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Adult mental illness in the community including depression and anxiety has achieved greater public awareness and visibility in recent years and this has also resulted in increased recognition about the widespread impact on dependent children. During the past decade in Australia, policies and specific programs for infants, children and youth in terms of prevention, early intervention and promotion in relation to children of parents with a mental illness (‘copmi’) have been devised. However, these have generally been disconnected projects, essentially supported only by non-recurrent funding. In more recent years, systematic and interconnected responses involving a wider range of government, non-government and consumer and carer organisations to build sustainability have become the focus. However, little research about change processes affecting the organisational systems serving children of parents with mental illness and their families has been undertaken. This aim of the current study is to describe the enablers and barriers that contribute to change in systems and government and non-government organisations in relation to children of parents with a mental illness in Australia over the past decade, within the context of sustainability. The study involved interviews, focus groups and website and literature searches regarding systems change across Australian states and territories and nationally in relation to the enablers, barriers and future directions. Strategic and intentional processes within organisations, more evolutionary ongoing cross-agency processes and links to sustained changes are key systems change findings. Relevance for change in other health services is highlighted. Refereed/Peer-reviewed