When leaders become clinicians: Erosion of clinical leadership in public mental health

Effective clinical leadership underpins the safety and sustainability of public mental health services. In Victoria, recent reforms have focused on workforce expansion and service redesign, but the capacity of clinical leaders who translate these reforms into practice has received less attention. This viewpoint argues that workforce shortages are reconfiguring clinical leadership, with particular consequences for regional services. As leadership becomes dominated by clinical demand, quality activities take a backseat and implementation of system reform is constrained. Sustaining clinical leadership requires concrete commitments across several domains; without which, the ambitions of mental health reform will remain aspirational.