We have seen greater empathy for those who live with mental health issues.

There has been a renewed understanding that anyone can find themselves struggling and a recognition that the psychological fallout from the pandemic is being felt by people from all walks of life.

We are on the road to recovery but the mental health tail will be long and complex.

As we begin to rebuild, I am hopeful about the opportunities before us.

Infused with that sense of optimism, today, I want to talk about how we can use the creative, adaptive thinking arising out of this crisis – and digital advancements – to help drive real system change that can improve – and even save – lives.

Specifically, I’ll share with you some examples of how Beyond Blue is using digital solutions to do just that.

But first, I want to talk about why I believe these changes are so important.

Nothing about us without us

During my time in politics, I was keenly aware that good policy must always be driven by evidence.

But I also learned that cold hard datasets are meaningless if you don’t understand the day-to-day lives of the people behind the numbers.

You can’t take a paternalistic, top-down approach that cuts people’s lived experience out of the decision-making process.

The best public policy must be driven by empathy, connection, and a willingness to listen and learn, as well as data.

Looking back, some of the achievements of which I’m most proud are those that put people at the centre of public policy.

I think of the quiet courage and dignity of the child sexual abuse survivors who shared with me their personal stories, highlighting the need for justice, and making the case for a Royal Commission.

Or 12-year-old Sophie Deane, who has, but is not defined by Down Syndrome. Sophie took my photo in Melbourne on the day Victoria agreed to sign up to the National Disability Insurance Scheme – an image that now sits in the Museum of Australian Democracy at Old Parliament House in Canberra.

We should never forget that behind every raw statistic is a real person.

When making decisions that impact on the quality of someone’s life, we must always centre real people.

As many advocates would say – nothing about us without us.

Our mental health system must be designed with this principle in mind.

Person-centred digital reform

But currently it isn’t.

It leaves people confused about where to start, with little autonomy over their own care.

The options are not nuanced – a GP-led mental health care plan, medication, or a trip to the emergency department.

But not everyone will need clinical support, especially if we intervene early.

We need different options for different people, in a stepped care system where every part of the ladder is built properly.

We can’t expect people to change to fit into a system that wasn’t built to meet their needs.

We must change the system to fit them.

Digital technology is a critical piece of this reform puzzle.

If we get it right, digital transformation can democratise mental health access and help build a system with multiple entry points – not just the traditional provider-led model.

We can do this through true co-design, where those with lived experience help us create a collaborative, more accessible, and easier to navigate system.

Because we know that when harnessed appropriately, technology can deliver great outcomes.

For many people living with depression and anxiety, online interventions can be as effective as face-to-face treatment, particularly if there is additional practitioner support.[1]

Digital services should be seen not as a replacement for the traditional ones delivered by our extraordinary GPs and mental health professionals – but an enhancement.

The true integration of face-to-face, telehealth and digital options would be a huge stride towards a system that sees the whole person, not just a collection of symptoms in need of a quick fix.

No more so than in prevention and early intervention.

Take the case of the millions of people every year who take those first tentative steps when they realise their thoughts and feelings are changing.

With connected platforms and services, there would be a clearer pathway from seeking information to actually getting the support they need – whether that’s a digital self-help resource, a web, text or phone chat with a counsellor or peer worker, or making an online appointment with their GP.

So when a sleep-deprived Mum picks up her phone in the middle of the night and does an online search for ‘why don’t I love my baby’, she finds a doorway into a system that wraps its arms around her with support that works for her unique circumstances.

And the journey doesn’t end there.

A truly integrated system would create lasting relationships, where that Mum only needs to tell her story once, and checks back with her to find out if she needs further support, listening to what worked and what didn’t about her experience.

Our vision

This is the future Beyond Blue wants to see.

And the reform starts at home.

2020 marked Beyond Blue’s 20th anniversary.

The way we reach out to support people, how they reach out to us, and how they interact with each other, has changed significantly – and increasingly these interactions now happen in the virtual world.

The Beyond Blue website has evolved to offer a greater variety of digital content and more bite-sized information for improved accessibility.

Our range of digital tools has expanded, giving people more agency over monitoring their own mental health, with a variety of online checklists, tools and apps.

In 2013, when we launched our online peer support forums, 25 per cent of visitors were accessing the Beyond Blue website on a mobile or tablet device. Today, it is 67 per cent.

We are rising to the challenge of growing demand for virtual supports and services.

With 13 million people connecting with us every year, our digital vision is for Beyond Blue to be the ‘Big Blue Door’ for the community.

A door that’s always open and has behind it a range of simple to navigate mental health and suicide prevention information, services, and resources – delivered not just by Beyond Blue but by our partners. 

We want to create an integrated, seamless, and welcoming experience across one ecosystem.

One that connects people with personalised care informed by dynamic data and insights to ensure we understand and anticipate the community’s needs so we can constantly improve what we offer.

COVID crisis & opportunity

In many ways, the pandemic has only accelerated the digital-first future we had planned.

Suddenly, the whole world was online, and the old ways simply wouldn’t work anymore.

Through necessity, major structural reforms like universal telehealth – for which Beyond Blue, along with others, had been advocating for more than a decade – were introduced overnight.

In April 2020, there were 5.8 million Medicare-funded telehealth consultations across Australia and as a category, mental health had the highest ratio – with just over half of all consultations taking place either over the phone or online. [2]

We were watching in real time how technology could help reduce barriers of access, affordability, and convenience, and challenge prevailing paradigms.

At the same time, Beyond Blue was busier than we’d ever been.

As the nation struggled with the sudden and dramatic changes in the way we live, service demand and distress were soaring.

We set up a coping with coronavirus thread on our online forums and it received seven times the traffic a similar thread on the bushfires received earlier in the year.

