A human touch to improve rural and regional mental health systems

“Successful problem solving requires finding the right solution to the right problem. We fail more often because we solve the wrong problem than because we get the wrong solution to the right problem.”

This quote from organisational theorist Russell L Ackoff remains front of mind for Dr Adam Hulme from UQ’s Southern Queensland Rural Health.

“In healthcare, I often wonder how many of the problems we work so hard to address might have been avoided through systematic redesign, rather than working within the confines of the current frameworks,” Dr Hulme said.

“I’m drawn to methods that can capture the messy and dynamic reality of problems, rather than treating them as fixed or linear.”

It’s this mindset that has led Dr Hulme on his research career path of systems thinking, systems science and applied health research.

Designing sustainable mental health services in regional communities

Dr Hulme uses system dynamics modelling to understand problems that emerge from the interactions between people, services, environments, policies and sociocultural conditions.

Simply put, Dr Hulme uses a computer simulation technique to understand, analyse and predict the behaviour of evolving systems over time.

His current research focuses on one of the most pressing challenges facing regional Australia; how to design and sustain mental health services in communities already under considerable strain.

“At the heart of this work is a new system dynamics simulation designed to better understand mental health care access in regional Australia,” Dr Hulme said.

“Rather than just looking at workforce planning, wait times or service demand in isolation, we bring them together in one interconnected picture.

“This means we can see the direct relationship between these areas, and identify exactly where strain builds, shifts and why some problems persist even when systems may appear to be coping.

“The model uses real historical data, creating a strong foundation for exploring future projections and testing ‘what if’ scenarios up until 2050.”

Adding a human touch

It’s the incorporation of softer human behaviours and lived experience into this model that makes this research particularly novel.

“Alongside traditional elements, this model also embeds human factors that are critical in real-world healthcare, including workforce energy, professional passion, service quality, turnover intention, public perceptions and attitudes towards wait times and performance,” Dr Hulme said.

“Including these softer human elements in the computer modelling frameworks is currently not broadly used in Australia.

“Bringing these ideas into an Australian regional and rural health context has helped to create a robust framework for understanding not only whether a system is under pressure, but how that pressure affects people, services and communities over time.”

In practical terms, this research offers a new way to think about rural health workforce planning.

“It allows decision-makers to move beyond static snapshots and instead explore how systems behave dynamically,” Dr Hulme said.

“Including insights into what happens if recruitment improves, if turnover worsens, if demand rises, or if parts of the system start to fail quietly.

“More broadly it shows how advanced computational systems science can be applied to complex health challenges in ways that are both analytical while still closely connected to human experience.

“While researchers and decision makers can understandably become preoccupied with hard data and metrics, these are only part of the picture.

“The lived experiences, professional judgement and ‘mental databases’ of people working within, moving through and depending on these systems are equally important.

“For me the real opportunity is to bridge the human and analytical worlds, the lived and the measured, so health systems are not only better understood but more intelligently and compassionately redesigned.”