Co-production and mental health – discussion in Scotland
1 July 2014
Background
The meeting was arranged by Outside the Box, as a broad discussion about mental
health and co-production. There were no fixed outcomes or aims for the day – it was
an exploratory discussion to see what emerges, what the issues particularly are on
mental health and co-production in Scotland, and about what could most usefully
happen as a result.
The discussion was prompted in part by the excellent literature review from the New
Economics Foundation and Mind on co-production and mental health, which has
given rise to similar discussions about “what next?” in England. You can see the
report at:
http://www.neweconomics.org/publications/entry/co-production-in-mental-health-aliterature-review
We started with the definition of co-production from nef and Mind:
"We understand co-production to be a relationship where professionals and citizens
share power to plan and deliver support together, recognising that both partners
have vital contributions to make in order to improve quality of life for people and
communities."
The session also built on ideas that are coming from the Getting There project, which
brings together user-led services who are working to promote and share ideas
around Self-directed support.
The people taking part came from a wide mix of settings, roles and interests in coproduction. This note is for:
 The people who took part in the discussion
 Others who wanted to come but were not able to
 Other people with an interest in the topic.
The day was facilitated by Anne Connor from Outside the Box (anne@otbds.org) and
Rich Watts from the National Development Team for Inclusion (NDTi,
rich.watts@ndti.org.uk).
To what question(s) might co-production with people with mental health
problems be an answer, or part of an answer?








Power imbalances
One size fits all service solutions
Getting services that work well for people and reflect their needs and
preferences
A way to make the resources we have go further and be used with more
impact
Creating more choices for people, especially in context of SDS
Tokenistic involvement of people who use services
Seeking legitimacy and shared responsibility and accountability for reform
Taking a holistic view of public sector change, rather than service-by-service
1
What facilitates effective co-production in mental health?












Capacity building of all relevant stakeholders
Trust between all relevant stakeholders, for example through regular contact
between people, irrespective of their position or organisation
Evidence and evaluation: making an economic case for co-production and
demonstrating added value that comes from co-production
Finding allies and leaders for co-production, as well as persuadable people
Being strategic about the contribution that co-production can make
Positive stories and examples about the difference co-production has made
Building capacity around the practice of co-production with people who have
mental health problems - having examples about the practicalities of how to
do co-production well
Training and support for staff on how to do co-production
Making the most of the best opportunities wherever they offer themselves –
from the small and practical to the large and strategic
A wide pool of people with relevant experience and expertise to contribute to
co-production
Leadership is values driven
Reassurance that co-production isn’t going to lead to a terrible outcome
compared to doing something a service-led way
What are the barriers to effective co-production in mental health?










Stigma of mental health users – how other people perceive us and people’s
low expectations for themselves
Money – not enough resources for service users to be involved in the
planning and developing. (Often very small sums compared to the costs of
providing services.)
It is seen as time- and/or money-intensive, and there feels to be a lack of
space and time to explore issues through co-production (system pressures)
There is often a risk averse culture within public sector organisations that isn’t
conducive to co-production approaches
The current approach to commissioning, and the culture of competition in
public services
Lack of understanding that small and local solutions can be just as good (if
not better) than large solutions
Many organisations do not have structures or systems designed to identify of
make the most of the contribution different people could make if given the
opportunity
Confusing / jargonistic language
The current culture of professional services is not conducive to effective coproduction in mental health
There is no easy model of change to which co-production is seen to
contribute
Is there something unique/different about co-production with people with
mental health problems? If so, what might this be?

Stigma and self-stigma are big issues that don’t always come up for other
groups
2


The process of co-production can have benefits for participants as well as the
outcomes of co-production. For example, being part of co-production can
support people to become or feel more resilient, more confident, improve their
self-esteem or promote their wellbeing
It can help give people a sense of belonging to a collective
What needs to be done differently to help enable more co-production in mental
health?





