Authors: Stuart Lee, Alex Moshovelis, Kristen Lewis, Alec Scott, Kath Thorburn, Kathy Wilson, Rebecca Martindale, Brett Bellingham, Erin Hill, Katherine Barling, Alyssa Morse, Heather Lamb, Amelia Gulliver, Michelle Banfield, Deb Carlon, Beth Dunlop
Event: 2022 TheMHS Conference
Subject: reform, services, co-design, lived experience
Type of resource: Conference Presentations and Papers
Abstract: LEAD PRESENTATION: Co-designing how to embed and grow co-design capability and use in public mental health
Stuart Lee, Alex Moshovelis, Kristen Lewis, Alec Scott
Co-design brings together consumers, carers, providers and other expert informants to explore why service problems exist, and design and test solutions. Through sharing different understandings, opportunities and change enablers/barriers, services, information resources and interventions that are more valued and effective can be designed and implemented. Alfred Mental & Addiction Health (AMAH), a Victorian public mental health service, has previously used co-design (e.g. new post-suicidal outreach teams and youth forensic or early psychosis services) and co-production (e.g. co-produced Discovery College courses) in multiple settings. But practice is inconsistent, and there are not recognised co-design expert facilitators or training and practice tools to embed and grow co- capability and use. To address these gaps, AMAH engaged design consultants (Today Design) in 2021 to co-design principles, practice tools, education resources and an implementation Roadmap. This presentation will describe governance, participation and design project methodology, and project outputs. Across 12 workshops, 22 clinical/operations and 17 lived experience participants shared 403 ideas that informed 12 principles for co-design and 13 implementation priorities. These will be described alongside how they are being used in preparing to transform our services to be more accessible, safer, self-determined and focused upon promoting meaningful lives as well as symptom recovery.
PANEL PRESENTATION: From Consultation to Partnership
Kath Thorburn, Kathy Wilson, Rebecca Martindale, Brett Bellingham
Various continuums describing relationships and sharing of information between government departments, the non-government sector and community organisations have been developed, most being adaptations of Arnstein’s Ladder of Citizen Participation. Over the years Arnstein’s Ladder has been modified to take into account evolving and new thinking and language.
Government engagement with non-government organisations and community groups including people with lived and living experience of mental distress and families, carers and supporters, has mostly been characterised as occurring on the ‘informing’, or at best ‘consultation’, rungs of Arnstein’s Ladder. Recently the Mental Health and Wellbeing Division, Department of Health, Victoria, moved towards developing partnership in key initiatives emerging from the Victorian Royal Commission into the Mental Health System.
Co-design and co-production are two processes used to create and embed partnership. Other tools and processes can also lead to strong commitment to joint action leading to positive change.
This paper will explore the concept of partnership as defined by people with lived and living experience of mental distress, families, carers and supporters, barriers to success and opportunities presented. It will present key findings and actions proposed to realise partnership with the Department and across Victoria’s mental health and alcohol and other drugs sectors.
PANEL PRESENTATION: Standing together while staying apart
Erin Hill, Katherine Barling
How choosing to foster connection in the face of hardship strengthened the Lived Experience voice at St Vincent's Melbourne, Mental Health.
The COVID-19 pandemic posed significant challenges for consumer and carers/ families/ supporters participation in mental health services. At St Vincent’s Melbourne, those in key lived experience roles worked creatively to ensure the continuation of activities that amplify lived experience voices in service design and delivery. Consumer and carers/ families/ supporters participation committees continued throughout the pandemic with representatives supported to engage using virtual platforms, providing vital connection for the groups and enabling key work to be safe-guarded and advanced.
Importantly, consumer and carer workforces chose to embrace this set of unique challenges as an opportunity to embed co-design; collaborating with each other and the service more broadly to ensure important service developments progressed with meaningful lived experience engagement. Collective work on service redesign and enhancement of the suicide prevention service are examples where consumer and carer voices were cemented in their position at the same ‘virtual’ table. Our consumer and carer workforces remain committed to working together to balance the discrete needs of both perspectives, welcoming warmth, nuance and curiosity into the ongoing conversations about service improvement and design.
PANEL PRESENTATION: Understanding Participation: Exploring the value and impact of lived experience voices in services and policy
Alyssa Morse, Heather Lamb, Amelia Gulliver, Michelle Banfield
Lived experience has an essential role to play in the health sector. How do we meaningfully embed and integrate people with lived experience at the level of health policy and services? The thoughts, insights and experiences of consumers, carers, service providers and policy makers can improve our understanding of how lived experience participation is valued in the health sector, and what “value” means from different perspectives. This consumer-led study addressed research questions developed and prioritised by Australians with lived experience of mental health issues. We aimed to understand the nature of lived experience participation in the Australian Capital Territory (ACT) and the meaning of “value” in this context. Research methods were co-developed by representatives from Health Care Consumers’ Association, The ACT Mental Health Consumer Network, Carers ACT, ACT Health, and independent lived experience representatives. Eleven interviews were conducted with lived experience advocates and representatives, organisation leaders, and policy makers. Study findings highlighted the key ingredients for active and meaningful lived experience participation, including timeliness, respectful and constructive relationships, and genuine commitment to participation processes. Barriers to these processes and their potential solutions were also identified. Our long-term goal is to co-create lived experience-developed principles for participation, value and impact.
PANEL PRESENTATION: Co-design: Placing those most impacted at the forefront of service reform
Deb Carlon, Beth Dunlop
The Royal Commission into Victoria’s Mental Health System has highlighted the importance of co-design in system reform. Victoria's Department of Health has funded the Center for Mental Health Learning to play a key role in providing co-design and co-production capability building support to existing and emerging co-design projects across Victoria’s Mental Health System.
Co-design within a mental health system needs to be genuine and authentically address power. Power is a lot like privilege, it is often invisible to those who have it. Central to this is acknowledging and addressing power imbalances.
Our work is grounded in the resources “Co-production Putting principles into practice in the mental health context” Roper, Grey, Cadogan, Kelly Ann McKercher’s definition, “co-design is more than a process. It is a social movement focused on challenging and changing inequitable power structures. Designing with, not for people” (2020). As well as training developed by TACSI and Indigo Daya “Co-design Doing it in the real world with authenticity."
During this presentation we will be discussing power and how each of us can acknowledge it, step into it and step out of it, whilst preferencing the voice of those most impacted.
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