Improving Mental Health Referral Systems in Rural Australia: Co-Design Study With Health Professionals and Consumers

Abstract

Background: In rural Australia, geographical isolation, limited resources, and complex health care navigation create significant barriers to mental health care access. Mental health care professionals and organizations often work in segregation, exacerbating existing barriers. Digital technology provides an opportunity to improve communication between providers and streamline workflows while supporting a diverse range of consumers.

Objective: This co-design study aimed to identify rural community needs and explore digital solutions to enhance mental health service delivery pathways.

Methods: Using a design-thinking methodology, we conducted focus groups and workshops with 17 participants (7 consumers and caregivers and 10 health care professionals) from a rural region to understand mental health service needs, systemic challenges, and design potential digital solutions. Thematic analysis followed a grounded theory approach, involving systematic coding and theme development through an iterative consensus process.

Results: Access to mental health care emerged as the central theme. Rural community participants reported strong community connections but faced challenges, including limited technological innovation and substantial travel burdens. Health care professionals highlighted critical systemic pressures: underresourcing, overwhelmed clinicians with extensive waitlists, and complex referral processes. Both groups identified overlapping barriers in service limitations and system navigation. During the design phase, we developed personas capturing consumer and health care professional experiences and conceptualized an integrated digital solution comprising a health care professional dashboard and a consumer-facing app with caregiver access to enhance service coordination.

Conclusions: The study demonstrated strong stakeholder support for implementing an integrated digital solution to enhance rural mental health service delivery. Further research is required to build upon the solution prior to testing, optimizing, and scaling.

Keywords: co-design; digital solution; focus group; mental health; referral; rural health care.

Figure 1.. Participatory and human-centered design-thinking methodologies (adapted from NNGroup: Design thinking 101). AI: artificial intelligence.

Figure 2.. Coding tree of the main themes and subthemes identified from the focus group discussions.

Figure 3.. Health care professional persona “Anna”.

Figure 4.. Consumer persona “Peter”.

Figure 5.. Interaction map outlining communication pathways within and between a health professional dashboard and consumer app. AI: artificial intelligence; DNA: did not attend; ED: emergency department; F2F: face to face; GP: general practitioner; HP: health care professional; MBS: Medicare benefits schedule; MH: mental health; MHCP: Mental Health Care Plan; MHR: My Heath Record; PATS: patient assistance transport scheme; PBS: pharmaceutical benefits scheme; SAAS: South Australia Ambulance Service.