Education
Examples are essential
Understanding why it might be scary for people
Strategic shouting – telling people making decisions and setting policy that
this works and is something we want to see more of, that good practice helps
make it work
Addressing the barriers highlighted above and enhancing the facilitating
factors)
What might be most useful to think about doing next when it comes to coproduction and mental health?
Have a peer support group for people who are trying to take forward co-production in
mental health. The contact list from today’s event is a good starting point!
Link in with the Scottish Coproduction Network - see below for more information
from Olivia Hanley (http://www.coproductionscotland.org.uk/)
Pull together as many examples / stories / evidence of co-production – both on the
results it is achieving and the process of how this has been achieved
 Produce and disseminate a summary/outline of the journey of co-production –
from the nub of an idea through to the impact it had
 This can include stories in a range of formats, poetry and other creative ways
of people explaining what co-production does and how it makes a difference.
Share and promote these examples across all relevant government departments
Find evidence that the process of co-production itself is beneficial for people with
mental health problems
Map other opportunities for co-production and mental health available at the moment,
including showing how it links to 2020 vision
(http://www.scotland.gov.uk/Topics/Health/Policy/2020-Vision)
Use the Public Bodies Bill consultation (http://www.scotland.gov.uk/Publications/2014/05/6659)
 Contribute suggestions on the development of the Integrated Care Fund
 It will be useful if individual people and local groups all put in their own
submissions
 We can cover the questions which we feel are important
 See below for more details
Share ideas and information on possible sources of funding for services based on
3
co-production and for smaller sums to support participation by people who have lived
experience of mental health problems
 Try to secure more funding from Government for co-production (need to
define what the funding would be for, how it would improve things for people
etc.)
 Explore the link between co-production and procurement – how councils
specify the services they want to buy
Identify who the leaders might be for co-production and mental health
 Make links with relevant teams or people – at national, regional and local
level
Host a repeat event/discussion in a few months
Include a short summary of today in as many organisation newsletters as possible,
so that we can convey to people this is something we’re all keen to do and trying to
build more interest in it – see below.
More information from Olivia Hanley at Scottish Co-production Network:
The Scottish Co-production Network – www.coproductionscotland.org.uk and
information about recent activities attached. We do an e-bulletin, events, case
studies and resources on the site.
We use #coproductionscotland for any tweeters. We also used #copro2014 at the
national conference (write up and storify from this here
http://www.coproductionscotland.org.uk/events-and-news/news/copro2014/)
This is a video from one of our learning seminars around evaluation where Julia Slay
of nef talks about some work they are doing around the wellbeing impact of
coproduction http://www.youtube.com/watch?v=OdRjLZYruCk
People Powered Health and Wellbeing programme in case anyone doesn’t know
about it http://www.alliance-scotland.org.uk/what-we-do/projects/people-poweredhealth-and-wellbeing/
CHEX – Community Health Exchange – is a good place to share and find useful
information about what other people are doing: www.chex.org.uk
Consultation on Health and Social Care Integration implementation
Comments are due back to Scottish Government by 1 August.
The form should be sent directly to Alison.beckett@scotland.gsi.gov.uk
Or by snail mail (but to arrive no later than 1st August please) to: Alison Beckett,
Scottish Government Area 2 E.R., St Andrews House, Regent Rd, Edinburgh, EH1
3DG
This is the link to the whole document if people would like to respond to other parts:
http://www.scotland.gov.uk/Publications/2014/05/5284/downloads#res449846
Shona has given an outline which says why mental health and wellbeing are
important. We’ve attached a copy for people to use or adapt.
4
Gathering examples of good co-production with people who have mental
health problems, and the difference it makes
We are looking for examples of co-production at any stage or aspect:






People planning service
Identifying the need or gap
Designing services
Delivering services
Aspects such as developing assessment tools and information about services
Assessing the impact
We can share these through several routes:
 The new Joint Improvement Team website which will be ready soon
 Scottish Co-production Network
 The Getting There project based at Outside the Box
Short paragraph – to get you started in your newsletters etc
Co-production is when people who use services, or people from a local community,
work alongside professionals to plan and then to deliver the service together.
People from user-led groups and other organisations came together on 1st July to
look at ways to promote co-production with people who use mental health services.
The meeting was organised by Outside the Box and the reports and other materials
which people are sharing will be on the Getting There website:
www.gettingtheresds.com
Some of the things that we agreed to do to help raise awareness about the benefits
of co-production are gathering examples of the benefits a co-production approach
brings for individual people and for wider services.
[something about who came from your organisation and what you will be doing next]
Contact, and for examples and stories about the impact of co-production
Outside the Box
0141 419 0451
admin@otbds.org
www.otbds.org
www.gettingtheresds.com
5