Agile Co-design in Public Mental Health: An Integrated Model for Continuous Service Improvement.

Co-design has become central to mental health reform in Australia, yet it is often applied episodically rather than as a continuous practice. In public mental health, service change must occur alongside ongoing service delivery, creating challenges for leaders seeking to apply co-design principles. Agile project management provides a structured approach for iterative, reflective, and adaptive collaboration. This paper proposes an Agile co-design model and illustrates its application through reflective analysis of implementation within a public mental health service in Victoria, Australia. This approach responds directly to the Royal Commission into Victoria's Mental Health System mandate for authentic co-design and lived experience leadership in reform, moving beyond one-off project phases to embed co-design as an ongoing governance capability. Evidence suggests that Agile approaches improve delivery pace and cross-functional collaboration in healthcare, while co-design strengthens service relevance, acceptability, and trust. As such, Agile co-design may provide a mechanism for incorporating consumer and clinician voices within continuous system reform, complementing existing co-design frameworks.