Consumer Experiences of the Australian Stepped Care Model in Primary Mental Health Care: A Qualitative Study

Mental illness remains a significant public health challenge in Australia, affecting nearly half of the adult population and placing a considerable strain on the healthcare system. The Australian government has implemented the Stepped Care Model (SCM) within primary mental health care to address this issue to improve service access, efficiency, and outcomes. This study explores the experiences of nine consumers (also referred to as patients) who received care under the SCM, focusing on their perspectives on accessing and navigating mental health services. Ethical approval was obtained from the Federation University Human Research Ethics Committee, and measures were implemented to ensure the privacy and confidentiality of all participants. Through a qualitative thematic analysis, five key themes emerged: (1) the mental health impact of life events; (2) hurdles in accessing care; (3) barriers to optimal care; (4) positive experiences with individual practitioners; and (5) mixed sentiments on the effectiveness of the SCM. While participants acknowledged the holistic and interdisciplinary benefits of the SCM, some expressed frustrations with waiting times, limited service capacity, and rigid session limits. Positive therapeutic outcomes were often attributed to empathetic, personalised care from individual practitioners, emphasising the need for continuity in therapeutic relationships. However, participants with complex mental health conditions felt underserved by the model's lack of flexibility. These findings highlight the need to address systemic barriers and enhance the SCM's adaptability to serve individuals with varying mental health needs better. Future research should explore longer-term interventions and more flexible care pathways to optimise the effectiveness of the SCM in Australia.