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Professor Paul Fitzgerald’s journey to transform depression treatment

For Professor Paul Fitzgerald, the founding of Monarch Mental Health Group was deeply personal.

Throughout his career as a psychiatrist, researcher and pioneer in brain stimulation, Paul met people whose lives had been consumed by depression. Many had tried one antidepressant after another, endured difficult side effects and waited months for each new treatment to work, only to find themselves no better.

Behind every patient was often a family struggling too.

Paul saw partners desperately trying to hold families together, parents frightened for their children and children watching someone they loved gradually withdraw from life. He saw the exhaustion, helplessness and heartbreak that developed when people were repeatedly told to try another medication, despite previous treatments making little difference.

What troubled Paul most was knowing that other possibilities existed.

As a scientist, he had spent decades studying the brain and exploring how its neural circuits could be treated more precisely. His research focused on TMS, a non invasive treatment that uses carefully targeted magnetic pulses to stimulate areas of the brain involved in mood regulation.

Paul understood both the science and its human significance. TMS represented more than an exciting development in neuroscience. It offered another pathway for people who felt they were running out of options.

Yet in Australia, access remained limited. Treatments supported by a growing body of international research were not reaching enough patients in everyday clinical care. Paul became increasingly frustrated by the gap between what science had made possible and what patients could actually access.

He believed people deserved more than an endless cycle of treatments that were not working. They needed a genuine next step, delivered with clinical excellence, scientific integrity and compassion.

That conviction became the foundation of TMS Clinics Australia.

Paul’s vision was to take TMS beyond the university laboratory and make it available through a trusted national clinical service. He wanted every treatment to follow rigorous and consistent protocols, while still recognising the individual person behind the diagnosis and the family standing beside them.

This vision brought him together with psychiatrist Dr Ted Cassidy, whose commitment to compassionate clinical care complemented Paul’s scientific expertise and determination to change the treatment pathway.

Together, they created TMS Clinics Australia, which later became Monarch Mental Health Group.

Today, as Co Founder and Medical Director, Professor Fitzgerald continues to guide Monarch’s clinical direction and its development of evidence based next step treatments. His purpose remains the same as it was at the beginning: to close the gap between research and real world care, and to give patients and their loved ones renewed hope when conventional treatments have not been enough

Professor Paul Fitzgerald

Co-Founder and Medical Director

Professor Paul Fitzgerald is one of Australia’s most respected clinical and research leaders in transcranial magnetic stimulation (TMS), with an international reputation for advancing next-step treatments for mental health conditions.

A qualified psychiatrist, clinician and researcher, Professor Fitzgerald has dedicated more than two decades to advancing new treatment options for people living with depression—particularly those who have not experienced sufficient improvement with antidepressant medication or other conventional treatments.

He is currently Head of the School of Medicine and Psychology at the Australian National University and Co-Founder and Medical Director of Monarch Mental Health Group. He also chairs Monarch’s Medical Advisory Committee and provides clinical leadership across the organisation.

Why Professor Fitzgerald co-founded Monarch

Professor Fitzgerald co-founded Monarch Mental Health Group after years of witnessing the limitations of conventional treatment for people living with persistent depression.

Through his clinical experience and research, he repeatedly saw patients try one antidepressant and then another—often enduring side effects, lengthy medication adjustments and months or even years of ongoing symptoms without achieving meaningful recovery.

Evidence shows that when depression has not adequately responded to two appropriately prescribed antidepressant treatments, the likelihood of achieving remission with further medication trials alone decreases significantly. Yet many patients continue to be moved from one medication to the next without being offered a genuinely different treatment approach.

For Professor Fitzgerald, this was a source of profound professional frustration. Patients were doing everything asked of them, but the available system was not always providing an effective next step.

He co-founded Monarch to help change that.

His vision was to bring treatments developed and validated through international research—including TMS—out of university laboratories and specialist research programs and into accessible, compassionate clinical care.

