Making change stick: what it really takes to transform mental healthcare
I’ve written previously about the well-documented problems with Australia’s mental health system — the crisis cycle, the fragmented services, the families left out of care. I won’t revisit that ground here. What I’m asked about far more often is the harder question: not what’s broken, but what it actually takes to fix it.
The gap between wanting to change and being able to
The services we work with at ODC are not short on motivation. Leaders across mental health, youth and community services tell me all the time that they want to shift towards more relational and community-centred ways of working — where the person experiencing distress has a genuine network of support around them.
But wanting to change and being able to sustain that change are two very different things. The kind of transformation that sticks — that becomes embedded in how a service operates regardless of who leads it — requires work at multiple levels simultaneously. Training practitioners is part of it, but so is leadership and culture, service architecture, workforce capability, community relationships, and ongoing support to adapt and translate learnings. Most services, operating under significant pressure, simply can’t do all of that on their own. That’s the gap ODC exists to fill.
The gap between wanting to change and being able to
ODC partners with services as they embed and adapt the Open Dialogue Approach — working alongside them at the practice level, the organisational level, and across their community. We co-design practice models that fit each community’s specific cultural, social and financial context. We build workforce capability through training and events. We also enable continuous improvement and evidence building through a nationally consistent evaluation approach.
Our new four-year strategy — A System That Works: 2026–2030 — takes these things further to include our goals around developing national standards and accreditation for Open Dialogue practice in Australia, and growing the network of services ready to make this shift. We have a portfolio of community partners in Victoria, NSW and Queensland. Services approach ODC when they’re ready — as happened in the Goulburn Region of Victoria, where local services collaborated with ODC to build a whole-of-community response to youth mental health.
Why Open Dialogue
Open Dialogue is both a practice and a way of transforming how services and communities respond to mental distress. It shifts the focus from crisis-driven care to community-centred practice by ensuring people have a network of support around them — family, friends, those with lived experience, and local services.
ODC has identified five practices at the heart of this transformation:
Dialogue: creating space for genuine listening and multiple perspectives;
Agency: enabling people to shape their own support;
Social networks: actively involving family, friends and service providers;
Continuity: facilitating joined-up support across services over time; and
Community capability: building a collective response to combine supports from across the community.
While these practices can be learnt and embedded within a single service or coordinated across a whole community, Open Dialogue is not a solution to every challenge in the mental health system. What it offers is a coherent, learnable framework that can anchor a service’s transformation — relational, community-centred, and oriented toward recovery rather than managing the crisis.
Grounded in Australian policy — and our own research
The Open Dialogue Approach aligns with Australia’s National Mental Health and Suicide Prevention Plan and features in the recommendations of the Victorian Royal Commission into Mental Health. The policy conversation is clear — toward community-centred, relational, networked care. What has been missing is the practical infrastructure to make that transition happen at scale.
In 2025, ODC commissioned a Rapid Review of Open Dialogue, led by Bridget Hamilton and her team at the University of Melbourne. It found a compelling body of evidence that showed that Open Dialogue aligns with mental health system reform priorities with robust evidence suggesting the approach centres consumer priorities, strengthens family and social network involvement, and enhances workforce wellbeing and capability.
The role that only philanthropy can play
There is a particular kind of work that neither government funding cycles nor service budgets are well-designed to support: the sustained, patient work of supporting the services as they transition to new ways of working.
This is where philanthropy plays an irreplaceable role. ODC’s model is built on it: short-term philanthropic investment catalyses the move toward community-centred practice; the Open Dialogue approach enables that change; services then own and sustain it as business as usual; and government funding then sustains the practice for the long term. Our goal is not about adding programs onto already stretched systems. We want to enable the transformation of what is already there — so it works better, costs less, and genuinely enables better outcomes in mental health.
We are deeply grateful to Grant Family Philanthropy, whose founding investment made ODC possible — and we are actively building the partnerships needed to grow this work across more services and communities.
The role that only philanthropy can play
In the coming months I’ll share more about our strategy — the services we’re working with, the challenges we’re navigating, and what we’re learning about making community-centred care the norm rather than the exception.
The conditions for change in Australia are more favourable than they have ever been. The policy intent is there. The evidence is building. The demand from services is real. What’s needed now is sustained investment, practical expertise and long-term commitment.
The conditions for change in Australia are more favourable than they have ever been. The policy intent is there. The evidence is building. The demand from services is real. What’s needed now is sustained investment, practical expertise and long-term commitment. People are drawn to places where something is already happening.
People are drawn to places where something is already happening. The quiet café stays quiet; the vibrant one becomes a destination. The Open Dialogue Centre is entering a vibrant phase—and we invite you to be part of what’s brewing.
Please get in touch if you’d like to know more how we can support sustained change in mental health.
Keith Bryant, CEO, ODC
