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The Queensland Alliance for Mental Health has completed the Psychosocial Approaches to Thriving Health Systems (PATHS) Project – a transformative, community-led initiative reimagining how people access psychosocial support outside the National Disability Insurance Scheme (NDIS).
Delivered between September 2024 and May 2025 with funding from Community Mental Health Australia, the PATHS Project responded to a critical service gap: nearly half a million Australians experiencing mental health challenges are missing out on psychosocial supports, largely due to the withdrawal of community mental health funding and ineligibility for the NDIS.
Over eight months, QAMH undertook a place-based co-design process in Townsville, selected for its service challenges and diverse population. More than 90 community members contributed through workshops, surveys and a Town Hall event, with targeted engagement reaching Aboriginal and Torres Strait Islander peoples, culturally and racially marginalised communities, carers, older adults, industrial workers, and disability service providers.
“This project set out to answer a big question – how do we support people who fall through the cracks of the existing system?” said QAMH CEO Emily Wolter. “What we learned in Townsville is that the answers are already in community. People know what works – we just need to listen and design with them, not for them.”
Consultations painted a picture of a fragmented, crisis-driven system that people often can’t access until they are in acute distress. Many were unaware of available services, encountered long waitlists, or felt existing supports were too clinical or culturally inappropriate.
“Many people don’t access support until the building is on fire,” another participant explained. “Initial help-seeking should be focused on informal and community-based supports, not formal mental health services.”
A clear message emerged: clinical care focused on diagnosis alone isn’t enough. Community members consistently called for earlier, face-to-face support that is culturally safe and delivered in trusted community spaces. They also highlighted the need for practical, everyday help with housing, employment, relationships, financial insecurity, cultural connection, and social inclusion. These are the social determinants that influence mental health and wellbeing.
“People need to feel safe, supported, and connected to seek help,” one participant shared. “Cultural stigma is still a major barrier – language like ‘wellbeing centre’ is more acceptable than ‘mental health service’.”
The PATHS model responds directly to this feedback. It offers:
- Soft entry points through familiar, non-clinical settings like Men’s Sheds, neighbourhood centres, and cultural hubs
- Flexible psychosocial support that adapts to changes in people’s level of need
- Integrated pathways connecting hospitals, GPs, peer workers, and community organisations
Grounded in lived experience, cultural safety and local context, the model is designed to be scalable, block-funded, and accessible without a formal diagnosis or restrictive eligibility criteria. The project also reinforced the critical role of peer, cultural and psychosocial support workers and the need to invest in a workforce that reflects the diversity and values of local communities.
Cost modelling found the PATHS model could be delivered for just $3-$65 per person daily – a fraction of hospital-based care. In 2022–23, Australia spent $3.3 billion on public hospital mental health services, with an average cost of $1,532 per patient day in acute psychiatric inpatient units[1] and an average stay of 15 days[2]. These figures make a strong case for early, community-based supports that prevent crisis and reduce pressure on hospitals.
The project demonstrated that effective support must move beyond clinical care to address the broader social and structural drivers of distress. It reinforces the growing recognition that recovery is not a linear or purely medical process – it is social, relational, and deeply tied to place. By focusing on flexible, person-led support delivered in trusted community settings, the PATHS model responds directly to these broader social determinants and the real-life contexts people live in. This approach echoes calls from national inquiries including the Productivity Commission and the NDIS Review to invest in community-led, culturally safe psychosocial supports for people outside the NDIS.
As the PATHS model shows, relationship-based care grounded in trust, connection, and place is not only socially impactful – it’s economically viable. Its emphasis on local leadership, flexibility, and lived experience is supported by growing national and international evidence for psychosocial supports and social prescribing, which have been shown to reduce psychological distress, improve wellbeing, and ease pressure on acute services[3],[4]. By intervening earlier and addressing distress before it escalates, this approach helps people stay connected to their communities and avoid crisis[5].
“PATHS gives us a real, evidence-based alternative,” said Wolter. “It’s not about replacing what exists – it’s about making the system work better. The PATHS model offers a blueprint to do that, not just in Townsville, but in communities across the country.”
QAMH has published a Project Summary and Infographic outlining the model’s design, findings, and implementation considerations. These resources are available to inform service design, workforce development, and future policy reform.
[1] Australian Institute of Health and Welfare. (2024). Expenditure on mental health services. https://www.aihw.gov.au/mental-health/topic-areas/expenditure
[2] Australian Institute of Health and Welfare. (2024). Admitted patient mental health-related care. https://www.aihw.gov.au/mental-health/topic-areas/admitted-patients
[3] Harvey, C., Zirnsak, T.-M., Brasier, C., Ennals, P., Fletcher, J., Hamilton, B., Killaspy, H., McKenzie, P., Kennedy, H., & Brophy, L. (2023). Community-based models of care facilitating the recovery of people living with persistent and complex mental health needs: A systematic review and narrative synthesis. Frontiers in Psychiatry, 14, Article 1259944. https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1259944/full
[4] Zurynski, Y., Vedovi, A., & Smith, K. (2020). Social prescribing: a rapid literature review to inform primary care policy in Australia. Consumers’ Health Forum of Australia. https://chf.org.au/publications/social-prescribing-literature-review
[5] Hayes, L., Brophy, L., Harvey, C., Herrman, H., Killackey, E., & Tellez, J. J. (2016). Effective, evidence-based psychosocial interventions suitable for early intervention in the National Disability Insurance Scheme (NDIS): Promoting psychosocial functioning and recovery. Mind Australia. https://mindaustralia.org.au/sites/default/files/2023-05/Effective_evidence_based_psychosocial_interventions_full_report.pdf
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