It was clear that with so many people seeking our support we needed to rapidly scale up our response.

In April 2020, thanks to Commonwealth funding, we set up the Coronavirus Mental Wellbeing Support Service – a dedicated digital site and omnichannel support service to provide free, round-the-clock, pragmatic digital content, professional counselling, referrals, and online peer support.

This enabled us to prototype our Big Blue Door vision, giving people a single entry-point to a range of tailored supports.

The service went live eight days after funding was announced.

We adopted a ‘try, test and learn’ approach – with all the clinical safety guardrails in place – that saw us forge new partnerships and continuously iterate and improve the service.

Data and insights allowed us to drill down in real time into the issues that people told us they were finding tough.

When the pandemic began, people were concerned about catching the virus or loved ones becoming sick.

As it progressed, we saw more worries about isolation, loneliness, job loss and financial pressures.

When lockdowns were reintroduced in Victoria, we began to see more talk of exhaustion, isolation, relationship and family tensions, and fears for the future.

We were able to use this data to constantly refine and update our digital content to reflect real-time concerns and point people to the appropriate supports.

Partnerships have also been a critical piece of the puzzle, with digital referral pathways directing people to the best resources for their needs, regardless of the host organisation.

Collaboration with sector partners including ReachOut, Mind Australia, Lifeline, and Financial Counselling Australia has been a win-win for providers and people.

At the same time, our counselling service witnessed a 30 to 60 per cent increase in call demand compared to 2019.

Without the strong digital presence, it’s likely our counselling line would have been overwhelmed in the early days of the pandemic, which would have been a bad experience for people in distress.

Greater choice

What all this tells us is that when appropriate, you use technology to give people greater choice and autonomy over the support they seek you can also take pressure off people provided services.

You can also help meet the community demand for assistance and relieve pressure on clinicians like psychologists and psychiatrists by investing in new workforces and offering low intensity services.

For example, Beyond Blue created New Access – a coaching service using cognitive behavioural therapy for people experiencing mild to moderate anxiety or depression.

Think of a New Access coach like a personal trainer for your mental health.

People can self-refer – without going to see their GP – and access six sessions free of charge, either over the phone, by video call, or in some circumstances, face-to-face.

New Access is currently commissioned by more than 11 Primary Health Networks across Australia.

Since its inception in 2013, its clinically supervised coaches have supported more than 13,000 people, with 70 per cent recovery rates.

Clinically validated outcome measures are routinely collected, and data shared with the person, their coach, clinical supervisor and GP so clinical risk can be managed in real time.

Importantly, it’s designed to fit within a stepped care system. People can be ‘stepped up’ to more intensive services at any point.

New Access is just one example of how we can integrate systems, new workforces and technology to reduce access and affordability barriers and provide safe, effective person-centred care.

Digital downsides

COVID has accelerated our digital thinking and proven organisations and systems can adapt to harness new technology for good.

But of course, we must stay vigilant to the risks.

Social media has radically changed the way we interact online, but we haven’t yet made the necessary regulatory adjustments to keep up with the pace of change.

When planning mental health reform, the sector and government must work directly with organisations like Facebook, Google, Instagram and TikTok to ensure safeguards are in place on all digital platforms to protect and support the community, particularly children.

And we must remember that we can’t truly have a digital revolution until we tackle digital exclusion.

An estimated 2.5 million Australians – approximately 10 per cent of the population – can’t access services digitally – through issues of affordability, access, or ability. [3]

A further 4 million rarely engage with the internet.

In general, Australians with low levels of income, education, and employment are significantly less digitally included.

People over the age of 65, those on a disability pension or without access to a fixed internet connection are among the top groups experiencing low digital inclusion.

Where you live can also have a significant impact.

About a third of all Australians live in regional communities, but around 90 per cent of psychiatrists and two-thirds of mental health professionals live in major metropolitan areas.

In an ideal world, digital health would reduce some of these barriers by providing access to care regardless of where you live, but only if the technology is up to scratch.

We need the infrastructure to support telehealth because until there is digital equity, we cannot have equity of access to mental health care.

Conclusion

At the very beginning, I spoke of optimism and that is how I would like to conclude.

We live at a time of huge stress and strain, but the opportunities for major reform have never been greater.

Seminal reports both federal and state have been released that will help shape the future of the mental health and suicide prevention systems in this country. Importantly, this work puts people at the centre of what we hope will be landmark reforms.

The Productivity Commission report specifically identified the need for prevention and early intervention in mental health, the potential in low-intensity approaches and the priority need for a national digital mental health platform. It also recognised the need to look outside of the healthcare system.

Now is the time to drive the reform conversation to conclusion and start the process of profound change.

Of course, in these challenging economic times, we must ensure the next investments are smart ones.

And that’s what I want to leave you with today – a call to action for a digital future that doesn’t just makes sense fiscally but could transform our mental health system and change lives for the better.

Now is the time to be bold and creative.

This is not about one organisation – it must be a commitment from all of us to partner in new and agile ways, to create a streamlined, connected system that puts people first.

Beyond Blue looks forward to working with you making that vision a reality.

This is an edited extract of Ms Gillard’s address to the Australasian Institute of Digital Health’s Digital Health Summit, delivered in November 2020.



[1] Griffith et al., 2010; Andersson and Hedman, 2013; Andrews et al., 2014

[2] Christensen, H, 2020. ‘Don’t waste this crisis, scale up digital mental health care’, Insight Plus, 3 August 2020

[3] Thomas, Barraket, Wilson, Rennie, Ewing, MacDonald, 2019. Measuring Australia’s Digital Divide: The Australian Digital Inclusion Index 2019. RMIT University and Swinburne University of Technology, for Telstra.

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