‘Like a library, but for mental health’ — Designing an integrated mental health hub service model
These insights come from a recent project our team led to design an integrated mental health hub service model on behalf of a Primary Health Network.
Why new and better models of mental health services are needed
Numerous reviews into Australia’s mental health system have identified that people generally face a range of barriers to getting the services and support they need when experiencing mental health challenges.
National strategies and policies consistently highlight the need for a more integrated mental health system, where people are able to more easily access services and support to meet their needs and preferences.
The National Mental Health Commission’s Vision 2030 Blueprint describes the national direction for mental health and wellbeing in Australia and highlights community ‘hubs’ as a focal point for delivering integrated mental health and social support services.
“Coordinated delivery of mental health care in single service centres can be efficient, easily accessible way of organising provision of assessment, treatment and recovery support to local populations. Hubs may include a range of social, and primary care supports alongside treatment resources. Hubs may be related to geographic location, meeting specific age or life stage needs, providing culturally support services to addressing specialist needs of illness or circumstances”
In the National Mental Health and Suicide Prevention Plan released in mid-2021, the Australian Government committed to establishing a network of Head to Health Adult Mental Health Centres, including ~16 full centres and 24 satellite centres in communities across Australia.
What makes an effective mental health service hub?
We started the process of designing a mental health hub by understanding people’s previous experiences of mental health services. We heard about what people with a lived experience of mental health challenges had found most helpful or effective, and what they had found to be unhelpful, challenging or frustrating.
We asked a similar set of questions with people working broadly across the mental health sector of their experiences of supporting or connecting others.
We heard that that the most helpful mental health services:
gave people a sense of purpose, hope and confidence
did not require people to continually re-tell their story
offered peer support and social connection
co-located services within one ‘place’
offered a genuine ‘no wrong door’ approach
overcame practical barriers such as cost, transport and timing
guided someone through a holistic range of services and supports
Those services or supports that were unhelpful, challenging or frustrating generally:
created silos between services and are difficult to navigate
didn’t address the drivers of mental health challenges
were delivered in unsuitable or unwelcoming environments
had restrictive eligibility criteria
involved long wait times
had high levels of workforce turnover
focused on the wrong outcomes
Using these needs as a point of reference, we then worked with people to design the ‘solution’.
The ideal model that emerged was an Integrated Mental Health Hub — a prominent community-based resource of information, support services and connections for people across a spectrum of mental health needs and situations. A Hub that aims to foster people’s wellbeing through connection, capacity, hope and empowerment. It would bring together the mix of supports someone might need in an integrated way to overcome the barriers and challenges people often experience when accessing the mental health system.
The analogy of a library
The analogy of a library was shared with us by one group of people with lived experience that we found particularly helpful in thinking about the concept.
Just like a library is a central place where anyone can find a variety of books to suit their interests, an integrated mental health hub is a one-stop destination offering a range of supports tailored to each person's unique mental health needs.
In the same way that libraries are open to all, regardless of background or level of knowledge, a mental health hub upholds a 'no wrong door' policy, welcoming everyone seeking support or advice.
A library is a community resource — it’s a place where people have the autonomy to come, go and just ‘be’ as they need. There might be expectations about how people engage with the space and helpful rules about who can use or participate in what, but ultimately there is something for everyone.
A library is more than just shelves with books — it offers a comfortable environment for reading, research, and community events. Similarly, a mental health hub isn't just about clinical services — it offers a warm, non-clinical space for people to connect, learn, and receive support from each other in a manner that best fits them.
Librarians in libraries manage the catalogue of resources and guide readers towards the books they need, helping them navigate through stacked shelves. Similarly, trained and compassionate people working within a mental health hub help people navigate their way to the right mix of services and supports. Importantly, they don't sit and read the book with someone — they make introductions, get to know people, welcome them into the space, and administer the necessary systems and processes.
And finally, just as a library evolves with the community's needs, adding new books, resources, and services based on demand, an integrated mental health hub adapts and grows to better meet the changing mental health needs of the community it serves.
How PHNs can commission more responsive service models
With Primary Health Networks establishing Head to Health Adult Mental Health Centres in communities across Australia, this presents a unique opportunity to design and develop these new service models around what people actually need and want.
‘Designing well’ requires deeply engaging with people with lived experience and those working in the sector, focusing on building on what’s already there (without creating more fragmentation) and an iterative approach to learning and adapting around what works.
Here are a few focused questions that can help prompt good conversations and design more responsive mental health hubs:
From your experience, what’s most helpful and unhelpful?
Thinking about what the ‘ideal’ service might look like, what would a good outcome look like?
How might someone experience the Hub, from finding out about it and arriving, to the things on offer and what happens when they leave?
What does the ‘place’ look and feel like?
Who are the people who work within the Hub, and what kind of skills, experiences, knowledge and attributes do they have?
What values and principles would you expect the Hub to uphold?