The silent mental health cost of leading through Support at Home reform

There is a conversation our sector is not having loudly enough.

Behind every Approved Provider navigating the transition to Support at Home are leadership teams carrying an extraordinary and sustained load.

Constant reform adjustments. Unclear or evolving operational guidance. Claiming and system changes mid-implementation. Reassessment delays outside provider control. Escalating participant frustration driven by inconsistent messaging. Financial risk sitting squarely with providers.

And yet — leadership must remain steady.

We must reassure participants. We must absorb distress and, at times, abuse. We must protect our workforce from burnout. We must ensure wages and suppliers are paid. We must meet compliance standards that continue to evolve.

Because if leadership destabilises, service delivery destabilises.

What is rarely acknowledged is the silent mental health impact this sustained instability is having on CEOs, Executives and Board Directors across aged care.

Leaders are holding:

• Workforce wellbeing • Organisational solvency • Regulatory accountability • Community confidence • Government engagement • Reform implementation

All while operating in ambiguity.

We are expected to be the stabilising force — even when the system itself lacks stability.

Many are doing this quietly. Many are exhausted. Some are questioning how long they can continue carrying this level of risk.

If experienced leaders leave the sector, we do not just lose positions. We lose governance capability. We lose reform memory. We lose regional knowledge. We lose decades of expertise that cannot be replaced quickly.

That is not simply a workforce issue.

It is a system risk.

A Call to Action

The first step forward is recognition.

There needs to be formal acknowledgement — including from the Minister for Aged Care — that elements of the current reform implementation have created system instability with sector-wide impacts.

This is not about blame. It is about accountability and repair.

Acknowledging that aspects of the system design, rollout sequencing and communication pathways have created unintended pressure on providers would be a powerful and necessary step.

From there, we need:

• Clear, consolidated operational guidance that does not shift mid-cycle
• Alignment between My Aged Care messaging and provider obligations
• Transparency around reassessment delays and funding bottlenecks
• Structured sector consultation before further system adjustments
• Recognition that provider and leadership wellbeing is directly linked to participant outcomes
• Sustainable reform requires sustainable providers.
• Sustainable providers require sustainable leadership.

If we genuinely want Support at Home to succeed, then we must protect the people responsible for delivering it.

Leadership resilience should not be assumed to be infinite.

It is time we bring this conversation into the open — constructively, respectfully, and with shared responsibility.

Because behind every policy decision is a workforce. And behind every workforce is a leadership team holding the line.