No quick fixes: Designing a new workforce for digital mental health services

For years, governments and service providers have rightly noted the workforce shortages that too often get in the way of implementing new and innovative ideas. This issue is particularly evident in digital mental health services, where workforce limitations have made it difficult to provide accessible, timely, and scalable mental health care.

Such shortages are most apparent when we limit our focus to the existing workforce: the usual suspects, in the usual roles, deployed in the usual way, delivering the usual services. Viewed through that lens, shortages can quickly appear insurmountable and can stall reform before it begins.

But what if we started using different workforces to those we have traditionally used, and started using them in different ways to the ways that we have traditionally used them?

Innovation is essential when capacity is constrained. Rather than asking: “Is there capacity in the existing workforce to deliver more services?” organisations and governments across the system should ask a different question. “If the workforce we rely on is overstretched or misaligned, how can we build, reshape, or better deploy a workforce that can deliver?”

In many cases, the capabilities already exist. They are just underutilised or overlooked parts of the system. In others, the answer lies in creating new roles and pathways that expand supply rather than compete for it. In practice addressing workforce shortages should be a collaborative design challenge, reframing these constraints as an opportunity for alignment and innovation rather than a fixed barrier.

This approach was applied in the design of the Medicare Mental Health Check‑In, which is used in this article as a practical example drawn from Nous Group’s work with the Australian Government Department of Health Ageing and Disability.

In recent years, the demand for mental health services has surged globally, prompting governments to explore innovative solutions. In Australia, mental health services are under significant strain. Workforce shortages mean many services are unable to scale up to provide timely and accessible mental healthcare. This challenge is particularly evident for people with mild mental challenges or those at risk, where tailored early-intervention services are limited. Combined, this results in hundreds of thousands of Australians missing out on support each year and many more receiving treatments misaligned with their needs.

Workforce shortages are a reality, but they should not constrain system reform or redesign. The core issue is not simply whether there is a workforce shortage. It is whether workforce constraints prevent systems from rethinking how work is done, who is best placed to do it, and how capability can be built in new and different ways. When workforce is treated as fixed, innovation stalls. When it is treated as something that can be designed, grown and redeployed, new solutions become possible.

The Medicare Mental Health Check In is an innovative example of this. A new commonwealth government digital mental health service for people at risk of, or experiencing, mild mental health challenges or transient distress, the service aims to encourage Australians to seek help early, so their mental health challenges can be managed through low-intensity cognitive behavioural therapy (LiCBT) before they become more serious. It also helps alleviate system pressures by creating and training a new workforce without diverting the existing one. Crucially, it shows that a purpose‑built workforce can be grown rapidly without drawing clinicians away from already stretched parts of the system. It enables rapid innovation in workforce design, without compromising safety, credibility, or alignment with existing systems.

The concept of a digital mental health service is not entirely new. Similar services have existed internationally and at smaller scale across Australia. However, delivering a service like the Medicare Mental Health Check In in a complex multi-jurisdictional landscape presents unique challenges. Introducing a national, free service that can be accessed following a phone assessment or referral from a health professional is a big step for Australia. 

The complexities of the Australian context mean that international models cannot be directly replicated. Instead, a tailored approach is necessary, one that considers the specific needs and constraints of the Australian mental health landscape including how to mobilise underutilised roles and grow new workforces that complement, rather than compete with, existing ones.

A successful redesign requires deep collaboration across the sector to ensure buy-in from key health professions and organisations. Credibility is strengthened further by evidence of effectiveness. International experience, including from the UK, shows how new workforces can be established, legitimised, and become integral parts of mental health systems over time. While these models require adaptation to the Australian context, they offer important lessons about how trust can be built, roles validated, and new workforce models embedded alongside existing services. 

Finally, credibility depends on clear and recognised qualifications. Even where roles are supported by foundational rather than clinical training, qualifications must be explicit, demonstrable, and sufficient to provide assurance to the sector and service users.

A further challenge is aligning new workforce models with meaningful career pathways without creating further competition for an already stretched mental health workforce. The Medicare Mental Health Check In initiative posed an important workforce design question: how can a service contribute to the supply of the mental health workforce tailored to its purpose, rather than create further competition for a workforce that is already stretched? 

Positioning new roles as part of a career progression in the mental health sector or service makes them more appealing to potential candidates and helps address long-term workforce shortages. When new roles form part of a clear and credible career path, rather than stand‑alone positions, they become easier to recruit to and support a more sustainable workforce over time.

Designing new roles within a broader career pathway also creates opportunities to leverage underutilised talent within the mental health sector. Many individuals with relevant qualifications, such as accredited counsellors and therapists, are not fully utilised in systems that rely heavily on clinical psychologists and psychiatrists. Creating roles that allow these professionals to work at the top of their scope can improve service delivery while supporting workforce retention and professional development.

Finally, workforce supply can be expanded by providing structured entry points to attract new talent to the workforce. A dedicated trainee pathway, linking formal training (such as a new LiCBT course) with on-the-job learning and employment in initiatives like the Medicare Mental Health Check-In, offer an entry point for individuals without prior mental health experience. These models provide both immediate capability and long-term career foundations. However, they must be carefully designed and monitored to ensure that the speed of workforce growth does not compromise safety, quality, or alignment with broader mental health services. Flexibility and ongoing evaluation are key to addressing these challenges.

Perhaps the most significant challenge is the need to develop this workforce rapidly. Leveraging existing training and education infrastructure, and building upon existing courses and qualifications, may assist in creating a workforce quickly and efficiently while maintaining consistency and reliability. However, while speed is crucial, safety, quality, consistency, and reliability cannot be disregarded. Workforce shortages may demand urgent responses,  but there are no quick fixes.

Maintaining safety and quality requires deliberate design choices. For trainees and new entrants, this includes structured on‑the‑job supervision, access to clinical oversight and support, and clear escalation pathways. It also requires active monitoring of service user outcomes, so that quality and effectiveness are continuously assessed and improved as the workforce scales.

The key is disciplined workforce design: start with what exists, identify what is underused, and create what is missing.

Taken together, these elements point to more than a single program or solution. They outline a repeatable approach to workforce design that can be applied wherever demand continues to outstrip traditional supply. In Australia’s complex service landscape, sustained success will depend on ongoing collaboration across sectors and a willingness to adapt as systems evolve.

Designing a new workforce for digital mental health demonstrates what is possible when workforce constraints are treated as a design challenge rather than a fixed limitation. By deliberately building credibility, expanding workforce supply without competing for existing roles, and scaling at pace without compromising safety or quality, new models of care can be delivered responsibly and at scale.

The implications extend well beyond mental health. Workforce shortages are not an immovable barrier; they are a signal that established ways of designing and deploying workforce no longer fit the task at hand. When systems stop treating shortages as a reason to limit ambition and instead design the workforce they need, through repurposed roles, newly activated talent, or entirely new pathways, they unlock new possibilities for service delivery, care, and systemic reform.

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