Social policy by Royal Commission: Our key learnings from mental health and aged care

It can be a challenge for for-purpose leaders to ensure their strategic direction aligns with and responds to the emerging policy. In an era where so much of our social policy is led by Royal Commissions, it’s imperative that leaders are across any of these reports that relate to their industry. The recent release of two Royal Commissions into our aged care and mental health systems exposed critical challenges and outlined a path forward for better care, health and wellbeing outcomes.

Reading both reports, there are many similarities in the findings between the two. The challenges detailed by both Commissions are not unique to just mental health and aged care – they highlight the critical challenges facing the entire for-purpose sector. In fact, these challenges and themes mirror many of the strategic conversations we have had with our clients over the past 12 months. That’s why it is so important for-purpose leaders to be aware and across these Royal Commissions and what they mean for the sector at large and their organisation.

In this blog, we have shared our four key takeaways from the Royal Commissions and how for-purpose leaders may respond:

Finding: Accessing help is challenging and frustrating

Perhaps the biggest challenge highlighted in both Royal Commissions is accessing help. For those who are eligible for support, understanding where to go, who to speak with and how to access credible information is incredibly difficult. Other factors that make access more challenging are an individual’s mental state and their age. Both Royal Commissions found that access to support is not equitable, with poverty, rurality and disadvantage in particular, making access to services more difficult. It was found that a disproportionate number of people living with mental illness have low income and no private health insurance. This has resulted in the people who are most in need of support, being the ones that have the hardest time receiving it.

“I personally have asked for help from all the promoted channels and been turned away as I was not suicidal enough … Surely if someone has the courage to ask for help, Australia has the resources to help.”

  • Response received during the Royal Commission into Victoria’s Mental Health Care System

“So what” for my organisation?

For-purpose organisations and leaders must question how accessible and equitable their services are to seek and receive. Simple information, strong partnerships and great referral pathways, hybrid delivery models (i.e. F2F and digital), a focus on equity and inclusion are all important ways in which access can be improved. It’s worth doing a quick audit of your current state and actioning any areas that fall short in terms of access.

Finding: Lack of focus on prevention

Intimately related to the challenge of access, is that of social and environmental systems and structures that are focused on responding to emergencies rather than preventing them. In the context of Royal Commissions, this was described as under-resourced prevention and early intervention arm of health and wellbeing. When our health systems fail to support individuals in the early stages of illness, the worse their condition becomes. Over time, this results in a health crisis event at which point our emergency departments start to become used as entry points for support. This can end up being a vicious cycle – as more of our resources and energy goes into response and rehabilitation, it’s easy for prevention and early intervention to be de-prioritised. In turn, this means that the frequency and severity of ill-health and injury increases, resulting in an even greater demand for response and recovery.

“So what” for my organisation?

For-purpose leaders need to question how they address the underlying or invisible problems and challenges that create the symptoms to which they respond. The first step in this process is to uncover the root causes for the problems you are addressing. To this end, for-purpose leaders can consider leveraging ‘systems thinking’ principles. These principles seek to explore and map how complex problems are influenced and affected by other elements within our broader context.

Finding: Collective responsibility

Another critical finding of the Royal Commissions is how our communities, businesses, social groups and public institutions (e.g. libraries, aquatic centres etc.) all share responsibility in supporting community health and wellbeing. The reality is, the burden of disease associated with health, wellbeing and age-related conditions impact our communities, our families and our economy. Our housing, employment status, education, income and social connections are key to our overall health and wellbeing and broader life outcomes. Yet there are still inadequate connections between our health systems and non-health systems to support people with their broader, more holistic needs.

“So what” for my organisation?

For-purpose leaders can consider how they respond to and have systems in place to understand and address some of the holistic needs and challenges facing the individuals they serve. There are also opportunities to target and leverage the work of others operating in the same space to scale impact. Creative partnerships; leveraging community settings to deliver services; co-designing and co-delivering services with people with lived experience are just a few examples of how for-purpose organisations can better serve the holistic needs of individuals.

Finding: An absence of quality data

Measuring and evaluating high-quality data is not always easy, but the fact that both Commissions highlighted it as a key failing was surprising to us. When we talk about high-quality data, this is about moving beyond tracking activities to measuring the impact or change that these activities create. This was especially an issue in the aged care sector and there are many reasons for this: a workforce that is stretched and focused on implementation; aged care providers struggling to attract research and evaluation grant funding; and a focus on activity indicators rather than outcome indicators (to name a few). 

“So what” for my organisation?

While many people might groan at the thought of undertaking research and evaluation, it doesn’t need to be hard. In order to move towards the notion of ‘high quality’ data, organisations must move beyond activity tracking to outcome tracking. A good place to start, is to understand your theory of change. At its core, a theory of change seeks to understand and articulate the context your organisation exists within, your response to that context, the medium-term outcomes your response creates and finally, the long-term change you aspire to create. You can find out more about a theory of change and how that can support your organisation’s evaluation efforts here.

Despite the challenges facing our health and wellbeing sector, the fact that we have processes such as our Royal Commissions in shining a spotlight on how we can build better systems is a testament to all those involved. Within the challenges highlighted above are opportunities for all for-purpose leaders to reflect on and enhance their strategic direction.

At Spark, we support for-purpose organisations to develop strategies that help create a better, more sustainable future for all. If you have any questions or comments about this blog and how you can help ensure that your strategy addresses these challenges, please contact Shaun Mascarenhas at shaun@sparkstrategy.com.au.

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