The global landscape of mental health is facing a perfect storm. We are witnessing a significant surge in demand for mental health care, but workforce shortages are an enduring problem. The data provided by the Australian Institute of Health and Welfare (AIHW) indicates that the demand for our mental health systems is enormous.
The problem is that our systems are facing a “revolving door.” The focus of our care is too narrow. We are only treating the symptoms of a crisis and not exploring the underlying behaviors that are causing these crises.
This is where behaviour support experts become the key to unlocking a solution. We need to think about care in a person-centered approach and not a system-centered approach.
The Gap in Traditional Mental Health Approaches
Standard mental health models have historically leaned heavily on crisis response. The first port of call when someone is in a state of crisis is often hospitalisation or medication. While these tools have their place, they often do not address the environmental factors or learned responses that led to the crisis in the first place.
Studies done by the World Health Organization (WHO) point to a move away from a more reactive approach to care, and a more positive approach to community-based care. It has also been noted that “challenging behaviors” are not often analysed to determine if they are, in fact, a reaction to an unmet need.
There has also been a noted disconnect between those who work in the field of disabilities and those who work in mental health. Without a bridge between these two groups, people tend to slip through the system, being offered short-term solutions to a long-term environmental and social problem.
What Behaviour Support Experts Actually Do
At its heart, behaviour support is about understanding the “why” behind what we see. These experts conduct what is known as a Functional Behaviour Assessment (FBA). This isn’t a cold, clinical checklist; it is a deep dive into an individual’s life to see what purpose a specific behaviour serves.
For example, is it a means of escape from an overwhelming environment? Or is it a tool for connection? Once the purpose is clear, a proactive and personalised approach is developed.
This is done by working closely with the individual and all those involved to ensure that everyone is working towards the same outcome. The end result is not about suppressing the behaviour by following a set of rules. Instead, it is about enhancing the person’s life and increasing their capabilities.
The evidence-based interventions for behaviour change, such as those described in the NICE Guidelines, prove that by changing the environment and improving communication tools, the so-called challenging behaviour will cease naturally. This is because the person is finally being heard.
A Shift from “Managing Behaviour” to Understanding It
We must begin to think of behavior in terms of communication. If an individual can’t find the right words to articulate their frustration or pain, their actions speak louder than words.
Context is everything. Our relationships, physical space, and past all play a role. By shifting the focus from control to context, we move from a short-term suppression to a long-term, sustainable outcome in which the individual feels safe and understood.
Why Mental Health Systems Are Missing This Expertise
If behaviour support is so effective, why isn’t it everywhere? The answer usually lies in workforce silos. There are psychologists in one corner, behavioural scientists in another corner, and disability support workers in another corner. The problem is that these groups do not necessarily use the same language.
There is also a general lack of awareness about behaviour support frameworks in mainstream settings. Most mental health professionals are trained in clinical diagnosis but may not have the training in environmental modification and behavioural science. The Lancet Commission on Global Mental Health has for some time advocated for changes in the systems to address these unmet needs. The integration of specific behavioural expertise is a slow process.
The Impact of Behaviour Support on Long-Term Outcomes
The real-world benefits of this approach are profound. Primarily, it leads to a significant reduction in restrictive practices, including things like physical restraint or chemical sedation that strip away dignity.
When we use Positive Behaviour Support (PBS), research published via PubMed shows it is highly effective at improving a person’s independence. For the person involved, it means better engagement with therapy and more confidence to participate in the community.
For the families and carers, the impact is just as vital. This constant crisis management results in severe burnout. If a family has a plan in place, the tension in the home decreases, and the relationships can even start to heal. It takes the focus off of just getting through the day and puts it towards the future.
Real-World Example: Supporting Sustainable Change
Take, for example, a young adult who, when in crowded shopping centers, becomes more and more distressed. The reactive approach might be to stay home or to be medicated to help cope with the anxiety.
The behavior support approach examines the sensory issues and the communication needs. It works to build up the young adult, Sam, to go shopping with his family. This not only provides stability for Sam but a sense of inclusion that medication could not provide.
Integrating Behaviour Support into Mental Health Systems
True change requires a multidisciplinary mindset. We should not wait for a crisis to bring in an expert. Instead, behaviour support should be embedded in early intervention. Prevention is the mainstay of mental health care, as highlighted by the CDC. It involves upskilling individuals in different fields, including teachers in schools and nurses in hospitals, in the basics of behavior.
In Australia, the NDIS scheme has offered a model for the way this can be done if adequately funded. But the next step is to ensure these frameworks extend to those without a disability diagnosis. It is important that every mental health facility is equipped with this knowledge to ensure the care is person-centered and dignity-based, not clinical and administrative.
Where Behaviour Support Practitioners Fit In Today’s Care Landscape
The role of a behaviour support practitioner is a key aspect in contemporary, compassionate care delivery. Working with a qualified behaviour support practitioner can help individuals and families gain a better understanding of why certain behaviors are occurring and help them implement strategies to support long-term health.
Behaviour support practitioners fill a critical gap in care delivery where medicine stops and life begins. Behaviour support practitioners are especially helpful in complex, chronic situations where talk therapy alone is not sufficient.
In the NDIS system and in healthcare in general, behaviour support practitioners are the glue that holds a multidisciplinary team together. They are the reality check for every strategy to ensure it is based on the reality of the individual’s life situation.
Conclusion
Our current mental health services have reached the point where we can no longer rely on the management of symptoms. To effectively support people, we have to change. Behaviour support is not an add-on to our current services; it is a basic requirement if we want to call our services person-centred.
Changing our focus from the management of people to the management of people’s needs is the way to a sustainable and dignified future. It is time we rethink the way we support people to ensure that we provide them with the tools and the environment to thrive.
