New Peer-Reviewed Research on Mental Health Outcomes in Australia by Michael Elwan

Our new peer-reviewed paper, co-authored by Michael Elwan, has been published in the Journal of Psychosocial Rehabilitation and Mental Health. The study explores how Australia measures recovery in its public mental health system - and what might be missing when we rely solely on symptom-based tools.

Australia’s public mental health services collect vast amounts of data each year. Every hospital, community team, and inpatient unit routinely records a bundle of measures known as the National Outcomes and Casemix Collection (NOCC). The goal is simple: track people’s progress, understand what works, and improve care.

But what if the very tools designed to measure recovery are missing the things that matter most? That question shaped our new research on mental health outcomes in Australia and how these measures align (or fail to align) with lived-experience perspectives of recovery.

The study examined key outcome tools used in adult services (HoNOS, LSP-16, and self-report measures such as K10+, BASIS-32, and MHI-38) and mapped every item against the World Health Organization’s International Classification of Functioning (ICF). This global framework defines health across body, activity, participation, and environment.

The findings were revealing. While the NOCC tools capture symptoms effectively, they overlook vital aspects of life: relationships, work, belonging, and community connection. Environmental and social factors - the foundations of recovery - are almost invisible. Even when measures are combined, half of what the WHO defines as core areas of functioning remains unmeasured.

Why This Matters

In mental health, what we measure shapes what we value. When outcome tools focus only on symptoms, services risk chasing clinical reduction rather than supporting meaningful lives. True mental health outcomes in Australia must capture participation, inclusion, and the environmental supports that make recovery sustainable.

This research calls for tools that reflect people’s lived realities; particularly for CaLD and First Nations communities, whose cultural and social contexts are often missing from standardised data. Embedding the ICF framework and co-designing outcome systems with lived-experience leadership can bring Australia closer to genuine recovery-oriented practice.

This publication reflects Michael Elwan’s broader work in mental health transformation; bridging research, therapy, and lived experience to make systems more compassionate, inclusive, and person-centred. Whether through individual therapy, supervision, or policy collaboration, his focus remains on turning data into understanding and outcomes into meaningful lives.

Because recovery isn’t a score on a form; it’s the story of someone rebuilding purpose, identity, and belonging.

Read the full paper in the Journal of Psychosocial Rehabilitation and Mental Health

Content validity of the Australian National Outcomes and Casemix Collection for Adult Mental Health: Linkage to the International Classification of Functioning, Disability and Health and Core Sets for Mental HealthDOI: 10.1007/s40737-025-00501-y

Based in Perth, WA, LEXs provides telehealth counselling across Australia for individuals, couples, and NDIS participants. Services extend to Social Work supervision, Peer Work supervision, training, and keynote speaking on men’s mental health, CaLD community wellbeing, and culturally responsive suicide prevention; helping people and organisations make mental-health care more compassionate, inclusive, and effective. LEXs provides services across Australia, supporting clients in Perth, Melbourne, Sydney, Brisbane, and beyond. To learn more about our work across Australia, visit LEXs' services.