Monarch was created so that people whose depression has not improved sufficiently after two or more antidepressants can receive a comprehensive specialist assessment and explore evidence-based next-step treatments, rather than feeling they must simply continue repeating approaches that have not been effective for them.

That founding purpose continues to guide Monarch today: to give people renewed hope and carefully considered treatment options when their current treatment has not been enough.

Internationally recognised TMS research

Professor Fitzgerald has played a pioneering role in the research, development and clinical implementation of TMS in Australia and internationally.

He has led more than 20 substantive clinical trials investigating TMS and related brain-stimulation treatments and has published more than 500 scientific papers. His research has explored innovative treatments for depression, schizophrenia, obsessive-compulsive disorder, post-traumatic stress disorder, autism and Alzheimer’s disease.

His work has received continuous support from Australia’s National Health and Medical Research Council for more than 20 years. He also co-authored the first comprehensive clinical guide to repetitive transcranial magnetic stimulation for the treatment of depression.

Professor Fitzgerald’s international contributions have included serving on the board of the International Society for Transcranial Stimulation and participating in the World Federation of Societies of Biological Psychiatry’s international taskforce on brain stimulation. He has also held senior editorial roles with leading scientific journals in psychiatry and brain stimulation.

Helping establish Medicare access to TMS

Professor Fitzgerald was instrumental in advancing the national application that led to Medicare funding for TMS treatment for eligible Australians with treatment-resistant depression in 2021.

This milestone made an important evidence-based treatment more accessible to people whose depression had not adequately responded to standard antidepressant treatments.

It represented the culmination of years of research, clinical advocacy and commitment to ensuring that people with difficult-to-treat depression could access a genuinely different therapeutic option.

Directly shaping the care delivered at Monarch

Professor Fitzgerald’s expertise is embedded throughout Monarch Mental Health Group.

He leads the development of Monarch’s TMS treatment protocols and clinical standards and oversees the education, training and professional development that support their delivery. Monarch’s clinicians are therefore trained within a framework shaped by one of the field’s most experienced researchers and clinical leaders.

Professor Fitzgerald established Australia’s first formal TMS training program and has trained more than 500 healthcare professionals in the safe and effective delivery of TMS. He has also personally treated more than 1,500 patients using TMS.

His leadership helps ensure that Monarch’s approach continues to reflect contemporary research, rigorous safety standards and extensive real-world clinical experience.

Experience patients can trust

For patients and families, Professor Fitzgerald’s leadership provides reassurance that Monarch’s TMS services are supported by decades of specialist research, clinical experience and internationally recognised expertise.

Every patient is individually assessed to determine whether TMS or another next-step treatment may be appropriate for their circumstances. Treatment is delivered by trained clinicians according to carefully developed clinical and safety protocols, with each person’s response and progress monitored throughout their care.

At Monarch, innovation is grounded in evidence, delivered with compassion and guided by one of the clinicians who helped establish TMS as a recognised treatment option in Australia.

Dr Ted Cassidy

Psychiatrist and Co-Founder of Monarch Mental Health Group

Dr Ted Cassidy is a Co-Founder and Chairman of the Monarch Mental Health Group.

Dr Cassidy is a qualified psychiatrist and medical graduate from University of Sydney.

Dr Cassidy has worked extensively since 2014 in the field of developing outpatient TMS treatment clinics for patients with chronic depression and other mental conditions. He has been TMS credentialed through the extensive training with Professor Fitzgerald and the Monash Alfred Psychiatry Research Centre TMS training program.

Dr Cassidy has extensive experience as a Psychiatrist and his interest in innovative, drug-free treatments for patients who do not respond to depression medication. These patients often fail 2 or more depression medications prior to their TMS treatment.

Dr Cassidy wants to assist patients gain access fast and convenient access to mental health programs and clinicians throughout Australia.

Dr Cassidy previously founded and owned The Hills Clinic group and hospital, the first purpose built private mental health hospital in Australia. From 2004 to 2017 he was the Medical Director, during this time more than 10,000 patients with Mental Illness were assisted in the Northwest of Sydney.