Australia is home to people from diverse backgrounds; one in five Australians experience mental ill-health in any given year with many not accessing mental health services when they need it or in a way that responds to their needs.

Within the context of public health, there are close connections between the principles of governance and human rights; the participation of those affected by public health is both an important principle of governance and a recognized dimension of the right to health. The principle of fairness and equity ensures that no one is left behind.

Australian mental health policy has promoted lived experience participation since 1992 and subsequent governments have insisted of participation by people with lived experience, their family, friends and carers  in service delivery and planning. Research cautions that co-design processes must ensure lived experience voices have equal weighting and participation at all levels of the system. Their individual and collective engagement, facilitated and enabled through purposeful governance is essential to enhance responsiveness.

The Australian community expects governance of public funded research to ensure all research is conducted responsibly, ethically and with integrity. Research governance not only implements the principles, requirements and standards of research it addresses, but provides protection of research participants, ensures the safety and quality of research, privacy and confidentiality.

Using a case study methodology, this paper critically reviews the multidimensional, purposeful, context-specific governance processes and mechanisms of the Health Literacy Initiative of the Mental Health Commission of New South Wales (Commission), Australia and its relevance to meaningful co-design.

The Commission with funding from the Commonwealth Health Innovation Fund has adopted an engagement, participation and co-design approach using the Ophelia framework aimed at enhancing the sensitivities and practical skills of health professionals and frontline service providers.  In partnership with a consortium of universities led by Swinburne University of Technology and including the University of New South Wales and the University of Newcastle, and over fifty NSW health and community organisations, this initiative is one of the most ambitious mental health literacy projects ever undertaken in Australia.