Centre the voices of lived experience in a new National Mental Health Strategy

27 June 2025 | Angela Jackson and Selwyn Button

This article appeared on Coakey health media in June 2025.

The Productivity Commission’s review of the National Mental Health and Suicide Prevention Agreement finds it has not delivered on its ambition to strengthen collaboration and improve outcomes for people with lived and living experience of mental ill health and suicide.

The interim report of our review finds that the Agreement’s objectives are not supported by the right actions or funding.

Over the past decade, governments’ real expenditure on mental health services has grown by 30 percent but funding in the Agreement only represents three percent of this total.

In 2022 the Australian, state and territory governments signed the Agreement, acknowledging they had to work together to create a unified and integrated mental health and suicide prevention system.

The Agreement commits governments to improving services that support the social and emotional wellbeing of Aboriginal and Torres Strait Islander people, but the review finds it has no specific measures or funding to achieve this.

It commits governments to greater investment in prevention and early intervention but again includes no actions that would deliver it.

There is also no funding to support collaboration between different parts of system. This is a core objective of the Agreement, because it is essential to reducing fragmentation and making the system easier to navigate.

This fragmentation leads to service gaps, exemplified by the up to 500,000 Australians who were left without access to psychosocial supports when the NDIS was introduced.

Addressing this was a key commitment of the Agreement. While Health and Mental Health ministers made some progress towards this commitment at their last meeting earlier this month, this is over three years after the Agreement was signed – a long wait for many of those left without necessary support.

In the Productivity Commission’s review of the Agreement, we heard from hundreds of people with lived and living experience, carers and providers who spoke of ongoing challenges accessing and affording care and of uncoordinated services that do not respond to need.

Many of these issues were highlighted by the people with lived and living experience we heard from in our Review.

It’s a reminder of how important it is to involve the people who engage with or work in the system in its design – not as stakeholders but as partners. The Agreement commits governments to doing this but fails to deliver.

Every year millions of Australians seeking support for their mental health must navigate a complex and fragmented mental health and suicide prevention system. Gaps in services and affordability challenges leave many people struggling to access support.

Some progress

There have been some areas of notable progress under the Agreement, including the establishment of a National Suicide Prevention Office that delivered a national suicide prevention strategy, underpinned by comprehensive co-design process with people with lived and living experience of suicide.

Medicare Mental Health Centres have been established in many locations with more to come. The centres have been well received, but they can only support a small number of people.

These successes serve to highlight the potential of a national agreement to deliver real progress.

The shortcomings of our mental health and suicide prevention system are a national problem that require a national solution. A well‑designed, dedicated national agreement still offers the best chance of delivering a system that meets our needs.

The current Agreement expires in June 2026. This gives governments the opportunity to start again and create a policy architecture, including a new national agreement, that enables collaboration and responds effectively to the needs of people with lived and living experience, their supporters, families, carers and kin.

We are proposing in our interim report that the first step should be a new National Mental Health Strategy, which for the first time since 2008 would bring together all the disparate strategies and centre the voices of people with lived and living experience across the system.

The next Agreement should clearly outline how systems will work together to achieve outcomes and create accountability mechanisms that ensure governments take meaningful action.

Taking this approach, a new national Agreement can move towards the unified and integrated system that we need.