Standing outside Guy’s Hospital in London, Dr Ava Carter (B Oral Health Dental Science ’12; GU Health Group Honours Prog ’12; GDip Dentistry ’13) felt the scale of what she was trying to achieve. Inside was one of the world’s leading programs combining dentistry and psychology. It was exactly the kind of model she had travelled overseas to study as part of her Churchill Fellowship research, looking for ways to help people with severe mental illness access vital oral care. But in that moment, it felt overwhelming. Where could she start?
Carter is both a registered dental surgeon and board-certified psychiatrist and is currently Medical Director at Deakin Private Hospital, Canberra. “Many people with severe mental illness can’t get to hospital or dental clinics,” she points out. “You might have phobias about dentists and big needles going into your mouth. You may also be on drugs which make you feel things that you don’t like, or make you feel sedated, but also dry your mouth out and affect your teeth.”
How could she bring these two issues together? Research was clearly needed—but this was an unusual subject that didn’t fit into the established funding networks. Then a colleague told her about the Winston Churchill Memorial Trust. Its Fellowships financially support experts for projects that don’t qualify for traditional funding.
But winning a Fellowship is no easy task. The project must benefit from the Churchill ethos of applying local knowledge globally—which means, in practice, six to eight weeks of travelling the world speaking to experts. As the Trust must ensure Fellowships go to worthwhile projects that will truly make an impact, the application process is challenging. Unsuccessful applicants don’t get feedback.
First, Carter had to boil her idea down to just 200 characters. “Having a clear idea is key, along with a vision about where it’s going,” she says. Next, she had to present her idea at an interview in front of a committee of ten people. “You’ve got five to eight minutes to convey your passion, your vision and your objectives, and why you deserve a $50,000 Fellowship,” she says.
After the initial euphoria of hearing she’d got the Fellowship, reality kicked in. Her overall goal was to create a dental charity that travels to people with severe mental illness. Carter now had to find and speak to relevant experts across the world who could advise on bringing this idea to life. Then she had to draw it all together into something that would work in Australia, with one of the world’s most geographically dispersed populations.
Her first big hurdle was dealing with resistance. “When I was overseas, I spoke to several senior national health service policy advisers who weren’t particularly positive about my idea. They didn’t feel like it was something that necessarily needed exploration,” Carter recalls. “One of the problems with this area is that we don’t know the extent of it. It’s bringing a problem to light that maybe they hadn’t considered.”
And that meant she had to do a lot of explaining. “A lot of people in Australia told me they already offer dental support to people with mental health problems—so what was I talking about?”
But when she talked to them, she found that what they were doing was very different from her project. “There are dental facilities, both mostly funded by the public system or the forensic justice health system, that visit at-risk patients, some of whom will have mental illness.
“They do supply dental care to patients with severe mental illness, but the difference is they’re not always funded for consistent full time equivalent (FTE). One particular hospital has a dental chair that’s been sitting there unused for 15 years. They don’t have the funding for the dentist. It’s also hard to find dentists with psychiatric or psychological training that are keen to work with patients in these areas.”
In those moments, Carter came back to her experience. “I reminded myself that I’m the specialist in the field. I’m the one who sees that patients with severe mental illness and severe oral health disease are dying.”
But she also had to stay open to challenge. “If you’re already doing this, great, show me the evidence and I’ll change my mind. It’s about being OK to have a conversation and not be offended. And having that confidence in your own expertise and your own research.”
Sometimes—as she found in London—the sheer scale of the project felt overwhelming. “But I remember, standing on those steps at Guy’s, hearing the voice of Vanessa Reher, my lecturer at Griffith. She’d always tell me to just keep going, because you’ll get better at it. You’ve just got to push through and that’s what I did.”
By the time she came to write up her findings and propose her solution, Carter had vast amounts of information. She kept herself grounded by considering the practicalities. “The first thing that brought me back to reality was: ‘How much time do I have to do this initially? Where am I going to get the funding? What can I set up? What can I do with this amount of time, this amount of money?’” Instead of trying to recreate large systems, she focused on outlining a program that was local, workable and scalable.
Her Fellowship report, A Case for Psychostomatology – To explore the implementation and design of dedicated dental care units for psychiatric patients, was published in April.
Now, Carter says she would love to see open discussions with health insurance companies about how to help patients with psychiatric illness engage in more dental care, and consider innovative models of care that involve the whole of the multidisciplinary team.
“Discussions within new setups—such as those currently taking place in some Sydney/Warrane hospitals—around how dental and psychiatric facilities can arrange to collate physical spaces would help activate these conversations. And, of course, talking more about funding public FTE for dentists and oral health therapists to work with psychiatric patients would go a large way to helping manage this divide.”
The experience has taught Carter a lot, too. “I used to jump straight in when I saw a problem that needed solving,” she says. “Now, when it comes to a complex issue or a fork in the road, I’ve learned to step back and not respond immediately.
“And I just reassure myself that even if I just start small, it’s progress. It doesn’t have to be perfect. There’s no point trying to go too big, too quick. It’s not going to work. I’m an ultra-runner and you can’t do a 100km run if you set off on a six-minute pace. You’ve just got to go slowly and steadily, not sprint.”
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Image captions (top to bottom):
- Dr Ava Carter.
Published 27 August 2026
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