A System at Breaking Point
In November 2018, the Royal Commission into Mental Health began hearing thousands of testimonies from Victorians affected by the mental health system. The testimonies exposed a system riddled with fragmentation and inefficiencies, leaving families without coordinated care and perpetuating cycles of exclusion.
When the Royal Commission delivered its final report in 2021, it revealed a system in crisis—fragmented services, barriers to innovation, and critically, the systematic exclusion of lived experience perspectives in both service design and delivery. The consequences were profound: individuals in urgent need of support were left navigating a maze of disconnected providers, often falling through the cracks or waiting months for care. Innovation was stifled by bureaucratic inertia, leaving promising solutions underutilized. Meanwhile, those with firsthand experience of the system—the people best positioned to inform meaningful change—remained sidelined in decision-making, perpetuating cycles of dysfunction.
At its core, the problem was structural. The system lacked the mechanisms to bridge gaps between research, clinical practice, and lived experience. Without integration, knowledge remained siloed, and opportunities for meaningful reform were consistently lost.
Building a New Institutional Model
The Commission’s bold recommendation was to establish an entirely new type of institution—the Victorian Collaborative Centre for Mental Health and Wellbeing—designed specifically to bridge these disconnects.
Unlike traditional academic centers or clinical facilities, the Centre was conceived as a hybrid entity with multiple integrated functions: direct service delivery, research, workforce development, and system improvement.
The design process itself embodied the collaborative principles the Centre sought to promote. Working groups combining clinicians, researchers, and people with lived experience collaboratively developed the Centre’s organizational structure, governance framework, and strategic priorities.
A New Institution Takes Shape
The Centre’s institutional architecture represents a radical departure from traditional health service models. Co-production—the equal partnership between people with lived experience and professionals—is embedded throughout the organization, ensuring that services are shaped by those who have firsthand knowledge of what works.
For individuals seeking support, this marks a fundamental shift from the previous fragmented system. Where once people faced disconnected providers, long wait times, and inconsistent care, they now engage with an integrated team that combines clinical expertise with lived experience insights. Care is no longer a disjointed series of referrals; instead, individuals receive personalized, coordinated, and timely support that adapts to their needs. By embedding lived experience at every level, the Centre creates a more empathetic and effective system, where people feel heard, supported, and empowered throughout their mental health journey.
This transformation is embedded in the Centre’s structure:
- Lived experience leadership positions exist across all departments.
- Integrated clinical service units deliver direct care while generating research insights.
- Research teams focus on practice-relevant questions identified by service users and clinicians.
- A dedicated knowledge translation team ensures findings rapidly influence practice.
- System improvement specialists drive the adoption of effective approaches across the broader mental health system.
The Centre operates with a governance framework that balances independence with accountability. A board of 12 members provides strategic oversight, with at least four members identifying as having lived experience of mental illness or psychological distress—including two with consumer perspectives and two with experience as family members, carers, or supporters.
The Centre’s establishment is formally anchored in the Mental Health and Wellbeing Act 2022, which codifies its mandate and governance structure. Its ongoing leadership role in system transformation falls within the portfolio of the Minister for Mental Health, ensuring direct alignment with government priorities.
Strategic Partnerships for System-Wide Impact
The Centre’s partnership model transcends traditional academic-clinical collaborations by connecting across three critical domains: academic institutions (University of Melbourne, Royal Melbourne Hospital), lived experience organizations (VMIAC, Tandem), and diverse community voices (Aboriginal, multicultural, and LGBTIQA+ organizations).
This tri-focal approach ensures knowledge flows freely between research, practice, and lived realities, breaking down traditional power imbalances. Rather than token consultation, these partnerships embed diverse perspectives in the Centre’s governance and decision-making, creating a model where clinical expertise, research rigor, and lived experience hold equal authority in shaping mental health innovation.
Early Impact and Emerging Results
Though still in its early stages, the Centre has begun demonstrating the value of its integrated approach through several notable achievements. Its co-produced service models have shown promising outcomes, with evaluation data indicating improvements in both clinical measures and patient-reported experience compared to traditional services. Research conducted within the Centre’s real-world setting has generated insights that might never have emerged in conventional academic environments, particularly around the implementation of trauma-informed approaches and recovery-oriented practice.
The Centre’s influence extends beyond direct service delivery. Its training programs have enhanced workforce capabilities, with participants reporting greater confidence in working collaboratively with people with lived experience. Perhaps most significantly, the Centre has begun to influence practice beyond its own walls, with other services adopting elements of its co-production methodology and integrated care approaches.
Navigating Complex Challenges
Like all innovative institutions, the Centre faces significant challenges in its multifaceted role. Balancing diverse stakeholder needs requires ongoing negotiation between research priorities and service imperatives, while securing sustainable funding presents complexities in a system where services, research, and advocacy are typically funded through separate mechanisms. Measuring systemic impact beyond direct outcomes requires developing new evaluation frameworks that capture both immediate results and longer-term influence.
The inherent tensions between service delivery, research, and system reform are common in ambitious institutional designs aimed at complex systems change. As the Centre progresses in its implementation journey, these challenges necessitate clear priorities and adaptive strategies—approaches the Centre continues to refine as it works toward achieving its transformative potential.
Reimagining Institutional Possibilities
The Victorian Collaborative Centre is more than a mental health service or research facility—it reimagines how institutions can be designed for systemic impact. By integrating diverse forms of knowledge and expertise, it challenges traditional hierarchies and demonstrates how structure shapes power dynamics in health systems. Its evolution offers valuable lessons for institutional design across sectors, showing how bridging research, practice, and lived experience can drive meaningful change.
At UNDP Istanbul Innovation Days
What if our most intractable problems persist not because we lack solutions, but because our institutions themselves are designed to maintain rather than transform? What can we learn from Victoria’s experience in creating a new type of mental health institution?
At IID, we invite participants through plenaries, discussions, and workshops to explore how deliberate institutional redesign can challenge traditional boundaries and create new possibilities for addressing entrenched societal problems.
