strong ‘backbone’ support, meaning: sufficient resources, influence, discipline and project management to align the activities of CONGO’s 90 members and beyond.  It is that type of leadership and disciplined action that will achieve the lasting and effective change for the people that are waiting for it.

About Kerry Graham and Dawn O'Neil

Social change consultants

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