Regional spotlight – Mental health NFP expands to help Australia’s north

Operating in Australia’s regions is no easy task, with boards and business leaders battling staff shortages, housing challenges and geographical distance from major cities. However one CEO and director with an entrepreneurial mindset, agile thinking and an accounting background has not only spotted opportunities and transformed her NFP selectability into a success, but is also now starting a new board regional development role with a $27 billion funding pipeline.

Pictured above: Debra Burden at the 2024 opening of the new selectability Burdekin (Ayr) Mental Health Hub with Professor Gracelyn Smallwood and local Elder Eddie Smallwood

Meet Debra Burden FAICD, CEO of regional mental wellbeing and suicide prevention provider selectability, director of the Townsville Hospital and Health Service and new chair of Regional Development Australia for Townsville and North West Queensland.

Burden is not one to shy away from tough market segments and her mission is clear. “At selectability, we have 3,000 clients with severe permanent mental illness and about 890 employees. It’s on me to ensure that they all have food on the table. We're not going to let this organisation fail, that's for sure.”

Armed with determination and a strong commercial mindset that is not always common in the NFP sector, Burden joined selectability in 2017. Since then she has transformed it into a charity which has halved its reliance on the National Disability Insurance Scheme (NDIS) from 90 per cent to 45 per cent of revenue and diversified its business footprint into aged care and child services and even housing for staff and clients.

At the time she joined, selectability was undergoing a major merger as the NDIS started rolling out. Revenue at the time was $7 million per year, with 70 staff and a surplus of $400,000. Eight years later, selectability’s revenue is around $70 million per year, employs nearly 900 staff and last year reported a surplus of $5.1 million.

“We have a philosophy that every day, every dollar counts. We ensure that we make a surplus and then we use that surplus to put back into the organisation. Then we use that to grow. We now have a regional expansion framework with 17 physical locations.”

Suicide a preventable leading cause of death

The statistics are shocking. Suicide is Queensland's leading cause of death in individuals aged 15-44. “Suicide is complex but it is also preventable and we know that regional, rural and remote areas in Queensland have particular risk factors and mental health needs,” says Burden.

Loneliness is a major risk factor. “One in three Australians at any time will say that they're lonely and it's worse for young people.” Almost half of all Australians will succumb to mental illness at some point in their lives.

The Productivity Commission Report into Mental Health estimates about 17 per cent of Australians have experienced an episodic mental health illness within the last year, while a further 23 per cent are at risk to require a preventative response. This leaves 60 per cent of “well” Australians, where prevention and early intervention remain important.

In response to COVID, selectability set out to become an organisation that was visible to the everyday community with “vehicles and buildings everywhere”, says Burden.

“We said we needed to ensure that the everyday person on the street knows what selectability is and how it can help them because potentially they might lose all their family, their job, their house. If a person is walking down the street thinking, ‘That's it, I'm going to kill myself by suicide,’ they need to know who we are and what we do.

“Getting our name out there with everyday people in the street and ensuring that funding bodies understand that we provide exceptional value for funding… that was the foundation, the driver to where we are today.”

Expansion and diversification

Selectability is one of regional Queensland's largest providers of NDIS psychosocial supports and works with state and federal governments to deliver mental wellbeing, suicide prevention and carer programs. It also owns and operates selectability Training (RTO #0281 registered name Jobtain).

“Nearly 70 per cent of NDIS providers are running at a loss, but our organisation is one of the few really doing well. We are a not-for-profit, but we ensure that we make a surplus. Which is why we've been able to expand across regional Queensland, because we invest our own money into that.”

“I'm not going to say it has been easy. It's not. But we do what we have to, to ensure that selectability is financially viable.”

Part of the success of the charity is due to the loyalty and commitment of staff. “Our management team is really stable, we haven't had anyone leave our management team for years. That’s because we honestly just love it. It's easy when you're doing something you love.”

