3 Keys Pilot Impact Study – Initial co-production workshop
Outline with commentary
Participants
A total of 16 people (9 women and 7 men) attended a workshop on Weds 16 May
2012 at Broadmead Baptist Church, Bristol between 1 and 3pm.
The participants included mental health service users, carers, consultant
psychiatrists, mental health service managers and academics. Participants were
very deliberately not asked to introduce themselves by their role at the workshop.
Whilst discussions would of course reveal roles and experiences, the deliberate lack
of ‘pigeon-holing’ people by experience at the start of the workshop was intended to
generate greater potential for person-to-person interaction and a more balanced coproduction experience.
The following gives details of the activities undertaken during the workshop, together
with a commentary on the experience. It focuses specifically on the methodology
employed at the workshop as opposed to the content of the discussion.
Objective of the session
This workshop was designed as the initial session of a series of four, planned to take
place between May and July 2012. (Further sessions may be added if funding
becomes available.)
It is intended that the workshops will lead to an idea about a service improvement
that will be developed, tested and evaluated. The idea is to be an intervention to
improve mental health assessment, based on the 3 Keys to a shared approach in
mental health assessment (NIMHE, 2008). As a resource for the workshop, cards
with the main points of the 3 Keys approach were printed and distributed to
participants. These consisted of three ‘key cards’ held together with a plain key ring,
plus a credit card sized card as an easy reference item.
The initial session aimed to establish the groundwork for co-production and address
some of the practical issues that may facilitate successful working, whilst avoiding
the pitfalls (Nesta, 2012). Some creative methodologies were used as an
experiment, drawing upon group work techniques developed by environmental
teacher, Joanna Macy (Macy and Brown, 1998). It was intended that the variety of
techniques would create a good flow for the work and keep participants alert, moving
around the room at certain points to bring a dynamism to proceedings..
Part 1 (50 minutes)
1-1.05 Introduction to the workshop – Aims, groundrules etc. (5 mins)
15.
Mindfulness/relaxation exercise (10 mins)
We aimed to create an atmosphere where participants felt relaxed and comfortable
contributing to the workshop. To help facilitate this, the session began with a short
mindfulness meditation with a focus on relaxing the body and the mind using the
breath and a brief ‘body scan’. This was delivered via a CD (Williams and Penman,
2011).
Participants appeared to respond well to this, and several expressed an interest in
mindfulness, though one commented on the evaluation form that they would have
preferred to have spent more time on discussion in place of the mediation.
However, the core team designing and running the programme felt that this was a
helpful way to begin the session and that it allowed people to settle in the space and
become increasingly ready to join in the discussions.
1.15-1.25 Group introduction – Name game - flipchart (10 mins)
This simple exercise invited each participant to come up to the flip chart in turn, write
their name on it and say a few words about how they felt about/got their name and
any variations used. This resulted in some interesting and sometimes humorous
thoughts and comments, and also provided an easy way to keep the names of the
participants visible throughout the session and act as an aide memoire.
1.25-1.30 Exercise 1 – Shaking hands (5 mins)
Participants then spent a few minutes circulating, shaking hands and introducing
themselves to other group members. The idea was that this should be a brief
handshake and ‘hello’ before moving on to allow people to circulate, but some
participants struck up longer conversations during this exercise, and this meant not
everyone met each other.
Learning note: Facilitator to be clearer about the instructions!
1.35-1.40 Feedback (5 mins)
A brief discussion was held to gain feedback. The vast majority said they were
comfortable with the exercise, but one commented that shaking hands and power
issues had arisen for them in the past.
1.40-1.50 Exercise 2 – Who are you? What do you do? (NOT work related) Working
in pairs, repetition of each question for approx 2 mins each before swapping.
(10 mins)
This exercise invited participants to work in pairs to explore who the other was and
what they do in their life. The aim was to allow participants to go beyond the surface
presentations of role/experience. All the participants appeared to be well engaged in
this exercise and there was plenty of animated conversation and laughter.
1.50-1.55 Feedback in small groups (5 mins)
Feedback was to the group as a whole rather than small groups as initially planned.
The ‘whole group’ approach felt more appropriate on the day. The feedback
confirmed participants had been engaged in the exercise, though many had gone
‘off-topic’ and found themselves in conversation. Others expressed the discomfort of
listening without responding (and perhaps this may have sparked some of the
opinions and feelings expressed later in the group regarding listening skills of mental
health practitioners).
1.55-2.10 Break (15 mins)
Part 2 (50 mins in total)
2.10-2.30 Circle discussion – 3 keys – Choose one topic for discussion initially (and
allow conversation to flow between. Interjection from facilitator if too
much drift).
To be voice recorded. (20 mins)
Service user/carer participation
Multidisciplinary approach
Strengths, resilience and aspirations
Using two circles of chairs, with 5 chairs in the middle, participants were invited to sit
where they liked, but one chair in the middle circle was to be left free. Discussion
was to be held by the middle circle only, with a fluid flow of people moving in and out
of the middle circle to join the discussion when they wanted to contribute. In the
middle circle, one chair was always to be kept free, thus when someone moved into
the middle circle, another person had to self select to move out again. This facilitated
a dynamic conversation, with everyone except one person joining the discussion in
the middle circle. The method was felt to be highly successful by the core organizing
team and several participants commented on their evaluation forms that they had
particularly enjoyed this element.
45.
Exercise 3 – Writing ‘As a service user I want assessment to ....’ Feedback in
small groups (15 mins) Could drop this??
This activity was not undertaken due to lack of time
2.45-2.55 Co-production Feedback - Ideas for interventions and next stages –
Flipchart (10 mins)
2.55-3.00 Evaluation (one sided A4) and close (5 mins)
References
National Institute for Mental Health in England (NIMHE) (2008) 3 Keys to a shared
approach in mental health assessment, London, Department of Health
Macy, J., Brown, M.Y.(1998) Coming Back to Life – Practices to Reconnect Our
Lives, Our World, British Columbia, New Society Publishers.
Nesta (2012) People Powered Health Co-Production Catalogue, Accessed online
http://www.nesta.org.uk/library/documents/pphcat.pdf 22/05/12, 17.34
Williams, M., Penman, D (2011) Mindfulness – A practical guide to finding peace in a
frantic world, St Ives, Piatkus.