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The 'Missing Middle' 

Lived Experience Australia conducted a national survey of consumers AND carers across Australia asking why they didn’t engage (or why they disengaged) from the mental health system. The voices and statistics of 535 people who responded have been faithfully recorded in our landmark report.

We wanted to learn why people slip through the gaps or do not receive the mental health care they need.

The Missing Middle Research
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Lived Experience Perspectives of the Mental Health System

The 'Missing Middle' Report Launch


We were honoured that Ms. Christine Morgan, Prime Minister's National Suicide Prevention Adviser and CEO of the National Mental Health Commission officially launched these landmark reports on Monday 29th March, 2021.  

Alongside Ms Morgan, a panel of industry professionals discussed their perspectives of the reports, including Lived Experience Australia's report authors, Ms. Christine Kaine and Professor Sharon Lawn.  

Key Findings

  • More than 50% of respondents identified that being unable to access the mental health services they needed contributed to the consumer declining into crisis, some having suicidal thoughts, attempting  suicide or suicided.

  • 48% of consumers in the study were discharged from emergency departments with no follow up or referrals  

  • 41% of consumers and 47% of carers could not access mental health services when they were needed. 

  • General Practitioners are the primary source of mental health support for consumers and carers, despite their generalist nature

  • Difficulties in navigating the mental health system, or meeting eligibility requirements, is a major reason consumers do not receive the care they need

  • Lack of communication and collaboration between health professionals results in people having to re-tell and re-live their trauma, and a lack of consistency in their mental health support.

  • Strategies suggested by both consumer and carer respondents to support engagement or re-engagement with mental health services included better quality providers, staff training, availability of peer workers with lived experience, affordability, persistent follow up, consistency, continuity and coordinated support.

What do consumers and carers need?

Through our research, consumers and carers pointed to these key things that would make services better.  

  • Affordability - consumers indicated this was a major factor in accessing mental health care

  • Availability - shorter (or no) waiting periods, sometimes mental health can't wait

  • Simpler access - finding ways to make the mental health care system easier to navigate

  • Improved collaboration - health care professionals working together to ensure gaps are closed and services remain consistent

  • Follow up after crisis - ensuring a mental health follow up plan is in place after crisis treatment

  • Inclusion - allowing consumers and carers to contribute and have a say in how their services are provided

  • Support - through peer workers, persistent follow up and coordinated approaches when a consumer may be in decline

Mental Health Missing Middle Download Re

The 'Missing Middle' Report is accompanied by three other documents.  

1. Missing Middle 'Our Voices' - in their own words.  This powerful document gives voice to those who have these lived experiences. 


2.  The Private Sector report analyses data from consumers, families and carers who access predominantly private mental health services and private psychiatric hospitals.

3. The Private Psychiatric Hospitals Report analyses data from consumers, families and carers accessing private psychiatric hospitals. 

Find out more

Lived Experience Australia is happy to conduct interviews, or provide any additional information you may need for articles or news items.  Please contact the Lived Experience Australia national secretariat office on 1300 620 042 or contact us through this page.  

Thank you for your interest in this important research.  If you would like to stay up to date with our research and advocacy work, please join our subscriber list.  

Support is available

If this research or information has triggered or brought up difficult emotions for you, please consider reaching out to Lifeline on 13 11 14 or Beyond Blue on 1300 224 636 to talk through what you are feeling. 

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