Services include:

• Forty quality homes across regional Queensland for  NDIS supported  independent living, affordable accommodation and child safety. It also offers staff housing in some areas, which helps with regional recruitment challenges.
• Wadda Mooli non-clinical support service delivered with partner Townsville Hospital and Health Service, providing urgent support for people presenting to hospital emergency in emotional distress and crisis.
• Selectwellbeing, funded by Queensland Health, which provides those impacted by severe mental illness and not currently on the NDIS with up to a year of individual and group support.
• Transition Care Program to support people to discharge from the Hospital and Health Service
• Aftercare to support people following a suicide attempt
• Ten Clubhouses providing a non-clinical recovery option that is member-led

The charity recently expanded services to include child safety. “We now have over 30 young people that we're supporting in child safety,” says Burden, adding that the Queensland Government invited selectability to move into this area.

It also expanded into residential aged care in the Lower Gulf of Carpentaria after being invited by local First Nations communities to do so. In September 2023, selectability took over management responsibility for three small First Nations residential aged care facilities; Ngooderi House (Doomadgee), Kukatja Place (Normanton)and Kuba Natha Hostel (Mornington Island). 

The charity has operated services for many years on Palm Island off Townsville and is seen as being part of the fabric of this First Nations community.  “We do operate differently in those communities, for example, with recruitment.” says Burden.

Early attempts to hire staff using online methods in First Nations communities failed and Burden decided to adopt a more lowkey personal approach using a sign placed outside local services inviting prospective employees to come in for a chat. “We do some reference checking and that's how we do it. And that's what has worked.”

Locals are also part of the volunteer community. “Local people come in to do things like working with the older people, just keeping them company, doing some artwork with them, taking them for a ride in the bus. Just doing those sorts of things makes a huge difference.”

All the communities are different. “Doomadgee, for example, is a very religious community. Mornington Island is a very artistic community.”

New regional development role

This year Burden was appointed by the Australian Government as Chair of Regional Development Australia (RDA) Townsville and North West Queensland. RDA works across 14 local government areas to drive economic development by attracting investment, supporting major projects and working with government, industry and communities to strengthen the local economy.

This is a pivotal time in Queensland’s development, with the RDA committee recently estimating major projects worth $27 billion in the pipeline, says Burden. “There are more major projects than at any other time in our whole history. So that's energy, minerals, defence, health… all these huge budget projects are happening right now.”

The RDA acts as a bridge for development applications in regional areas, working with councils and other stakeholders. “We've just had a funding agreement approved for the next five years for about $500,000 a year. So it's a really small, lean organisation, but we punch above our weight with what we're doing.”

Burden accepted the role as chair because …”at this stage in my life, I think it's a good opportunity to give back. I've been in Townsville now for nearly 20 years”.

In the past, Burden has held senior roles with Queensland Country Credit Union and Health Fund, 1300SMILES and Canegrowers Burdekin and director roles with North Queensland Primary Health Network and North and West Remote Health. She says the ASX-listed 1300SMILES role gave her a more commercial mindset.

“Those two years there really taught me a lot around the commercial side and operating extremely commercially and that's been exceptionally beneficial for us here.”

The future

On the personal front, Burden is also president of Townsville and District Pony Club and owns two horses. She grew up riding horses in Lithgow, NSW. “I am a keen rider. There’s nothing better for me than to start the day with a nice ride on one of the horses.”

This outdoor activity inspired one of Burden’s favourite wellbeing work projects which she personally champions. Users can enjoy for free selectability's BikeSheds, where locals meet at bike sheds in four regional areas to take a group ride and connect and drink coffee.

Loosely based on the proven Men’s Shed concept, the model helps people overcome loneliness and get more active. 

“The most important thing isn't the bikes or the bike ride at all. It's the coffee and sitting around talking. What we found is people would just stay all day. So my goal …I want to retire when I'm 70 … what I would really like to see by then is for there to be a bike shed across all our key areas.”