“Game-changer”: The charity retaining mental health workers in regional Victoria

It’s a wet-day timetable at Ararat West primary school - the yard devoid of squealing children, and the small playground dreary and alone at the school entrance.

Inside tells a different story. The inclement weather is juxtaposed by the infectious energy of 260 students, their spirit emanating through the school halls. School principal Terry Keilar says there's been a shift in culture over the past five years.

“The culture has built around acceptance, access to support, and families feeling a lot more comfortable to reach out and ask for help.”

The shift started with the introduction of One Red Tree - a grassroots charity providing mental health care and support throughout Western Victoria. With its base in Ararat, a town 200kms west of Melbourne, the organisation was founded in 2021 to address the local shortage in mental health professionals.

Led by mental health and education practitioners, the organisation partners with local council and universities to provide provisionally registered and early-career psychologists with placement and employment opportunities in schools and aged care facilities.

Keilar says access to mental health services has always been a challenge in the region. He says the charity has been a “game-changer” for Ararat.

“We recognised that some of our students weren't accessing the support services that perhaps they needed. There was nothing else,” he says.

“For a lot of our families, it meant driving to Ballarat (100kms away) or to a larger city, and some of those things were just not accessible.”

Co-founder Tammie Meehan says the program removes barriers to mental health care. Most sessions are provided at low-cost or bulk-billed, and having the service close by mitigates issues related to proximity and waiting lists.

One Red Tree’s integrated approach, she says, has reduced the stigma associated with mental health care.

“Some parents decided their child should not participate in the program due to perceived stigmas. The opposite has happened.”

“The provisional psychologist integrates into the school, they are well-received by the school community and soon other children are asking when they can have a turn. Families are requesting participation for their children.”

A “wraparound” approach

The program operates on a wraparound model. Where many health professionals are often sent to rural and regional areas alone, One Red Tree embeds psychologists in communities, providing supervision, accommodation, and training. 

Meehan says a “drop-in-drop-out model” doesn’t work.

“Rural placements, especially ones like [ours] where the placements engage the provisional psychologists in the community by linking them with peers, opportunities for group activities, having on-the-ground support wherever they’re placed, are crucial for encouraging them to aspire to working rurally when they graduate.”

“This method has helped us recruit many ex-students to be employed by One Red Tree or by other local schools and health services.”

Psychologist Erin Love started her internship at Ararat West primary school and is now working locally in aged care. Originally from Melbourne, she says a model which supports provisional psychologists in their work allows for sustainability in the workforce, particularly in regional and rural settings.

“I was very grateful that One Red Tree is in a position where they can [support] students and cover expenses, otherwise it would’ve been very difficult,” she says.

“You’re not working at all or a lot, so you’re not making the money to support yourself, pay for petrol costs or accommodation. So it’s a really great thing they have to be able to give an allowance.”

Ararat Rural City councillor and One Red Tree board chair, Jo Armstrong, says the organisation's community-centric approach is working.

“Existing government policy settings don’t yet provide surety of workforce supply to regional communities and that’s exactly what’s needed,” she says.

But being a rural, local, grassroots organisation has its setbacks. 

“Departments of government have funding models that habitually rely on a cookie-cutter approach – they roll out service provision to larger regional centres, with minimal regard for the challenges that rural people must overcome to access those services.”

Meehan agrees. “Just because they are national does not mean they know the communities they are working in.”

A practical response

Meehan and her co-founder Carly McKinnis both grew up in Ararat. From a young age, they were exposed to repeated experiences of suicide and mental health struggles in their community.

“Professionally, I had been working as a psychologist in regional areas for over 20 years, including in remote communities, and had seen firsthand how limited access to services can be devastating,” McKinnis, who is also a clinical psychologist, says.

It was during the Covid pandemic that the situation escalated and there was also a spate of suicides in the area.

“I was the only psychologist seeing children across a huge geographic area, with no meaningful referral pathways. Parents, schools and GPs were desperate for help that simply wasn’t available.” 

“Then, a psychology student approached us asking if we could organise a rural placement and we said ‘yes’ before we knew how. 

That first placement at the end of 2021 became the seed for One Red Tree.

“It was a practical response to an urgent community need - creating access to mental health care while also building a sustainable rural workforce.”

When One Red Tree first launched, the team noticed a surge in mandatory reporting by its team of psychologists. This led to the strengthening of ties between families and local agencies such as Uniting VicTas and Orange Door.

“We are engaging families who have been living under the radar and have never engaged with support agencies,” Meehan says.

Over the past five years, the charity has engaged more than 1,000 families through its school program alone, providing more than 12,000 clinical sessions across 26 different schools.

Starting with five practitioners, there have now been more than 100 early-career psychologists who have moved through the organisation.

One Red Tree has now expanded to almost 20 towns around regional Victoria including Warracknabeal, Hepburn and Skipton, operating in schools, aged-care facilities as well as a small number of private clinics.

“A fantastic model”

Western Victoria has a higher than state average rate of mental health conditions in young people and higher youth mortality with Ararat Rural City and Northern Grampians Shire experiencing disproportionately high rates of mental ill-health, suicide risk and family violence compared to the Victorian average. 

According to the Victorian Suicide Register, there were 50 suicide deaths in the Grampians region between 2019 and 2023. The Australian Institute of Health and Welfare states Australians living in the regions face unique challenges due to their geographic isolation and often have poorer health and welfare than those living in major cities.

“In regional areas like where One Red Tree is based, there's just never going to be enough health professionals,” says Prof Myfanwy Maple, director of the Manna Institute, a mental health research and training institute for regional Australia.

“We know that mental health and just high levels of distress are increasing in young people. And to be able to address that quickly without having waiting lists or anything like that, people who are trusted in the school is a really, really good way of being able to break down some of the barriers between distress and getting the help you need when you need it.”

Prof Maple says such initiatives are exactly what is needed, allowing provisional psychologists to practice in real time, under “really clear supervision”.

“We've looked at whole health hubs in schools where you might have psychologists, social workers, nurses, you might have exercise, physiologists, pharmacists, all sorts of professions could potentially be operating in schools and opening up access to health services to the whole community from the school. 

“What's happening in Victoria is a fantastic model.”

For McKinnis, the solution “must grow from within communities, not be imposed from outside.”

“Mental health isn’t just a health issue, it touches every part of community life,” she says.

“Every community will look different, but the principles are transferable - build on existing strengths, listen to what people need, collaborate across sectors, and create shared ownership.

“Real change often happens in small, human moments. When leaders know people by name, when services talk to each other, and when communities take responsibility together. Those are the conditions where prevention becomes possible.”

Meehan says the team wants to be remembered for strengthening relationships in the community. “Grassroots and local responses work,” she says. “They know their communities and their contexts.”

“The result is that we have a healthy, thriving community.”