Lay summary
The context within which mental health service providers operate is challenging due to workforce shortages, resource limitations, reliance on diverse funding sources with varying reporting requirements, and the inability to address upstream determinants of mental health such as poverty. Smaller providers face additional challenges competing for funding against each other and more established entities, as funders seek evidence of impact and aim to reduce duplication. These challenges undermine the service ecology, including the innovative niche that small providers occupy. There is an urgent need for funding models that strengthen collaboration and support among all providers to deliver efficient, effective, and equitable mental health care. Our project engages Waitaki-based mental health services to explore how co-commissioning—where providers and funders collaboratively plan, fund, and govern services—might build a robust service ecology. Using systems thinking and Māori and Pacific health frameworks, we will examine governance, managerial, and operational challenges, co-design a prototype co-commissioning