Co-production is more than consultation

• Written by: Hilda Campbell — COPE Scotland — Chief Executive
• Published: 23rd November 2018

Hilda believes that co-production involves many experts and including the voices of lived experience to provide real solutions.

Co-production is more than consultation, think that perhaps is the first thing we need to remember, how often have we all been involved in something where decisions are already made, or we put our time and effort into contributing something and either it goes no where ; and we don’t understand why it wasn’t used, or,  we never find out what happened, or worse, we feel the decision has already been made and our presence is ticking a box before publication?

If we were designing a new style of chair for someone who enjoyed reading a book, would it be better to have a group of chair design experts locked away in a room until the big TARA moment when they produce the chair and ask people who enjoy reading what they think of it? Or. If designing a chair for someone who enjoyed reading a book would the designers be better to start with a think tank of people currently not feeling comfy in the chairs they had, who had a better idea of what a comfy reading chair would be like and enjoy being part of the process of co designing that new chair? And just what new creative designs may emerge from this joining of minds, experience and creativity?

If we recognise, well yes, having people with experience of reading and what they would find a comfy reading chair makes sense, then surely it stands to reason, that involving people with experience in helping design something new related to that experience is logical?

COPE Scotland have followed this ethos since we began in 1991, recognising there are many experts and the voices of lived experience are often the experts in the room who could provide real solutions if only someone asked them.

We have been doing some work with primary care and other partners looking at different stakeholders’ perception of wellbeing and making these into Jigsaw lids. ‘What is a Jigsaw lid?’ I hear you ask. Well, imagine we are all at a table and asked to consider what we think is needed for good mental health and wellbeing. We each have a Jigsaw puzzle and the lid on the box is our vision of what this looks like and the pieces in our box are the pieces which make up the picture on our lid.

Now we may think, well this is easy, and we all think the same. In truth, this may not be the case at all. If we don’t understand we each are coming from a different place then you can see, very quickly there can be communication challenges even breakdown of communication and rather than working together to look at doing something new, we spend energy trying to convince everyone our lid is the right one.

Truth is, all the lids are the right one, they just all may be different. Understanding more about how each of us views the lids of our puzzle means we stand a better chance of finding areas in common, where we can work together, and learn from each other, learning to trust and respect each other and realise we have more in common than we think.

Using a variety of methods, we have so far developed 4 Jigsaw lids to the puzzle, what supports good mental health and wellbeing? These are the perspectives of:

• GP’s
• The Community
• The voices of lived experience, people needing support now
• The third sector

The Jigsaw lids are only what the puzzle looks like when complete, we need to find the pieces to put in the box which result in that puzzle, so we wanted to know more to understand what next. We went back to people with lived experience of mental distress and ill health and asked, what would a perfect mental health service look like. We purposefully use the word perfect so there were no limits to the imagination. What people came back with was actually pretty achievable if we change some ways of doing things, some of it is already starting. The suggestions were as follows:

• Education on mental wellbeing relevant to all ages and stages of life from nursery, maybe even when someone is expecting a baby through to older adults
• Health professionals and GP’s be more understanding (We had a further discussion on why this may happen and recommendation from those present was that service providers need to look after their wellbeing so more compassionate to others and aren’t burnt out. That the systems people deliver health services in need to be compassionate and caring of their staff too, so they are caring and compassionate to others)
• Better connections made to services not just piece of paper with a phone number. Those who had experience of a community links practitioner shared how helpful it was to have someone help you make the connections and not be left to do it alone which sometimes could be a big step.
• Welcoming environment people shared was really important and commented on premises at 20 Drumchapel Rd as an example of a welcoming environment
• Self-help, self-care, self-management is all good BUT you can’t just give someone a leaflet and expect them to get on with it, people need support and advice how to self-manage and get support when they can’t manage on their own
• Peer mentoring (we had further discussion on this and agreed it would need to be closely supported and peer mentors supervised and very clear boundaries. People also expressed an interest in AA model for people where people have sponsors)
• Group work
• Filling gap for loneliness
• Unstructured drop in (we had further discussion and it was agreed although unstructured some boundaries were needed as there is a danger that things like this can become clique)
• Phone support, people discussed the Good Morning Service for people over 55 and said something like this for someone experiencing mental ill health would be great
• Bereavement groups and other themed groups where people could share experiences in a supported environment
• Challenge stigma (We spoke about the work of See Me, which people recognised but also wanted to be part of helping COPE Scotland co design something, we agreed we would meet in the New Year and begin to explore this further)

This is co-production, not consultation, we are at the beginning of something new as some of the points above are things which COPE Scotland can take on board, others we will share with anyone keen on learning from our experience. It would be great during Co Production week 2019 to report back what happened next…

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